MS Living Well: Key Info from Multiple Sclerosis Experts

In this era of highly effective treatments, early intervention for multiple sclerosis can be life changing. However, the wide range of initial symptoms often leads to many people being undiagnosed or misdiagnosed, leaving them without the proper care for years. In this podcast episode, we'll discuss the early signs of MS and the key tests, such as specific MRI and spinal fluid results, that are crucial for a timely and accurate diagnosis.

Criteria to diagnose MS continues to evolve to help make a diagnosis more swiftly and correctly. Specific MRI findings in the brain and spinal cord can allow for an immediate diagnosis of MS with the first attack. Brand-new updates highlight the role of the optic nerve and even offer a path to diagnosing MS in people who show no neurological symptoms. With so much at stake, a timely and accurate diagnosis of MS is more important than ever.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Xavier Montalban MD PhD, Chair of Neurology, Director of CEMCAT (Multiple Sclerosis Center of Catalonia) at Vall d’Hebron University Hospital, Barcelona, Spain  

Léorah Freeman MD PhD, Assistant Professor, Dell Medical School Department of Neurology, UT Health Austin Multiple Sclerosis and Neuroimmunology Center 

The spinal cord serves as the main communication highway between the brain and body. Did you know that 80% of people with multiple sclerosis have spinal cord lesions on MRI? These lesions can disrupt specific neural pathways, leading to common MS symptoms like numbness, weakness, impaired coordination, balance issues, bladder problems, constipation, and sexual dysfunction. For instance, damage to the corticospinal tract on one side of the spinal cord can weaken an arm or leg.

A remarkable autopsy study revealed that nearly 90% of people with MS still had active inflammation in the spinal cord. This finding brings new hope for potential treatments, even for older and progressive MS patients. Advances in imaging technology, including more powerful MRI scanners (3 Tesla and higher), are enhancing our ability to see inside the spinal cord, which is as thin as a pinky finger. Improved spinal cord imaging is driving the development of new therapies in clinical trials and helping identify those at risk for worsening disability, ultimately guiding better treatment decisions.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Gabriele De Luca MD DPhil, Professor of Clinical Neurology and Experimental Neuropathology, University of Oxford, United Kingdom

Bruce Cree MD PhD, Professor of Neurology at University of California, San Francisco School of Medicine

Awareness of the more uncommon multiple sclerosis symptoms can lead to an earlier diagnosis and appropriate treatment. For instance, experiencing electrical shock sensations when bending the neck forward, known as Lhermitte’s sign, may indicate an attack on the cervical spinal cord. Likewise, excruciating bolts of pain across either side of the face, called trigeminal neuralgia, can be caused by a MS relapse. The MS hug, an unfriendly, squeezing sensation around the torso, can respond to muscle relaxants and nerve pain medications. Some MS symptoms, like tingling in legs, only surface when exercising or overheated (Uhthoff’s phenomenon).

Vertigo, a spinning sensation, can be a sign of MS, especially when lasting days and accompanied by other symptoms like gait imbalance, facial numbness and double vision. Brainstem attacks may also lead to swallowing issues and shaky vision. While MS bladder issues are commonly addressed,  bowel problems, including constipation, urgency, incontinence and trouble evacuating, should not be overlooked. Overcoming stigma is essential to treat sexual dysfunction.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Mary Ann Picone MD, Medical Director, MS Center at Holy Name Medical Center, Teaneck, New Jersey

Bruce Hughes MD, Director of the Ruan Multiple Sclerosis Center, MercyOne, Des Moines, Iowa

Prepare to be intrigued by the groundbreaking intersection of artificial intelligence (AI) and multiple sclerosis care! By combing through extensive databases, including genetic information and real patient records, AI can forecast with remarkable accuracy the likelihood of MS onset. In the near future, AI could even serve as a guiding light for clinicians and MS patients in selecting the most suitable disease-modifying therapies, armed with predictive algorithms tailored for each individual.

But the marvels of AI don’t stop there. In a recent study, AI detected an astonishing 93% of new and enlarging T2 brain lesions in MRI scans, far surpassing the 58% accuracy rate of routine radiology reads. Artificial intelligence is also making waves in drug development and early clinical trial design, accelerating the quest for innovative therapies to combat MS.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Tal Arbel PhD, Professor, Department of Electrical and Computer Engineering, McGill University, Montreal

Michael Barnett MBBS (Hons) FRACP PhD, Professor in Neurology, University of Sydney and Director of the MS Society Clinic & MS Clinical Trials Unit at the Brain and Mind Centre

Living with multiple sclerosis isn't just about managing the condition itself, but often involves navigating a myriad of additional health concerns known as comorbidities. Individuals with MS face a higher risk of experiencing new relapses when dealing with comorbidities like high cholesterol or depression. Furthermore, autoimmune diseases such as psoriasis and inflammatory bowel diseases like Crohn’s disease and ulcerative colitis are more prevalent among those with MS. There is even a heightened risk of bladder cancer.

Interaction of MS treatments and other common conditions like high blood pressure (hypertension), high cholesterol and diabetes are addressed. Experts share how immunotherapies used for other autoimmune diseases may benefit or actually worsen MS disease activity. Crucial information is shared on cancer treatment concerns in individuals with MS. Adopting healthy lifestyle behaviors is essential to minimize the development of these comorbidities.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Ruth Ann Marrie MD PhD, Professor of Medicine and Community Health Sciences at University of Manitoba, Canada

Mark Cascione, MS neurologist, South Tampa MS Center, USA.

Sex hormones, such as estrogens and testosterone, affect each individual's journey living with multiple sclerosis. While both genders face equal MS risk before puberty and after menopause, women experience up to three times higher risk during their reproductive years. Pregnancy generally brings less relapses, potentially attributed to high estriol levels. However, navigating treatment decisions well while trying to conceive and after delivery requires finesse and expertise. Equip yourself with the latest women's health info regarding MS, covering topics from birth control and fertility treatments to menopause and osteoporosis.

Testosterone has important anti-inflammatory and neuroprotective benefits in multiple sclerosis.  Nevertheless, men are at higher risk for disability progression then women. Declining testosterone levels over time (called andropause) and Y chromosome genes may tilt the scales towards disability. Listen to current testosterone research including potential remyelination benefits.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Maria Houtchens MD, founding director of the Women’s Health Program at the Brigham MS Center and Associate Professor of Harvard Medical School in Boston, USA

Jorge Correale MD, Head of Neuroimmunology and Demyelinating Diseases at the Dr. Raúl Carrea Institute of Neurological Research in Buenos Aires, Argentina

In a paradigm-shifting discovery, researchers uncovered that B cells, not T cells, wield significant influence on orchestrating neurological damage in MS. Join UCSF Professor Dr. Stephen Hauser as he shares the remarkable odyssey from hurdles to triumphs of developing B cell monoclonal antibody treatment for multiple sclerosis.  Disease impact, safety concerns and personalization of MS treatment of these medications including Ocrevus (ocrelizumab), Kesimpta (ofatumumab) and Briumvi (ublituximab) are highlighted. 

Brain-penetrant BTK inhibitor therapies that may offer more direct targeting of B cells within the central nervous system, potentially unlocking new possibilities in treating progressive forms of MS. Professor Heinz Wiendl explores the connection between Epstein-Barr virus infection of B cells and the initiation and progression of MS including trials investigating strategies to target EBV-infected B cells. Pioneering approaches like CAR-T therapy and brain shuttle techniques provide optimism for the next generation of MS treatment.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: 

Stephen Hauser MD, Professor of Neurology at the University of California, San Francisco (UCSF) and Director of the UCSF Weill Institute for Neurosciences

Heinz Wiendl MD, Professor of Neurology and Chair of the Department of Neurology at the University Hospital of Muenster in Germany

Christine Ha, an award-winning blind chef and restauranteur, shares her experience grappling with neuromyelitis optica spectrum disorder (NMOSD). Facing relapses with the inability to walk and feed herself that challenged her independence, she leaned on the support from family and friends. As she lost her sight due to optic neuritis in both eyes, Ms. Ha had to embark on a journey of rediscovery in the kitchen, starting with the fundamentals. Winning MasterChef Season 3 marked a turning point, propelling her culinary career forward despite the obstacles posed by her disability. 

NMOSD is an autoimmune disease in which an antibody attacks water channels on astrocyte cells in the optic nerves, spinal cord and sometimes the brain. Attacks or relapses can be devastating and incomplete recovery from attacks is typical. Like Ms. Ha, some people living with the condition can be misdiagnosed with multiple sclerosis. A blood test for the aquaporin-4 antibody is key to getting diagnosed correctly early. Since 2019, highly effective treatment options have been FDA-approved that reduce relapses by 77-94%.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Christine Ha, "The Blind Cook".  Her first cookbook, Recipes from My Home Kitchen, was a New York Times best-seller. Ms. Ha’s first restaurant in Houston, The Blind Goat, was named a semi-finalist for 2020 Best New Restaurant in America by the James Beard Foundation. She was also named a James Beard finalist for Best Chef in Texas in 2022.

Michael Levy MD PhD, Associate Professor at Harvard Medical School and Director of the Neuroimmunology Clinic and Research Laboratory

Wherever you are on your multiple sclerosis journey, there are many reasons to be optimistic about the future of mobility. Our experts, both holding doctorates in physical therapy, offer invaluable guidance on enhancing your walking abilities through targeted exercise and specialized therapy. Learn how to reduce the risk of falls, alleviate spasticity, and build endurance for a more active life.

Cutting-edge technology, from wearable electrical stimulation devices to incredible exoskeletons, are revolutionizing mobility for those living with MS. Discover how neuromodulation, in conjunction with physical therapy, can pave the way for new neural pathways. Virtual reality and anti-gravity treadmills are redefining therapy options for those people with advanced MS. Moreover, gain insights into conquering travel challenges, empowering individuals living with multiple sclerosis to venture out into the world.

Barry Singer MD, Director of The MS Innovations in Care, interviews Gretchen Hawley DPT, The MSing Link and Annie Morrow DPT, Director of the Stephen A. Orthwein Center.

Health equity represents the pursuit of the highest level of well-being for all individuals, ensuring that every person, regardless of their background, enjoys a fair and just opportunity to achieve their optimal health.

Disparities exist within the multiple sclerosis community. It's a stark reality that Black individuals with MS face an increased risk of disability, while Black women are disproportionately affected by this condition compared to their White counterparts based on a Kaiser study.  Additionally, Hispanic patients often contend with an earlier onset of MS, occurring 3-5 years before it typically manifests in White individuals. Both social determinants of health and genetic factors play significant roles in shaping outcomes for these communities. Strategies to enhance MS care in underserved communities include increasing the availability of healthcare providers, providing crucial translation services, and addressing biases both within the healthcare team and the communities they serve.

Rural MS patients experience unique challenges, often encountering barriers in accessing specialized care.  Connecting lower-income patients to vital resources, including medications and MRI scans, is essential. Innovative approaches like telehealth and improved transportation options can bridge the gap for those with higher levels of disability. As an MS community, we can all advocate to ensure that everyone regardless of their circumstances receives the comprehensive care that they deserve.

Barrry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Lilyana Amezcua MD, Associate Professor of Neurology, University of Southern California. She spearheaded the collaborative research consortium Alliance for Research in Hispanic MS (ARHMS) and serves as principal investigator. Dr. Amezcua serves on numerous national and international committees including as an elected member to the NMSS National Medical Advisory Committee and NIH NINDS Health Disparities Strategic Steering Committee.

Jacqueline Rosenthal MD, MS neurologist at the Shepherd Center's Andrew C. Carlos Multiple Sclerosis Institute in Atlanta. Dr. Rosenthal completed her medical degree from Morehouse School of Medicine in Atlanta, neurology residency at Madigan Army Medical Center in Tacoma and neuroimmunology fellowship at Emory University School of Medicine.

Navigating life with multiple sclerosis? Gain valuable insights from MS insiders! Stanford nurse practitioner Jong-Mi Lee reveals strategies for accessing MS centers and maximizing available resources. Acquire valuable tips on various topics including overcoming mobility challenges, managing workplace issues, and receiving quality care despite insurance obstacles.

Many inspiring and resilient individuals living with MS actively share their perspectives on social media platforms within the MS community. Dominic Shadbolt, a renowned UK MS patient advocate and founder of The MS Guide, highlights his personal favorites and provides essential advice for sifting through the wealth of online information.

Access reliable knowledge and support from global non-profit organizations. Dr. Jaime Imitola, esteemed MS neurologist and Associate Professor of Neurology at the University of Connecticut, offers practical approaches to surmount financial barriers and attain crucial MS treatments.

Podcast Host: Barry Singer MD, Director of The MS Center for Innovations in Care, Missouri Baptist Medical Center, St. Louis, USA

Step into the powerful realm of MRI imaging, providing us with an unparalleled view of multiple sclerosis. Discover how acute inflammation becomes vivid with contrast, and how various MRI sequences unveil the past battles fought within your brain and spinal cord. We'll explore advances in techniques, revealing brain shrinkage, gray matter disease and myelin repair. Understand the impact of MS on brain processing efficiency during rest and specific tasks through functional MRI imaging. Crucial questions regarding where and how often to get MRI scans are addressed. Latest guidance on avoiding contrast for routine MRI monitoring in MS shared.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Christina Azevedo MD, Assistant Professor of Clinical Neurology at the University of Southern California

Robert Zivandinov MD, PhD, Director of the Buffalo Neuroimaging Analysis Center & Professor of Neurology at Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, State University of New York.

Dive into a deeper understanding of the role of inflammation in causing injury to the brain and spinal cord in multiple sclerosis. It’s a journey marked by ups and downs, where the adaptive immune system composed of lymphocytes (T and B cells) attack myelin and the innate immune system clears damaged myelin. An immune cell called microglia can create smoldering inflammation in MS that poses a threat of progressive disability.

Explore the arsenal of MS treatment strategies developed over the past 3 decades to either alter or suppress the immune system to reduce inflammation. Triumphs and limitations of our current MS therapies shared. Antioxidant research, diet and new therapeutics tackling smoldering inflammation bring newfound hope.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Klaus Schemierer MB BS, PhD, FRCP, Professor of Neurology at the Blizard Institute, Queen Mary University of London, and Consultant Neurologist at The Royal London Hospital, Barts Health NHS Trust.

Michael Kornberg MD, PhD, Assistant Professor of Neurology at John Hopkins.

Yes, children can get multiple sclerosis.

Children ages 12 and up are more typically affected and rarely before age 8. Awareness is essential for prompt diagnosis and treatment of pediatric-onset MS (POMS). Accurate diagnosis of multiple sclerosis in children requires screening for other conditions like MOG antibody-associated disease (MOGAD). Risk factors associated with higher rates of developing MS in kids include Epstein-Barr virus infection, genetic susceptibility, pesticide exposure, smoking (and secondhand smoke), low vitamin D, obesity and diet high in saturated fats.

Multiple sclerosis in kids can be very active with frequent relapses and concerning MRI activity kids. Rapid use of highly effective treatment is important to preserve brain health including cognition. Completed and ongoing global pediatric trials are redefining care. Oral fingolimod, for example, reduced relapses by 82% compared to interferon beta-1a injections weekly. Thanks to treatment advancements, teens living with MS have a brighter future ahead of them.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews Brenda Banwell MD, Chief of the Division of Neurology at the Children's Hospital of Philadelphia (CHOP) and Emmanuelle Waubant MD, PhD, Professor of Neurology , University of California San Francisco and Director of the UCSF Regional Pediatric Multiple Sclerosis Center.

Trying to confirm if you have multiple sclerosis can be a frustrating process. Dealing with a new diagnosis a MS can be overwhelming. Julian Gamboa and Dr. Jakai Nolan shed light on a positive path forward living with multiple sclerosis.

Julian Gamboa shares his first symptoms of multiple sclerosis including spinning sensation and double vision. He had substantial obstacles and setbacks in being diagnosed including a prolonged hospitalization. After being in a very low place, Julian rallied with the support of others including his family. He conveys how he eventually obtained superb MS care and utilizing his social media guru skills to help others being diagnosed with MS.

Dr. Jakai Nolan opens up about her own unique insights on being diagnosed with multiple sclerosis since she is both a neurologist specializing in multiple sclerosis and a person living with MS. As she shares her own personal story, she reviews key symptoms suggestive of MS and the importance of advocating for prompt evaluation to prevent a delay in diagnosis and treatment. Dr. Nolan covers treatment selection, mental health concerns and lifestyle modifications for someone recently diagnosed.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Julian Gamboa is the Social Media Director for Maximum Effort, supporting brands affiliated with Ryan Reynolds including Mint Mobile, Aviation Gin and Wrexham AFC. He was the former senior marketing and social media manager at Adweek. He serves on the Board of Directors of the Multiple Sclerosis Association of America.

Dr. Jakai Nolan is a neurologist specializing in multiple sclerosis in Villa Rica, Georgia and Endowed Neurology Chair for Tanner Medical Center. She received her undergraduate degree from Vanderbilt University, a Master's degree in Public Health at Emory University and her medical degree from Philadelphia College of Osteopathic Medicine, Georgia Campus. Dr. Nolan completed a MS fellowship at OhioHealth.

Years before the first typical neurological symptoms of multiple sclerosis such as numbness or visual loss, individuals can have other symptoms that are often overlooked. This period of time is called the MS prodrome. During the prodrome phase, there is an increase in symptoms including skin, gastrointestinal and psychiatric issues. Research may lead to earlier detection of MS.

Sometimes brain spots or "lesions" typical of multiple sclerosis can be surprisingly found in people who get an MRI scan of the brain for unrelated reasons such as headaches or head trauma. If the person never had MS symptoms, it's called radiologically isolated syndrome (RIS). RIS risk factors that really increase the risk of a MS relapse include spinal cord lesions, oligoclonal bands in spinal fluid and new MRI lesions over time. Clinical trials for RIS treatment reviewed including recent positive results.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Helen Tremlett PhD, Professor in the Division of Neurology at the University of British Columbia and the Canada Research Chair in Neuroepidemiology and Multiple Sclerosis

Erin Longbrake MD PhD, an Associate Professor of Neurology at Yale School of Medicine and Director of Neuroimmunology Clinical Research

Knowing which MS changes are significant enough to warrant speaking up can be hard. Relapses can occur every 1-2 years without treatment, but much less frequently on disease-modifying treatment. Distinguishing between an actual relapse, a pseudorelapse or just brief worsening of symptoms (Uhthoff’s phenomenon) explained. Options for relapses such as steroids, plasmapheresis and ACTH are reviewed. Importance of MRI monitoring addressed since most new MS lesions pop up on MRI scans without actual symptoms.

Slow progression of disability can be challenging to detect. Physical changes can include slower walking, worsening balance and more hand coordination problems. Cognitive worsening may be noticeable due to short-term memory loss, word-finding issues and multitasking challenges. Tools to improve monitoring for disease progression highlighted such as in-office testing, remote electronic monitoring and biomarker blood testing. Why multiple sclerosis disability can worsen without MRI change explained. Ways to better advocate for prompt care of worsening MS shared.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews Jacqueline Nicholas MD, System Chief of Neuroimmunology & Multiple Sclerosis at the OhioHealth Multiple Sclerosis Center and James Bowen MD, Medical Director of the Multiple Sclerosis Center at Swedish Neuroscience Institute in Seattle.

With over 20 options, what is the best multiple sclerosis treatment for me? Selecting an appropriate disease-modifying therapy (DMT) needs to consider your risk of worsening disability over time. Your age, sex and race can affect your prognosis and can influence the power of treatment chosen. Details about your early relapses and MRI activity are very important for treatment decisions.

Treatment selection should also consider responsiveness to vaccines, family planning and other medical problems (another autoimmune disease or cancer). For each individual living with multiple sclerosis, balancing power of treatment against serious risks of treatment needs to be considered.  The future of personalizing care to better pick the right medication shared.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews Celia Oreja-Guevara MD PhD, Vice Chair of Neurology & Head of the Multiple Sclerosis Center, University Hospital, San Carlos, Madrid, Spain & John Foley MD, Director, Rocky Mountain MS Clinic, Salt Lake City, Utah

Digital technology has transformed our lives. For people living with multiple sclerosis, electronic health opens a new world. Biosensors in our smartphones and wearable devices can monitor physical activity levels and sleep and may detect MS disease changes faster than that next neurologist appointment. New apps can help people with MS manage and track their disease including gaming to assess cognition.

Digital health is becoming an indispensable part of in-office and virtual patient appointments. Privacy concerns with electronic healthcare addressed. Treatment decisions facing both doctors and patients are getting increasingly complex. New artificial intelligence technology may soon help personalize treatment and predict treatment response using a concept of a digital twin.

Barry Singer MD, Director of The MS Center for Innovations in Care interviews:

Jennifer Graves MD PhD is an Associate Professor at UC San Diego School of Medicine and serves as Director of the UC San Diego Neuroimmunology Research Program. Dr. Graves completed a fellowship in neuro-ophthalmology and residency in neurology at the University of Pennsylvania Perelman School of Medicine. She earned her medical degree and PhD in molecular biophysics from University of Texas Southwestern Medical School. She also holds a master's degree in epidemiology and biostatistics from UC San Francisco.

Tjalf Ziemssen MD PhD is founder and director of the MS Center in Dresden, Germany where he did his neurology training. Professor Ziemssen is also Director of the Center of Clinical Neuroscience and the neuroimmunological lab at the Carl Gustav Carus University Hospital in Dresden. He completed his medical training and doctoral thesis at the University of Bochum. He also was a research fellow at the Max Planck Institute of Neurobiology.

Multiple sclerosis frequently causes visual impairment. 70% of people living with the disease can develop optic neuritis at some point and often the first sign of MS. The symptoms, medical evaluation, treatment and prognosis of optic neuritis are conveyed. Besides multiple sclerosis, other causes are discussed including MOG antibody-associated disease (MOGAD) and neuromyelitis (NMO).

Double vision and shaky (or jumpy) vision are other concerning visual symptoms for people with MS. The reason for these eye movement abnormalities and detailed treatment options are covered. Experts share the latest advancements in vision research for those living with multiple sclerosis. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Dr. Anneke van der Walt is an Associate Professor of Neurology at Monash University in Melbourne, Australia. She is the head of the MS and Neuro-ophthalmology Research Group. She completed her undergraduate work in South Africa and completed her neurology training and PhD at the University of Melbourne. She is also the Chief Operating Officer of MSBase Foundation.

Dr. Tariq Bhatti is a neuro-ophthalmologist currently at Kaiser Permanente in Northern California. He completed his neuro-ophthalmology fellowship at Emory.  Dr. Bhatti was most recently a Professor of Ophthalmology and Neurology at Mayo Clinic and previously Chief of Neuro-ophthalmology at Duke University. 

Rapid recent advancements have led to blood tests (biomarkers) to track multiple sclerosis disease activity. A biomarker is something that can be measured to check normal functioning or the impact of a disease. Blood biomarkers are common in medicine to measure response to therapy such as measuring hemoglobin A1c levels for diabetic control and cholesterol levels for high cholesterol treatment.

Injury to nerve cells (neurons) and other cells in the brain and spinal cord can be measured in the blood by checking levels of proteins such as neurofilament light chains (NfL) and glial fibrillary acid protein (GFAP). One panel of these blood markers helps identify people with multiple sclerosis with current active MRI scans. The future of MS biomarkers involves blood tests to diagnose multiple sclerosis, select the best treatment for an individual, and measure treatment response.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Tanuja Chitnis MD, Professor of Neurology at Harvard Medical School, is the Director of both MGB Pediatric Multiple Sclerosis Center and Translational Neuroimmunology Research Center at Brigham and Women’s Hospital. She is also Co-Director of the Brigham Multiple Sclerosis Center at Brigham and Women’s Hospital. 

Our immune systems become less robust as we age. With an autoimmune disease such as multiple sclerosis, a weakened immune system can lead to less relapses and active MRI lesions. However, many people living with multiple sclerosis develop progressive disease with worsening physical and cognitive disability as they age. Strategies to live better with MS as one grows older are shared.

The vast majority of treatments for multiple sclerosis have been studied in people 55 years of age or younger. However, 46% of people living with MS are older than age 55. New studies are answering important questions about MS treatment in older patients. At what age can treatment safely be stopped without risk of relapse or worsening disability? Safety concerns such as serious infections, cancer risk, and immunization responsiveness in older MS patients on immunosuppressive treatments are addressed.

Barry Singer MD, director of The MS Center for Innovations in Care, interviews:

Bianca Weinstock-Guttman MD, Professor of Neurology at the Jacobs School of Medicine & Biomedical Sciences in Buffalo, New York, and the Director of the Jacobs MS Center for Treatment and Research.

John Corboy MD, Professor of Neurology at the University of Colorado Denver School of Medicine and Co-Director of the Rocky Mountain MS Center.

Trying to figure out the ideal diet for multiple sclerosis?  Two of the leading experts on diet and multiple sclerosis share our current understanding based on the latest research. Diets reviewed include intermittent fasting, Swank diet, Wahls protocol and Mediterranean diet.  The role of the gut organisms, called the microbiome, on immune health explained.

In-depth information highlights how certain foods affect people living with multiple sclerosis. Specifically dairy, gluten, polyunsaturated fats, fruits, vegetables, salt, vitamins and supplements are covered.  Dr. Ellen Mowery and Dr. Ilana Katz Sand also discuss how they counsel their own MS patients on diet.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Ellen Mowry MD is a Professor of Neurology and Epidemiology at Johns Hopkins University.  Dr. Mowry also co-directs the Johns Hopkins MS Precision Medicine Center of Excellence. Her research focuses on environmental factors that influence the risk and prognosis of multiple sclerosis.

Ilana Katz Sand MD is an Associate Professor of Neurology at the Icahn School of Medicine at Mount Sinai and on staff at the Corinne Goldsmith Dickinson Center for MS in New York City. One of main areas of her research is the role of diet in MS.

The Epstein-Barr virus (EBV) causes multiple sclerosis based on a new monumental study in young adults serving on active duty in the US military. The study found that the risk of developing MS increased 32-fold after infection with the Epstein-Barr virus. EBV causes infectious mononucleosis, spreads through saliva and infects B immune cells. 

Alberto Ascherio MD DrPH shares his group's recent findings, published in Science. Epstein-Barr virus treatments in clinical trials reviewed including vaccination studies with the goals of stopping disease progression and preventing MS from ever occurring. The impact of vitamin D, smoking, and obesity on the risk of developing multiple sclerosis is reviewed. 

Howard Weiner MD details the genetic risk factors for developing multiple sclerosis such as human leukocyte antigen (HLA) and risks of passing the disease onto children. The role of gut organisms, known as the microbiome, in both potentially causing multiple sclerosis and protecting people with the disease is explored. Strategies for a multiple sclerosis cure are highlighted.

Barry Singer MD, Director of the MS Center for Innovations in Care, interviews:

Howard Weiner MD is the Robert L. Kroc Professor of Neurology at the Harvard Medical School, where is has been on faculty since 1976. He is the Director and Founder of the Partners Multiple Sclerosis Center as well as the Co-Director of the Center for Neurologic Diseases at the Brigham & Women’s Hospital in Boston. He is also a film writer, director and author. Dr. Weiner is the author of “Curing MS.” His latest book is “The Brain Under Siege: Solving the Mystery of Brain Disease, and How Scientists are Following the Clues to a Cure.”

Alberto Ascherio MD DrPH is Professor of Epidemiology & Nutrition at the Harvard Chan School of Public Health. Dr. Ascherio obtained his medical degree at the University of Milan in 1978.  His research group focuses on identifying causes, risk factors and biomarkers of susceptibility and early diagnosis of multiple sclerosis including key research on Epstein-Barr virus and vitamin D.

Visit www.mslivingwell.org for more information.

Interested in improving MS care? Participating in a clinical trial may have personal advantages and help others in the future. Trial design discussed including whether or not a placebo (no treatment) will be used. Criteria needed to enroll in a clinical study called inclusion and exclusion criteria explained. Key elements of clinical trials outlined including multiple safety measures and informed consent.

Current clinical trials in multiple sclerosis are covered including using highly effective treatment early for someone living with multiple sclerosis. Current studies in progressive MS and remyelination shared. Compounds highlighted include BTK inhibitors, masitinib, ibudilast, simvastatin and gold nanocrystals.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Jiwon Oh MD PhD is the Director of the BARLO MS Centre at St. Micheal’s Hospital in Toronto. She is an Associate Professor of Neurology University of Toronto. Dr. Oh’s research focuses on developing advanced imaging techniques of the spinal cord and brain for use in clinical settings. She is the principal investigator on local and collaborative, multi-center MRI studies. Dr. Oh is the lead of the Canadian National Progression Cohort, which is focused on better understanding progression in MS. She completed her undergraduate degree at the University of Toronto and medical school from Queen’s University. Dr. Oh completed her residency at the University of Toronto, PhD in Public Health at John Hopkins and neuroimmunology fellowship at John Hopkins.

Robert Bermel MD is a neurologist specializing in multiple sclerosis at the Mellen Center for Multiple Sclerosis at Cleveland Clinic. He received a medical degree with thesis honors from the State University of New York at Buffalo. Dr. Bermel completed his neurology residency training and served as Chief Resident at Cleveland Clinic. He was funded as a National MS Society postdoctoral fellow in clinical neuroimmunology and advanced imaging at Cleveland Clinic. Dr. Bermel cares for patients, conducts imaging research, and an investigator in multiple clinical trials at the Mellen Center. His current research interests focus on the identification of advanced imaging methods to evaluate and improve recovery from inflammatory demyelinating disease.

Visit www.mslivingwell.org for more information.

Cutting-edge research is revolutionizing how multiple sclerosis is diagnosed and monitored. The central vein sign on MRI may soon be a key way of confirming if someone has multiple sclerosis versus other conditions such as migraine, vasculitis, neurosarcoidosis and blockage of small blood vessels (from age, smoking and hypertension). Early clues on MRI imaging are shared in people with evidence of MS prior to developing symptoms (called radiologically isolated syndrome or RIS). New imaging techniques in development visualize changes in progressive multiple sclerosis like slowly-expanding lesions and inflammatory cells called microglia. Dr. Daniel Reich from the NIH covers additional topics from routine MRI monitoring of the brain and spinal cord to remyelination imaging.

With incredible medical advances, some people that were considered to have multiple sclerosis are now diagnosed with neuromyelitis optica (NMO) and MOG Antibody Disease (MOGAD). Dr. Sean Pittock from Mayo Clinic shares how NMO and MOGAD are different from multiple sclerosis and reviews the alternate approaches to treatment including the 3 FDA-approved treatments for NMO, Soliris (eculizumab), Uplinza (inebilizumab) and Enspyrng (satralizumab). Latest research in screening spinal fluid and blood for clues of multiple sclerosis discussed to improve diagnosis and monitoring of the disease.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Daniel Reich MD PhD is the Chief of the Translational Neuroradiology Section of the National Institute of Neurological Disorders and Stroke (NINDS) at the National Institutes of Health (NIH). He obtained his undergraduate degree in math and physics at Yale, PhD in neuroscience at The Rockefeller University and MD degree at Cornell. Dr. Reich completed residencies in both neurology and diagnostic radiology and a neuroradiology fellowship at John Hopkins Hospital.

Sean Pittock MD is a Professor of Neurology at Mayo Clinic. His is the Director of Mayo Clinic's Center for Multiple Sclerosis and Autoimmune Neurology and Director of Mayo's Neuroimmunology Research Laboratory. He earned his medical degree from University College Dublin, post-doctoral degree at the Royal College of Surgeons in Ireland followed by residency and fellowship at Mayo Clinic in Rochester, Minnesota.

Visit www.mslivingwell.org for more information.

Share your MS story on https://ICanWithMS.org

Wellness is a proactive approach to living with multiple sclerosis. Wellness complements routine neurological care, which is often reactive to new relapses, symptoms and disease progression. Nutrition reviewed including diets such as intermittent fasting, paleo and Wahls Protocol. Great physical health relies on keeping up with routine cancer screenings and vaccinations. Options for protecting cognitive health and improving mental health are highlighted. Ways to improve social and spiritual connections are shared.

Successful exercise strategies presented for an array of MS disability levels. Information given on how to balance the need for increased muscle strength with concerns of overexertion and fatigue. The role of physical, occupational and speech therapy for people with MS reviewed. The latest and future technology explored including zero-gravity treadmills, electronic foot braces, robotic exoskeletons and implantable microstimulators.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Riley Bove MD is an Assistant Professor of Neurology at the University of California-San Francisco. Her multiple sclerosis research focuses on hormones and digital medicine. Dr. Bove started her studies in anthropology at Harvard and then global studies on a Fulbright scholarship. She returned to Harvard for medical school and then completed her residency at Massachusetts General Hospital and Brigham Women’s hospital in Boston. She completed a clinical research fellowship at the Partners MS Center and a Master’s Degree through Harvard Medical School’s Clinical Investigator Training Program.

Ben Thrower MD is the medical director of the Andrew C. Carlos MS Institute at Shepherd Center, a leading rehabilitation hospital in Atlanta. He completed his medical degree at University of Florida and neurology residency at the University of Texas in San Antonio. Dr. Thrower is a Clinical Instructor of Neurology at Emory University and participates actively in clinical research. He serves on the board of directors of the Georgia Chapter of the National MS Society and has served on the board for the Consortium of Multiple Sclerosis Centers. In 2005, he was the first physician inductee into the Georgia Chapter of the National MS Society Volunteer Hall of Fame.

Visit www.mslivingwell.org for more information.

Share your MS story on https://ICanWithMS.org

Struggling with anxiety or depression? Over half of people living with multiple sclerosis can experience depression and up to 40% have anxiety. Both psychological and physical symptoms that people with MS experience are explained. Causes for these mood disorders are discussed including immune inflammation in the brain, adaptation to having a chronic disease and medication side effects such as interferons and steroids. People with depression are at higher rate of developing multiple sclerosis. In addition, depression is associated with more disability for those living with MS which may be due to not taking medications properly, smoking, not exercising and even chemical brain changes.

Therapy options explored including meditation (including mindfulness), stress reduction, cognitive behavioral therapy and virtual platforms. Prescription medication options for both anxiety and depression covered including benefits and risks including dependence. Experts share resources and hope for those living with MS with severe depression including suicidal thoughts.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Amy Sullivan PsyD, ABPP is a board-certified, staff clinical health psychologist and the Director of Behavioral Medicine at the Mellen Center for MS Treatment and Research at the Cleveland Clinic. Dr. Sullivan received her doctorate degree at Argosy University-Atlanta, her internship at the University of Cincinnati, and her fellowship at the Cleveland Clinic in Pain Medicine. She is also the principal investigator for several clinical trials at the Mellen Center, where her research interests are focused on MS, pain, exercise and behavioral medicine.

Adam Kaplin MD PhD is the Chief Scientific Officer of MyMD Pharmaceuticals Inc. since December 2020. He completed his undergraduate degree from Yale University, graduating magna cum laude, and obtained both his MD and PhD degrees at Johns Hopkins. Dr. Kaplin complete his residency in psychiatry at Johns Hopkins Hospital, where he served as the chief resident of psychiatry. He served as an Assistant Professor of Psychiatry and Behavioral Sciences at John Hopkins and the principal psychiatric consultant to the John Hopkins MS Center. He remains as adjunct faculty at John Hopkins.

Visit www.mslivingwell.org for more information.

Share your MS story on https://ICanWithMS.org

Progressive multiple sclerosis can be a worrisome diagnosis, filled with questions about one's personal future including independence. In this podcast, Mark Webb shares his personal story of transition to secondary progressive multiple sclerosis with incredible resiliency, brilliant humor and tenacious optimism. He explains how MS has affected his career from Euro Disney to Head of Communications at Shift.ms, a global online MS community. He candidly describes the impact of the disease on his functioning including cognition, mobility and bladder and how he has adapted to these obstacles. Mark reflects on his acceptance of progressive MS and emphasizes his motivation to make a difference for himself, his family and the MS community.

Dr. Gavin Giovannoni describes in the podcast primary progressive MS, secondary progressive MS and active secondary progressive MS and whether or not these are truly different conditions. He moves beyond labels and explains that people with progressive disease, even those with limited mobility, can still be at risk of relapses affecting vision and arms. Continuing, switching or stopping disease-modifying therapy in progressive multiple sclerosis patients are covered. The impact of early MS damage, aging and ongoing, smoldering inflammation on progressive disease is described. Progressive multiple sclerosis treatments in clinical trials are highlighted including masitinib, BTK inhibitors, ibudilast, simvastatin, biotin, lipoic acid and remyelination strategies.

Mark Webb is Head of Communications for Shift.ms, an online community of over 38,000 people living with MS. Mark lives with secondary progressive multiple sclerosis and first developed MS symptoms back in 1992. He's a blog writer: onemanandhiscatheters.com, public speaker and rugby wheelchair player. Mark lives in the U.K. with wife and 2 sons.

Gavin Giovannoni MBBCh, PhD, FCP, FRCP, FRCPath is the Chair of Neurology of the Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry at Queen Mary University of London. Professor Giovannoni completed his medical training and neurology training in South Africa. In addition, he completed a PhD in immunology from the University of London in 1998. He is particularly interested in clinical issues related to optimizing MS disease-modifying therapies including progressive disease.

Visit www.mslivingwell.org for more information.

Share your MS story on https://ICanWithMS.org

People living with multiple sclerosis often experience chronic numbness, burning, tingling and pins-and-needles sensations. In a recent study, 70% of people with MS reported numbness and tingling, and 55% reported pain associated with relapses. MS neurologists explain typical symptoms for brain and spinal cord MS attacks compared to a pinched nerve in the back (like sciatica) or neuropathy. Lhermitte's sign (shocks down the spine when moving neck) and Uhthoff's phenomenon (numbness when overheated) are covered since frequently the first symptoms of multiple sclerosis. Options for relief from burning, tingling and pins-and-needles reviewed including medications such as Neurontin (gabapentin), Lyrica (pregabalin), Elavil (amitriptyline) and Cymbalta (duloxetine).

Painful MS syndromes including trigeminal neuralgia, MS hug, and flexor and extensor spasms are reviewed with numerous treatment options. MS experts also share options to alleviate painful muscle cramps and spasms as well as musculoskeletal pain, such as low back pain. The podcast aims to provide awareness and options for relief so that people living with MS can better communicate with their doctors to improve their care.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Mitzi Joi Williams MD, a MS neurologist and the founder and CEO of  Joi Life Wellness Group Multiple Sclerosis Center. Dr. Williams completed her neurology residency (including serving as chief resident) and multiple sclerosis fellowship at Georgia Health Sciences University (formerly MCG) in Augusta, GA. She is the author of MS Made Simple: The Essential Guide to Understanding Your Multiple Sclerosis Diagnosis.

Brandon Beaber MD, an MS neurologist at Kaiser Permanente in Los Angeles. He completed his neurology residency at Kaiser Permanente’s Los Angeles Medical Center (LAMC) and fellowship in multiple sclerosis and neuroimmunology at University of Southern California. He authored Resilience in the Face of Multiple Sclerosis and regularly posts educational videos for people living with MS on his YouTube channel.

Visit mslivingwell.org for more information.

At this recording, the COVID-19 pandemic is raging with nearly 100 million people affected and over 2.1 million dead.  Recently available COVID-19 vaccines are providing some much needed hope. Vaccinations have been extremely effective in saving people from fatal diseases but many people living with multiple sclerosis have questions about whether COVID-19 vaccines are safe and effective for them. This episode explains the two major COVID-19 vaccines types — mRNA and adenovirus — and what people with should know about them. 

This episode also covers different types of vaccines people with multiple sclerosis should avoid and which vaccines are safe. Experts tackle questions like whether vaccines can trigger MS relapses and review specific vaccines such as measles-mumps-rubella (MMR), chicken pox (varicella), hepatitis B and influenza (flu).

Multiple sclerosis disease-modifying therapies (DMTs) can suppress the immune system and potentially impact whether a vaccine will be protective or not. Existing info on each MS medication type is discussed. Timing of vaccinations and medication dosing strategies covered. Vaccines as a strategy to prevent or treat multiple sclerosis are explored.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Anne Cross MD is Professor of Neurology at Washington University in St. Louis and Dr. John Trotter MS Chair in Neuroimmunology. Her leading work in B cells in multiple sclerosis was recently recognized with the 2019 John Dystel Prize for MS Research.

Amit Bar-Or MD, FRCP is Professor of Neurology at University of Pennsylvania Perelman School of Medicine. He serves as Director of the Center for Neuroinflammation and Neurotherapeutics, and Chief of the Division of Multiple Sclerosis and Related Disorders. He runs a cellular and molecular neuroimmunology lab focused on injury and repair of the human central nervous system.

Visit mslivingwell.org for more information.

Being diagnosed and living with multiple sclerosis is often overwhelming. Your MS journey might be challenging, frustrating and depressing at times. On the bright side, superb MS care is available. This podcast lays out ways that you can take charge of MS and get the care you deserve. Topics include finding the right neurologist for you and how to get reliable MS information. Improve your communication with your doctor regarding worsening symptoms, progressive disease, MRI imaging and medication risks. Making shared decisions regarding treatment with your neurologist highlighted. If you feel more comfortable sticking with the treatment plan called "adherence," you will be better off in keeping your MS in check. Financial assistance for treatments, MRI and office visits outlined. Expert information reviewed on diet, vitamin D, smoking, alcohol and exercise.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Cathy Chester was diagnosed with multiple sclerosis in 1986 and has become a leading national MS patient advocate. Cathy is a graduate of Boston College with a Bachelor of Arts in English and Business and The Alfus Patient Advocate Certificate Program at The University of Miami. Cathy’s An Empowered Spirit was named Top Health Blog by Healthline and Top Multiple Sclerosis Blog by Healthline and WEGO Health for several years. Cathy is a regular contributor to MultipleSclerosis.net and Multiple Sclerosis News Today.

Bhupendra Khatri MD is the founding medical director of the Regional MS Center of the Center for Neurological Disorders in Milwaukee, one of the largest multiple sclerosis centers in the U.S. Dr. Khatri completed his residency in neurology at the Medical College of Wisconsin and fellowship at University of California in San Francisco. He has been a principal investigator in numerous clinical trials, as well as an invited speaker at both national and international conferences. He has published over 55 papers in peer-reviewed journals and has contributed chapters to six books. In 2015 he was honored with the National Multiple Sclerosis Society Lifetime Achievement Award. He is an accomplished book author and published the award-winning bestselling book, “Healing the Soul, Unexpected Stories of Courage, Hope and the Power of Mind.”

Visit mslivingwell.org for more information

Share your MS story on ICanWithMS.org

Struggling with MS fatigue? You aren't alone. Approximately 90% of people living with multiple sclerosis deal with fatigue. An overwhelming sense of tiredness can be disruptive at work and take away from your family time and social life. This podcast dives into the different causes of MS fatigue, including disease impact on nervous system, medications and poor sleep. Approaches to improve both mental and motor fatigue are highlighted including energy conservation strategies, exercise and workplace changes. Fixing sleep issues can substantially help fatigue. Treatment options reviewed for causes of poor sleep such as anxiety, restless legs, leg cramps, need to urinate overnight and sleep apnea. Medication options for MS fatigue are reviewed including, amantadine, modafinil, armodafinil and amphetamines.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Randy, from Must Stop MS!, was diagnosed with multiple sclerosis in November 2012. Initially he was worried about his future: wheelchair? providing for his family? Knowing how he felt after the diagnosis led him to become an advocate for this disease. He started Must Stop MS! on Facebook to provide support, new information regarding MS, and to raise awareness of the disease. Must Stop MS! quickly spread to Twitter and Instagram. He started a weekly Twitter chat named #ChatMS that occurs every Monday at 7pm EST. His mission is to bring the MS community together to help raise awareness, support each other, and provide hope. Randy won't stop until "we get that cure we all need."

Enrique Alvarez MD PhD is an Assistant Professor of Neurology at the University of Colorado School of Medicine and cares for patients multiple sclerosis patients at the Rocky Mountain MS Center. He was a graduate of the Medical Scientist Training program at the University of Colorado Denver and completed his neurology residency and neuroimmunology fellowship at Washington University in St. Louis. He has a special interest in using biomarkers to customize treatments and patient care.

Visit MSLivingWell.org for more information.

Share your MS story on ICanWithMS.org

Warning: ADULT CONTENT for 18 Years of age or older. 

Sexual health is an important part of quality of life for many people. Multiple sclerosis can cause new challenges and disrupt sexual relationships. Positioning options, including pillows and slings, are reviewed that can help overcome weakness and stiffness of legs. Factors that can reduce a woman's libido, or sexual drive, are addressed such as medications and hormone levels. Ways to achieve a satisfying sexual relationship with disability from multiple sclerosis are discussed in terms of intimacy and foreplay. Detailed solutions are presented such as stimulation and lubrication to overcome decreased or painful sensations with intercourse.

Up to 40% of men with multiple sclerosis can have low testosterone which can decrease libido. An array of testosterone replacement options highlighted depending on whether a man still wants to father children or not. Erectile dysfunction treatments discussed in depth including oral pills, intra-urethral suppositories, self-injection therapies, vacuum erection devices and penile implants.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews:

Heather Raznick MSW, LCSW is a psychotherapist in clinical practice in St. Louis. She obtained a Masters in Social Work from Washington University. She trained at the world-renowned Masters and Johnson Institute, where she studied clinical sex therapy under the direct supervision of legendary sexologist Dr. William Masters. She provides academic and clinical training to residents and medical students as well as lectures at several area hospitals. She is a member and has received certifications in multiple organizations including American Association of Sex Educators, Counselors and Therapists and the International Society for the Study of Women’s Sexual Health.

Etai Goldenberg MD is the Director of Men’s Health at Urology of St. Louis. Dr. Goldenberg completed his undergraduate degree at University of Michigan and medical school at Wayne State University School of Medicine in Detroit. His urological surgery residency was obtained at Washington University in St. Louis. In addition, he completed a fellowship in male reproduction and sexual health at the Smith Institute for Urology in New York City. He specializes in male sexual health, male reproduction, microsurgery, prosthetic urology and testosterone replacement.

Visit MSLivingWell.org for more information.

Share your MS story on ICanWithMS.org

Trouble with your bladder? Most people with multiple sclerosis have bladder issues. Penelope shares her personal bladder challenges with urgency, trouble emptying her bladder and use of catheters. Rather than being embarrassed, Penelope gives advice on when to speak up to get needed medical care and how to cope (laughter helps). Dr. Travis Bullock explains what happens to the bladder in MS, treatment strategies for bladder urgency reviewed including pelvic exercises, medications and Botox injections. Options for trouble emptying bladder highlighted including self-catherization and suprapubic catheters. Ways to reduce frequent urinary tract infections (UTIs) discussed including methenamine, d-mannose and cranberry tablets.

Barry Singer MD, Director of The MS Center for Innovations in Care interviews:

Penelope is the author and founder of Positive Living with MS where she uses humor and her own life experiences with MS to help others navigate this unpredictable journey.

Travis Bullock MD is a urologist with expertise in multiple sclerosis at Urology of St. Louis.  He completed his urologic surgery residency at Washington University School of Medicine in St. Louis and fellowship in Female Urology, Neuro-urology and Pelvic Floor Reconstruction at the Center for Continence Care and Female Urology at Metropolitan Urologic Specialists in Minneapolis, Minnesota.

Visit mslivingwell.org for more information.

This podcast explores cognitive issues in multiple sclerosis. Caroline Craven aka The Girl With MS shares the impact of MS on her short-term memory, word-finding ability and multitasking skills. She talks about the role of stress, sleep and mood have on her cognition. Caroline reviews how she copes with these changes partially through diet, exercise and good sleep. Abbey Hughes PhD, a rehabilitation psychologist from John Hopkins, outlines ways to deal with memory and multitasking obstacles for those living with MS. Strategies to help cognitive functioning are shared including task completion tips, journal use, brain-empowering apps, speech therapy, stress reduction and depression control. Screening tools to check for cognitive problems such as brain processing speed reviewed. MS brain changes and key ways to maintain brain health and better cognition emphasized.

Barry Singer MD, Director of The MS Center for Innovations in Care interviews:

Caroline Craven aka The Girl with MS is a certified life coach, writer and motivation speaker. Her writing focuses on articles in health journalism and highly rated blog. Her blog post topics range from personal experiences, research-based articles, recipes, life hacks and resources.

Abbey Hughes PhD is a clinical psychologist with expertise in rehabilitation psychology and multiple sclerosis rehabilitation. She is an Assistant Professor of Physical Medicine and Rehabilitation at John Hopkins. Her clinical and research interests include the assessment, treatment and management of psychological and cognitive difficulties associated with multiple sclerosis including adjustment to disability, sleep disturbance, fatigue, depression, anxiety, and problems with thinking or memory.

Visit mslivingwell.org for more information.

Share your MS story on ICanWithMS.org

Since the outbreak of the coronavirus, telemedicine has rapidly become the new standard for patients to communicate with their neurologists. Video conferences on smartphones, tablets, and laptops have… for now at least… replaced almost all appointments that used to be done in person.

Dr. Stephen Krieger from New York City and Dr. Annette Okai from Dallas discuss their early insights to advantages and disadvantages of the new virtual appointments for their patients with multiple sclerosis. Tips to navigate the technology and improve your virtual visit shared. These MS experts share their advice on whether you should have a virtual appointment now or wait for an in-office appointment. The neurologists also speculate on the future of telemedicine.

Barry Singer MD, Director of The MS Center for Innovations in Care at Missouri Baptist Medical Center, interviews:

Annette Okai, MD is a MS specialist and Medical Director of the Baylor Scott & White Multiple Sclerosis Treatment Center in Dallas, Texas. She completed her residency in Neurology in 2006 and fellowship in Neuroimmunology in 2008. Dr. Okai interests include studying multiple sclerosis in diverse populations and the utilization of conventional and novel MRI techniques in multiple sclerosis.

Stephen Krieger, MD is a MS specialist at the Corrinne Goldsmith Dickinson Center for MS at Mount Sinai in New York. He is an Associate Professor of Neurology at the Icahn School of Medicine at Mount Sinai and Director of the Neurology Residency Training Program. He created a topographical model to better understand MS disease course that has been adopted globally.

Visit mslivingwell.org for more information.

Share your MS story on ICanWithMS.org

At the height of the COVID-19 pandemic, neurologists from multiple sclerosis centers from Barcelona, Spain and Rome, Italy share their experiences on the front lines. These MS specialists share how they are supporting and advising patients during this crisis. 

Barry Singer MD, Director of The MS Center for Innovations in Care at Missouri Baptist Medical Center interviews: Giovanna Borriello, MD, MS Neurologist working at the MS Center in the academic Hospital Sant' Andrea in Rome, Italy since 2001. She has been an investigator over 40 clinical trials on multiple sclerosis including trials focused on new treatments.

Jaume Sastre-Garriga MD, PhD is the Deputy director of Cemcat, The MS Center of Catalonia in Barcelona, Spain. He serves on the executive board of RIMS (Rehabilitation in Multiple Sclerosis) and the steering committee for MAGNIMS, the European networks for best practice and research in MS rehabilitation and MS MRI imaging, respectively.

Visit mslivingwell.org for more information.

Share your MS story on ICanWithMS.org

Multiple sclerosis experts share valuable information about pregnancy and multiple sclerosis. The podcast covers pregnancy planning for a healthy baby while minimizing risk of multiple sclerosis disease activity. Topics of unplanned pregnancies, birth control and role of high-risk obstetricians addressed. Infertility and the role of in vitro fertilization in woman with MS covered. Genetic risks to child and pros and cons of nursing addressed. Information for men who want to father children reviewed.

Barry Singer MD, Director of The MS Center for Innovations in Care at Missouri Baptist Medical Center in St. Louis, interviews:

Claire Riley, MD is the Director of the Multiple Sclerosis Center at Columbia University Irving Medical Center and an Assistant Professor of Neurology.

Amy Perrin Ross, APN, MSN, CNRN, MSCN is a board certified neuroscience nurse and the Neuroscience Program Coordinator at Loyola University Medical Center. She is a former President of the International Organization of Multiple Sclerosis Nurses.

Visit MSLivingWell.org

Multiple sclerosis experts share advice on how to substantially improve your care when interacting with your neurologist. Key insights to develop trust and understanding with your doctor reviewed. Compelling info to help you advocate and communicate your goals and needs. Specific ways to make the most of your appointments addressed. Difficult questions are tackled such as progressive disease and long-term planning. Managing MS symptoms and wellness highlighted. Benefits of reviewing MRI images in the exam room outlined. Excellent tips on how to access free medication and MRI programs for people who are uninsured or have high out-of-pocket costs.

Barry Singer MD, Director of The MS Center of Innovations in Care at Missouri Baptist Medical Center interviews:

Flavia Nelson MD, Associate Professor of Neurology, Director Multiple Sclerosis Division at the University of Minnesota in Minneapolis. She completed her residency and multiple sclerosis fellowship at the University of Texas Health Science Center in Houston, Texas. Dr. Nelson has served as Chair of the Department of Defense Panel for Multiple Sclerosis Research Program, committee member on Consortium of MS Centers MRI Guidelines Committee and Chair of International Advisory Board on Brain Atrophy and MS (2016).

Timothy West MD, MS Neurologist, Rocky Mountain Multiple Sclerosis Clinic in Salt Lake City, Utah. Dr. West completed medical school at the University of California-San Francisco (UCSF) and fulfilled his residency in neurology at UCSF. He has had extensive experience and research in the area of MS, including at the Cleveland Clinic Lou Ruvo Center for Brain Health in Nevada, the Sansum Clinic in California, and the UCSF MS Center in California.

Visit: mslivingwell.org & ICanWithMS.org

Multiple sclerosis often causes nerve pain with burning and pins-needles sensations, and spasticity associated with muscle tightness and cramping. The specific role of medical marijuana components including THC and CBD in MS in alleviating these MS symptoms addressed. Information regarding which MS patients are more likely to benefit from cannabis are reviewed in depth. Risks and concerns of cannabis use in MS addressed. All federal, state and local laws should always be followed.

Barry Singer, MD, Director of The MS Center for Innovations in Care, interviews:

Allen Bowling, M.D., Ph.D. , MS neurologist at the Colorado Neurological Institute

Jacob Sosnoff, Ph.D., Associate Professor in Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign 

To learn more, mslivingwell.org. To share your story, check out ICanWithMS.org.

Country living far from large cities has wonderful advantages, but can present some unique challenges to receive optimal multiple sclerosis care. This podcast addresses when it’s time to drive to see a MS specialist. MS experts share their wisdom on various strategies to access the most current treatments while still enjoying life in countryside from the plains to the mountains. Creative ways of coordinating care between local heathcare providers and MS specialists in MS centers described. Emerging telemedicine options reviewed to get remote care.

Barry Singer, MD, Director of The MS Center for Innovations in Care, interviews:

Susan Scarberry, MD, Sanford Medical Center, Fargo, North Dakota. Clinical Associate Professor of Medicine at the University of North Dakota School of Medicine and Health Sciences.

Gabriel Pardo, MD, Director, OMRF Multiple Sclerosis Center of Excellence, Oklahoma City.

See also: www.mslivingwell.org 

Myelin is the coating on the nerve cells (neurons) of the nervous system that allows messages to travel rapidly in our body. Myelin wrapped around the neurons also keeps neurons healthy. In multiple sclerosis, the immune system attacks myelin disrupting electrical signals and making neurons vulnerable to chronic damage. Remyelination is the strategy to recoat the nerves with new myelin. Myelin-making cells called oligodendrocytes (“oligos”) are described. The podcast reviews recent laboratory breakthroughs in screening for new treatments to turn on immature oligos to repair myelin. The exciting initial steps are presented regarding the transition from the laboratory research into clinical trials with multiple sclerosis patients.

Barry Singer, MD, Director of The MS Center for Innovations in Care at Missouri Baptist Medical Center interviews:

Ari J Green, MD, Chief of Division of Neuroinflammation and Glial Biology, Medical Director of Multiple Sclerosis and Neuroinflammation Center, Debbie and Andy Rachleff Distinguished Professor of Neurology, Departments of Neurology and Ophthalmology, University of California San Francisco.

To learn more, www..mslivingwell.org To share your MS story, check out www.ICanWithMS.org 

Treatment approaches to multiple sclerosis continue to change. Over the past quarter of a century, MS went from an untreatable disease to a disease responsive to a broad array of oral, intravenous and self-injected medications. Greater long-term disease control is now possible for more people living with MS. However, undertreatment can result in significant physical disability including imbalance, weakness, visual loss, incontinence and pain and significant cognitive impairment including short-term memory loss, multitasking impairment and word-finding problems. This podcast outlines different treatment strategies to maximize quality of life long-term to realize your individual goals with the least disability. Information is presented on which people with MS might be at increased risk of disability and need early use of a highly effective medication. Treatment safety is weighed against the treatment benefits and risk of long-term disability.

Barry Singer MD, Director of The MS Center for Innovations in Care, interviews two amazing MS specialists who are also phenomenal patient advocates:

Heidi Crayton MD, Director of The MS Center of Greater Washington in the Virginia suburbs of Washington, DC. Dr. Crayton completed her neurology residency and multiple sclerosis fellowship at Georgetown University Hospital. She is a national leader in MS treatment and clinical trial investigator.

Aaron Boster, MD, is an MS expert at Ohio Health in Columbus, Ohio. Dr. Boster completed his neurology residency at the University of Michigan in Ann Arbor and a fellowship focused on clinical neuroimmunology and multiple sclerosis at Wayne State University in Detroit. Dr. Boster continues to be active in clinical research, authoring academic publications and lecturing globally.

To learn more about multiple sclerosis, go to: www.mslivingwell.org