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Studies on MS diets, stem cells and health disparities are among those reported at the AAN meeting

May 3, 2023

This year’s meeting of the American Academy of Neurology was held in late April in Boston. Thousands of scientists and neurologists from around the world attended in person or remotely to hear about and share the latest progress in research on MS and many other neurological disorders. 
Below are just a few highlights of many presentations, organized along the three Pathways to MS Cures: stopping MS, restoring function, and ending MS forever.  
Study results presented during conferences like this are typically considered preliminary until they are published in peer-reviewed journals.
Stopping MS in its tracks means achieving a state of no new disease activity or brain and spinal cord injury, no worsening of daily living or quality of life, and no new manifestations of the disease. By doing this, we prevent disability, create an environment for repair of nervous system tissues and cultivate pathways that promote the restoration of function.
Personalizing approaches to MS: No two people experience MS in exactly the same way. Understanding this variability will help to personalize MS treatment. Dr. Catharina Gross (University Hospital Münster, Germany) and colleagues used state-of-the-art “computational biology” (the use of data analysis, mathematical modeling and computational simulations to understand underlying biology) to look at immune system activity in the blood of 378 people with MS who had not yet received treatment with disease-modifying therapies. The team identified several distinct patterns of immune system disturbance that linked to different genetic backgrounds and that may respond to therapies differently. Further research on these results may yield personalized, targeted treatment strategies for individuals. (Abstract)
Dystel Prize Lecture on Stopping MS: Dr. Roland Martin (University of Zurich, Switzerland) received the John Dystel Prize for MS Research and gave the prize lecture. His work uncovered how key MS susceptibility genes are involved in launching immune attacks on the nervous system and he identified specific components of nerve-insulating myelin that are targeted by those attacks. His team has developed an experimental therapy designed to make the immune system ignore those targets but leave the rest of the protective immune system intact. This strategy is now in clinical testing. (Read more about his team’s work)
MS and iron abnormalities: Iron is a mineral that the body needs for growth and development. Do abnormalities in how the body absorbs iron affect the course of MS? Possibly. Dr. A. Giordano (San Raffaele Hospital, Milan, Italy) and colleagues looked at the activity of 319 genes involved in iron processing (metabolism) in people with relapsing-remitting and secondary progressive MS. They identified one iron metabolism gene, called HIF1A, that appears to protect against moving from relapsing to secondary progressive MS. Further study of this and other iron-related genes may point to new targets for therapy development. (Abstract)
STOPPING MS: Health Disparities
Not everyone can use telehealth: Dr. Marisa McGinley (Cleveland Clinic) and colleagues compared in-person versus telehealth (by computer or phone) visits among nearly 200,000 people with MS from July 2020 to July 2022. The likelihood of a telehealth visit was lower for people who were older, Black, Hispanic/Latinx, and had lower socioeconomic status. Telehealth care in combination with in-person visits improved access to neurological care, especially for people with mobility challenges, but efforts are needed to understand the barriers that exist for underserved populations. (Abstract
Ocrelizumab in underrepresented populations: Dr. Evanthia Bernitsas (Wayne State University School of Medicine, Detroit) and colleagues gave an interim update on the progress of the CHIMES clinical trial, funded by Genentech. This ongoing trial is testing the safety and effectiveness of ocrelizumab in Black and Hispanic/Latinx people with relapsing MS, because they represented less than 10% of people in the trials that led to its approval. This analysis included the first 49 of 182 participants who have been followed for 48 weeks. All participants are on active treatment. So far 38 of the 49 people experienced at least one adverse event, and 3 had a serious adverse event. As of 48 weeks, about 41% showed no evidence of disease activity on MRI scans, relapses or progression. (Abstract)
Hispanic/Latinx people with worse MS: Dr. Daniel Ontaneda (Cleveland Clinic) and collaborators in the MS PATHS MS registry compared the health records of 660 Hispanic/Latinx people and nearly 1,000 white people. On average, Hispanic/Latinx people were younger and had a shorter duration of MS, and yet had worse MS, with slower walking speed, more cognitive problems, and more tissue injury seen on MRI. These results add to previous studies and highlight the need for additional research to understand these differences and how to better treat MS in Hispanic/Latinx people. (Abstract)
Learn more about MS in the Hispanic/Latinx and Black Communities
Restoring function in people with MS involves improving nervous system repair to reverse or slow MS progression and improve symptoms and implementing rehabilitation and symptom management strategies to restore function, reverse MS symptoms and enhance quality of life.
Stem cell trial results: Dr. Saud Sadiq (The Tisch MS Research Center of New York) presented results from a phase 2 clinical trial involving 54 people with progressive MS, funded in part by the National MS Society. The study used participants’ own bone marrow stem cells, which were removed and expanded in the laboratory and developed into specific cells called Mesenchymal Stem Cells-Neural Progenitors. They were then infused into the spinal fluid every two months for one year. The primary purpose of the trial was to see improvement in physical mobility after the first year, which was not achieved. The stem cell treatments were well tolerated. Other outcomes may point to potential benefits of this treatment, such as improved walking, especially in those with more mobility challenges. Further study is needed to determine if this form of stem cell therapy is safe and beneficial as a treatment for progressive MS. (Abstract)   
Study suggests keto diet improves sleep: The ketogenic diet focuses on whole, fresh foods, mainly proteins and healthy fats, and minimal carbs from produce, nuts, or dairy. Keto diets have been associated with improved sleep quality in epilepsy. Since sleep problems are common in people with MS. Dr. Jacob Perlman (University of Virginia Health System) and team studied whether a keto diet improved sleep in a study of 45 people with MS. After six months on the diet, there were reductions in daytime sleepiness, sleep disorder symptoms, insomnia and sleep apnea. This study adds to growing evidence of how diet can affect the experience of people with MS. (Abstract)
Can a Mediterranean diet protect against cognition problems? Dr. Illana Katz Sand (Mount Sinai, NYC) and team administered a questionnaire related to how closely individuals adhered to a Mediterranean diet (lots of fruits and vegetables and olive oil, and low butter, sugary drinks and red meats) to 563 people with MS followed at their MS Center. They compared answers with results from cognitive testing. After accounting for other factors, they found a strong link between higher adherence to the diet and lower risk for cognitive impairment. This link was stronger in people with progressive disease. Further studies are planned to better understand this finding. (Abstract)

Get the latest on diets for MS
Ending MS forever requires preventing MS before it occurs by limiting exposure to MS risk factors in the general population and reducing or eliminating the impact of MS before onset of signs/symptoms by identifying early signs in people at higher risk for MS, such as close relatives of people living with MS.
MS in young veterans: Scientists believe that MS is caused when people with the right combination of genes and other factors trigger the disease. Dr. Mary Jo Pugh (University of Utah, Salt Lake City) and colleagues looked at the development of MS among more than two million veterans (average age, 33), and specifically examined the contribution of other neurological disorders. The results showed that having a history of traumatic brain injury, stroke, and other neurologic conditions increased the risk of developing MS. The authors caution providers to keep this possibility in mind when treating veterans with a history of these conditions. (Abstract P1.027)
Second study shows therapy can delay or prevent symptoms of MS: On rare occasions people may have brain scans for other reasons but show signs of MS-type lesions without MS symptoms (a condition called RIS - radiologically isolated syndrome). Studies show that about half will eventually develop MS within 10 years. Dr. Christine Lebrun Frenay (University Hospital of Nice, France) and colleagues conducted a clinical trial of 89 people with RIS showing that teriflunomide lowered the risk of developing a first symptom of MS within 2 years by about 72% compared to placebo. This is the second trial showing that disease-modifying therapy can delay or prevent the onset of MS. (Abstract)
These and many other studies are bringing us closer than ever to cures for MS. Read more about Research Funded by the National MS Society

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system. Symptoms range from numbness and tingling to blindness and paralysis, and there is currently no cure for MS. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. An estimated 1 million people live with MS in the United States. Most people with MS are diagnosed between the ages of 20 and 50, and it affects women three times more than men.


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