MS Living Well: Key Info from Multiple Sclerosis Experts

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.

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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.

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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

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.

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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.