Past Research Efforts

In 2005, the Society targeted four areas for MS research, selected by our scientific advisors to improve the care, treatment and understanding of multiple sclerosis. In November of 2004, the Society made a bold promise: we would raise $32 million over five years to support these four research initiatives.
Thanks to thousands of supporters, these critical funds were raised and the targeted areas filled crucial gaps in our understanding of MS. This initiative proved to be a challenge and an inspiration—a promise that is not only being kept, but one that has profoundly impacted MS research as it moves forward. 

Promise: 2010 -- The MS Lesion Project
Because people with MS experience the disease in so many different ways, most MS investigators question whether a single therapy will be found to work for all.  Understanding patterns of MS damage in lesions—spots of brain tissue where myelin has been stripped from nerve fibers—is the focus of the path-breaking international collaboration known as The MS Lesion Project.

Claudia F. Lucchinetti, MD, with collaborators in the U.S., Germany and Austria, launched the most extensive attempt ever to map and understand the meaning of MS damage in the brain.  They amassed an unprecedented collection of tissue samples from more than 1,000 people with MS, obtained from brain biopsies (a rare procedure) or autopsies. By identifying four distinct kinds of lesion patterns, the collaborators have:

• Changed the way researchers think about MS.
• Discovered that unique antibody patterns are associated with different lesion patterns, which could lead to a blood test to help inform treatment decisions.
• Made significant gains in understanding when lesions form and how tissue is damaged, opening up new possibilities for strategies to stop that damage.

An additional grant from the National Institutes of Health is making it possible for these investigators to continue making discoveries about variations in MS that may ultimately drive treatment decisions and increase our understanding of the cause of MS.

Promise: 2010 -- Nervous System Repair and Protection
Solutions in MS means not just stopping the disease but repairing damage and restoring lost function. Promise: 2010 provided the largest grants in Society history to launch an international effort to address this need. More than 70 leading researchers in four teams in the U.S. and Europe participated.

Outcomes included --

• Groundbreaking progress developing cell transplantation techniques, which may ultimately enable nervous system repair.
• Development of better imaging methods to track the success of attempts at repair and protection in clinical trials.
• Successful induction of “stalled” myelin-making cells in lab dishes to begin producing myelin using molecules that have potential as future therapies.
• Advanced knowledge for further research into repair and protection by publishing more than 180 research papers on nervous system repair in MS.

Because of this targeted progress, the stage is now set for clinical trials of nerve-protecting therapies and for advanced studies of cell transplantation and other strategies for stimulating repair in MS. These projects formed a platform that continues to generate promising results, and investing in this critical area remains a top priority for the Society. This is important not only for restoring function, but many believe that re-establishing the protective myelin coating on the wire-like axons will shield them from further harm.

Download (PDF) a report evaluating the outcomes of this important initiative.

Promise: 2010 -- Pediatric MS Centers of Excellence
Some 8,000–10,000 children have MS! Another 10,000–15,000 experience what may be MS symptoms.

With Promise: 2010 funding, the Society established the first-of-its-kind network of six Pediatric MS Centers of Excellence to provide comprehensive evaluation and care to children with MS and related central nervous system demyelinating disorders.

Outcomes -- Project members:

• Provided multidisciplinary care to more than 1,150 kids and their families.
• Developed consensus on how to diagnose and care for kids with MS.
• Developed specialized programs and resources for kids, parents, school personnel and healthcare professionals.

Now the way is clear for deeper research into the triggers of MS in young children, which may clarify the cause of MS in adults as well. Since 2013, the Society has committed $5.8 million to support the research Network -- which now includes 12 centers -- to provide essential infrastructure to facilitate research, including searching for the cause of MS by studying risk factors for the disease in children, close to the time it is diagnosed.

Learn more about pediatric MS.

Promise: 2010 -- The Sonya Slifka Longitudinal MS Study
The first of its kind in the U.S., this study follows 2,000 Americans with MS. Overseen by Sarah Minden, MD, the study integrates clinical information, health-care practices and socio-economic data to track what happens to people living with MS over time. The study name honors the mother of long-time leadership volunteer Richard Slifka, who lived with MS.

Outcomes -- Findings to date are enhancing the Society’s advocacy, research and treatment efforts. Data from the study has:

• Been used by the Social Security Administration in preparation for the introduction of the Medicare Part D prescription drug benefit, enhancing access to MS therapies.
• Helped in the passage of state legislation, resulting in better health care and assistance for severely disabled people with MS.
• Been used to understand unmet needs of people with MS and new initiatives—such as outreach to enhance community-based care for those living with the disease.
• Been used to discover that people with MS had significantly lower health-related quality of life than the general population as well as those with diabetes, congestive heart failure, heart attack, high blood pressure or depression.
• Helped determine that people with MS who see neurologists were more likely than those who see other providers to receive treatment with disease-modifying agents and to see rehabilitation specialists and urologists.

The crucial information gathered from this study is still being used today by investigators who can apply for access to the database to answer questions about quality of life, rehabilitation, prognostic indicators, the cost-effectiveness of therapies and many others.

View a list of publications from the Slifka Study.
 

MS affects women two to three times more often than men. Pregnancy has a temporary beneficial effect on MS disease activity in women. Exploring these and other gender-related aspects and differences is bringing new insights about the course of MS and may lead to new therapies.

In 1998, the National MS Society targeted this area to fuel its potential for unraveling the mysteries of MS and developing new therapeutic strategies. In 2003, the initiative was declared to be a success in attracting investigators into this previously underserved area, and credited with new data generation resulting in the expenditure of nearly $10 million in new research and training focused on sex-based issues that impact MS.

Outcomes -- The Society’s gender initiative, which was funded by a special campaign, generated new information on sex differences in disease course, the immune system, brain tissues, hormonal influences, and response to infection, and significantly increased the body of scientists pursuing these questions in MS.

Here is a sample of studies funded by the National MS Society on this now-mainstreamed area of gender research:

• In the first effort of its kind in MS, Rhonda Voskuhl, MD (University of California, Los Angeles) led a team of investigators at 15 medical centers to conduct a two-year, controlled clinical trial of the oral sex hormone estriol added to standard therapy to treat MS. This study was based on a previous, smaller trial funded by the Society’s gender research initiative. In the larger trial of 164 women, the investigators determined that oral estriol plus Copaxone reduced the rate of relapses after one-year by 47% compared to women taking Copaxone alone, and also showed significant positive benefits in the scores of cognition tests. These positive effects were not however maintained through the second year of the study – the reasons why are not clear, but a more thorough analysis might reveal some answers. This study was funded by the National MS Society in partnership with the Society’s Southern California and Nevada chapter and the National Institute of Neurological Disorders and Stroke. Read more
• Riley Bove, MD (Brigham and Women's Hospital, Boston), is investigating the effects of menopause on the brain in women with MS. Women with MS often report that their MS symptoms worsen with menopause. The reasons and implications for this are not clear. In previous research, Dr. Bove gathered information on MS during menopause from 391 women enrolled in a large-scale, long-term study at Brigham and Women’s Hospital in Boston. The results showed that progression (measured with the standard EDSS scale) changed at or around menopause toward a more rapid accumulation of disability. Now Dr. Bove and her team are determining how menopause affects MS disease severity and brain lesions. They are looking at 30 women with MS who have had their ovaries removed for the treatment of other conditions, compared to 30 premenopausal women with MS. They are also examining 100 women with MS who have undergone natural menopause. They are using novel imaging techniques to determine if brain lesions and loss of brain volume increase during menopause. They also are assessing whether hormone replacement therapy protects the brain from any MS-related adverse effects of menopause. These results should shed light on an under-explored aspect of the MS experience, and may suggest ways to overcome negative impacts of menopause on women with MS.
• Seema Tiwari-Woodruff, PhD (University of California at Los Angeles) is funded by the National MS Society to test estrogen-like compounds that act on estrogen docking sites in the brain and may provide nervous system protection, without impacting the reproductive system. They are testing various forms in a mouse model of MS called EAE, and determining if versions of these compounds can protect the brain, and even stimulate myelin repair. She and her team are also seeking to learn how these compounds work. Recent exciting findings show that one of these compounds repaired myelin and improved motor symptoms in mouse models of MS. (Proc Natl Acad Sci U S A. 2014 Dec 16; 111(50): 18061–18066) Finding a way to protect the brain from MS destruction and stimulate repair of damaged myelin would be a major step forward in efforts to stop MS progression and restore function.

With seed funding from a National MS Society Collaborative MS Research Center Award, MS geneticists from around the world have joined to create the International MS Genetics Consortium, whose work has already sped the search for MS genes exponentially.

Outcomes to date –

• In 2007 the Consortium published a groundbreaking initial genome-wide association study (GWAS) that clearly identified two new genes (representing only the 2nd and 3rd susceptibility genes identified overall at that time) that predispose people to developing MS. That work demonstrated that the GWAS approach could successfully identify important MS genes, but also made it apparent that much larger studies would be necessary to identify most of the remaining common MS susceptibility genes.
• The Consortium expanded to include more groups from more countries, forming the basis for its grant from The Wellcome Trust to perform such a study. They then identified 29 new genetic variants associated with MS, and confirmed 23 others previously associated with the disease, verifying a major role for the immune system in the development of MS.
• The team then identified 48 new genetic variants associated with MS, bringing the total number of genetic variants that may influence susceptibility to MS to 110. The study involved nearly 30,000 people with MS and more than 50,000 controls without MS, and was funded by more than 40 agencies and foundations, including the Wellcome Trust, the National Institutes of Health, and the National MS Society. These findings do not enable genetic counseling to individuals, but should add knowledge about complex biological pathways that lead to the development of MS.

Genes identified in this study are now being confirmed and expanded in an independent, second large-scale set of cases with a research grant from the National MS Society.