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The director of the John A. Schafer, MD Multiple Sclerosis Achievement Center at Dignity Health discussed the effect of loneliness and social isolation on individuals living with multiple sclerosis.

NeuroVoices: Tiffany Malone, MSW, MSCS, on Combating Loneliness in MS Care Through Connection and Community Programs

The ExTINGUISH trial investigates inebilizumab's efficacy for NMDAR encephalitis, aiming to enhance treatment options for diverse patient populations.

Phase 2B ExTINGUISH Trial Aims to Assess Efficacy of Inebilizumab for NMDAR Encephalitis

Videos

The assistant professor of neurology at the Medical College of Wisconsin talked about the complexities of advanced multiple sclerosis, highlighting gaps in clinical trials and the need for individualized care strategies. [WATCH TIME: 3 minutes]

Challenges and Considerations in the Care Management of Advanced Stages of Multiple Sclerosis: Sam Hooshmand, DO

The neuropathologist at Mayo Clinic Florida discussed why EEG-based sleep biomarkers may help detect Alzheimer disease earlier and how they could enhance clinical trial design. [WATCH TIME: 3 minutes]

Bridging Sleep Science and Biomarkers in Neurodegeneration: Lea Grinberg, MD, PhD

Researchers uncover a latent infection model for Creutzfeldt-Jakob disease, revealing insights into its mysterious origins and potential triggers.

Understanding How a Rare Brain Wasting Disease Hides in Neurons For Decades

Director of the Center for Brain and Mind Health at Yale University.

The director of the Center for Brain and Mind Health at Yale University discussed new findings in thrombolytic therapy, stroke monitoring, neuroprotection, and imaging technologies presented at ESOC 2025. [WATCH TIME: 7 minutes]

Advances in Therapeutics and Imaging from European Stroke Organization Conference 2025: Kevin Sheth, MD

Associate Professor; Director of Outpatient Operations, Jefferson Headache Center; Co-Chief, Division of Headache, Jefferson University Hospital



The director of outpatient care at Jefferson Headache Center reflected on advances in migraine care and the ongoing outpatient challenges in treating this widespread yet under-recognized condition. [WATCH TIME: 3 minutes]

Evolving Perceptions and Care Challenges in Migraine: Michael Marmura, MD

The multiple sclerosis condition center is a resource for clinical news on the diagnosis, treatment, and management of multiple sclerosis. | NeurologyLive.


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Clinical

 MS Disease Spotlight page offers specific updates and coverage on the latest expert conversations and data readouts related to the treatment and management of patients with multiple sclerosis and demyelinating disorders.

 to subscribe on your favorite streaming service.

The Mind Moments podcast features exclusive interviews with leaders in the field discussing the latest research and disease management strategies across the breadth of neurology, including epilepsy, multiple sclerosis, Parkinson disease, dementia, sleep disorders, and more.

In this episode, "Understanding Major Changes to New McDonald Criteria for Multiple Sclerosis," Daniel Ontaneda, MD, PhD, a staff member of the Cleveland Clinic Mellen Center for Multiple Sclerosis, provided an in-depth overview on the new McDonald criteria to diagnose multiple sclerosis (MS), which was presented at the 

40th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS)

. Ontaneda, who also serves as an assistant professor of neurology, discussed the most notable changes to the criteria and how it may help towards improving rates of misdiagnosis and missed diagnosis. He spoke on the incorporation of new biomarkers, such as central vein sign and paramagnetic rim lesions, and the ability to diagnose MS in stages before clinical presentation shows. Furthermore, Ontaneda gave some perspective on the areas of the new criteria that will take some time to adjust to, as well as how these criteria may change the philosophical perspective of the disease as a whole.


The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here:

Potential Regulatory Submission for Inebilizumab in Myasthenia Gravis Following Positive Phase 3 MINT Data

Parkinson Agent Tavapadon Meets Primary and Secondary End Points as Monotherapy in Phase 3 TEMPO-1 Trial

Sage Therapeutics and Biogen Officially Announce Ending of SAGE-324 Program in Essential Tremor

 – Focus and direction of new diagnostic criteria

 – Overviewing specific changes to McDonald criteria

 – Approach to diagnosing pre-MS; treating radiologically isolated syndrome earlier

 – Incorporation of new biomarkers, central vein sign, paramagnetic rim lesions, OCT

 – Unanswered questions/challenges left out of the diagnostic criteria

 to subscribe to the Mind Moments podcast. Be sure to leave a rating and review for the show. Thanks for listening!

Hoping to listen on your favorite podcast app? See below:

European Committee for Treatment and Research in Multiple Sclerosis Congress (ECTRIMS)

Mind Moments®, a podcast from NeurologyLive®, brings you an exclusive interview with Daniel Ontaneda, MD, PhD. [LISTEN TIME: 27 minutes]

Episode 125: Understanding Major Changes to New McDonald Criteria for Multiple Sclerosis

The Mind Moments podcast features exclusive interviews with leaders in the field discussing the latest research and disease management strategies across the breadth of neurology, including epilepsy, multiple sclerosis (MS), Parkinson disease, dementia, sleep disorders, and more.

Episode 47, "Incorporating Physical Therapy Into MS Care," features an exclusive interview with Patricia Bobryk, MHS, PT, MSCS, ATP, physical therapist, UC Health, and cochair, 

International Organization of MS Rehabilitation Therapists (IOMSRT)

. Bobryk shared her insight into the clinical care of MS from the perspective of a rehabilitative specialist, and the importance of including physical therapy approaches as part of the multidisciplinary approach to care as early as possible to ensure more beneficial long-term outcomes for patients, also speaking to the latest advances and developments in rehabilitative medicine.

The stories feature in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here:

Noncontact Boxing Exercise Assessed for Parkinson Disease Benefit

Opicapone Demonstrates Small Benefit for Sleep in Parkinson Disease

Amylyx Announces Plans to Submit NDA for AMX0035 for ALS

Episode Breakdown

"Mind Moments," a podcast from NeurologyLive, brings you an exclusive interview with Patricia Bobryk, MHS, PT, MSCS, ATP.

Episode 47: Incorporating Physical Therapy Into MS Care

Episode 38, "Advancing MS Care and Awareness," features an interview with Barry Hendin, MD, clinical professor, University of Arizona; director, Multiple Sclerosis Clinic, Banner University Medical Center; and chief medical officer, Multiple Sclerosis Association of America. He shared his perspective on the recent World MS Day on May 30, the impact awareness efforts have had on care, and how treatment has evolved during his time as a multiple scleorsis (MS) physician.

"Mind Moments," a podcast from NeurologyLive, brings you an exclusive interview with Barry Hendin, MD.

Episode 38: Advancing MS Care and Awareness

Sam Hooshmand, DO, assistant professor of neurology at the Medical College of Wisconsin, discussed the complexities of defining, diagnosing, and managing advanced MS.

Clinical Insight on Challenges and Evolving Strategies in Advanced Multiple Sclerosis Care

The associate vice president of research at the National MS Society discussed a growing research initiative focused on defining and promoting evidence-based psychosocial wellness strategies for individuals with MS. [WATCH TIME: 6 minutes]

Expanding the Scope of Wellness Research in Multiple Sclerosis: Kathy Zackowski, PhD, OTR

Ahmed Abdelhak, MD, assistant professor of neurology at the UCSF, discussed the evolving landscape of biomarkers in multiple sclerosis and their potential to transform remyelination approaches.

Conversations on Biomarker Use in Multiple Sclerosis Remyelination Research

The associate vice president of research at National MS Society talked about the need for evidence-based wellness strategies in multiple sclerosis, particularly focusing on psychosocial interventions.

NeuroVoices: Kathy Zackowski, PhD, OTR, on Promoting Psychosocial Wellness Research in MS Care

The assistant professor of neurology at the Medical College of Wisconsin talked about the complexities of advanced multiple sclerosis, highlighting gaps in clinical trials and the need for individualized care strategies. 

"Advanced MS is a particularly challenging entity, and we as neurologists need to advocate and work with our industry partners to try to include these patients in clinical trials to get the data we need to make better decisions in terms of disease-modifying therapies."

Advanced multiple sclerosis (MS), particularly secondary progressive MS (SPMS), is often characterized by insidious neurologic decline marked by increasing physical disability, cognitive dysfunction, and a significant symptom burden. Traditional tools like the Expanded Disability Status Scale (EDSS), commonly used by clinicians to assess disease progression, may underrepresent cognitive, bowel/bladder, and sensory deficits in later stages of the disease, symptoms that can precede overt motor deterioration.

 Therefore, early identification of these changes, aided by cognitive screening tools and digital assessments, may support more proactive care strategies before functional decline becomes pronounced in patients.

Besides the complexity of diagnosis, the management of advanced MS in clinical practice presents distinct challenges, largely because of the lack of definitive evidence from pivotal clinical trials, which have typically excluded patients with EDSS scores above 6.5. In a recent meta-analysis, findings suggested that disease-modifying therapies could offer some benefit in slowing progression in patients with progressive MS, though their use should possibly be carefully balanced against adverse risks.

 As a result, there is a growing clinical imperative to include more patients with advanced MS in trials and to tailor treatment approaches based on disease progression as well as individual risk-benefit considerations.

2025 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting

, held May 28-31, 2025, in Phoenix, Arizona, 

, an assistant professor of neurology at the Medical College of Wisconsin, spoke with 

on the lack of a universally accepted definition of advanced MS.

 Using aspects from his talk presented at the meeting, Hooshmand emphasized the limitations of using the EDSS score alone to assess disease progression and the significant impact of secondary complications on advanced MS. Furthermore, he highlighted the importance of personalized care that supports functional independence and noted the absence of patients with advanced MS in most disease-modifying therapy clinical trials.

Click here for more coverage of CMSC 2025.

REFERENCES
1. Pozzilli C, Pugliatti M, Vermersch P, et al. Diagnosis and treatment of progressive multiple sclerosis: A position paper. Eur J Neurol. 2023;30(1):9-21. doi:10.1111/ene.15593
2. Wu X, Wang S, Xue T, et al. Disease-modifying therapy in progressive multiple sclerosis: a systematic review and network meta-analysis of randomized controlled trials. Front Neurol. 2024;15:1295770. Published 2024 Mar 11. doi:10.3389/fneur.2024.1295770
2. Hooshmand S. Advanced Disease States in Multiple Sclerosis: A Clinical Perspective. Presented at: 2025 CMSC Annual Meeting; May 28-31; Phoenix, AZ. Whitaker Track Invited Lectures: MS in Special Populations.

A patient and neurologist discussed personal and professional perspectives on treatment initiation, ongoing research, and patient advocacy in multiple sclerosis. 

Patient and Clinical Perspectives on Advancing MS Care Through Treatment, Advocacy, and Research

Early signs and symptoms of multiple sclerosis (MS) can be subtle and varied, often leading to initial misdiagnosis or delayed recognition. These may include visual changes, numbness, fatigue, or mood-related concerns, which can be mistaken for more common conditions. To reach an accurate diagnosis, clinicians typically rely on MRI imaging and other specialized tests to rule out alternative causes. Once MS is identified, shared decision-making between the patient and clinician may be essential, aiming to guide individualized treatment strategies and support long-term disease management.

 held a roundtable discussion with an MS expert and patient living with MS who talked about the early signs of the disease and the impeding challenges that can delay diagnosis. The featured guests included neurologist 

, director of the Multiple Sclerosis Experimental Therapeutics Program at John Hopkins Medicine, and 

, director of regulatory affairs at the National Multiple Sclerosis Society, who spoke on the importance of patient-clinician collaboration in navigating care and treatment planning.

In this final episode, Boschi and Mowry talked about the evolving landscape of MS care from both a patient and clinical-research perspective. Boschi, as a patient newly diagnosed with MS, shared her anticipation of starting treatment and her involvement in advocacy efforts with the Society, including work on Medicaid access and pharmacy benefit reform. Mowry highlighted ongoing advancements in MS research, particularly in progressive MS, and emphasized the importance of accurate diagnosis, rehabilitation strategies, and international collaboration. Both, in the conversation, underscored the value of community resources and a team-based approach to care.

: Thank you both for sharing your perspectives on this. Those are all the questions that I have for this discussion, unless there was anything else that you wanted to add to this conversation in terms of what you're looking forward to this year in the field of MS—or even on the patient advocacy side of things—what you're looking forward to there as well?

: Personally, I'm looking forward to just starting on treatment. I think the most anxiety-inducing place is knowing that you have this disease and not doing anything about it yet. So, I'm very excited to have my first treatment tomorrow. Professionally, as I do work for the National Multiple Sclerosis Society, there are so many interesting advocacy things going on. We're working on pharmacy benefit manager reform. We're working on being able to keep access to Medicaid for people who need it. There are so many interesting advocacy efforts, and I'm so glad to be part of it—and also to join the people living with MS who are our advocates. Now I'm one of them, and it's so empowering. I can't wait—we have our Hill Day next month, and I can't wait to go to the Hill with them and say, "Now I'm one of you, and we're in this together."

: Yeah. In addition to working with people with MS in the clinic, as I mentioned earlier, I spend a lot of time doing research, and so I feel lucky to be engaged with that community as well. I know there are people all around the world who are constantly thinking of new ideas, new potential treatments to test, designing the trials to test out those treatments and see if they help people with MS—new ways of trying to measure MS and quantify what's happened in people, so that it will enable that medication development. New ways of doing rehab, new ways of improving the diagnosis and the diagnostic criteria to make sure people are getting an accurate diagnosis so they can start on treatment in time.

I'm always excited to go to our international and national meetings and find out what new details there are. There's a lot of push to help people with the forms of MS that typically come up later in life, where things get a little bit slowly worse—called progressive MS. There's a lot of attention and promising new medications around the corner. So hopefully, hopefully, we'll see some of those come to fruition in the next year.

: The reason I wanted to talk about patient advocacy is because after a diagnosis and after having a treatment plan, where would the patient go from there in terms of maybe extra resources or extra support from the community? So, I thought that was also very important to highlight.

: The National Multiple Sclerosis Society is a fantastic resource for those living with MS—for those affected by MS. It’s really great. I know that I've sent people in my own family videos from the website to explain what this is, and I highly recommend you get in touch with the Society.

: I agree. I also send most people to the National MS Society for well-balanced information. I also think it's generally nice to connect with other people living with MS. Sometimes I think what we see in the media is a little bit skewed. I would say most of the people with whom I get a chance to work who are living with MS are out living their lives and doing the things—and you don't even know that they live with MS unless you ask. Because, you know, with these medications, folks are doing much better than in the past. But yeah, I think the National MS Society does a great job. And as a clinician and researcher, I like engaging on many levels, including in fundraising to help bring care and new science to the field.

: Always happy to educate people on what MS looks like. And when I was first diagnosed, I remember my grandmother thinking that this was the end—because that’s what she knew. The people of her generation, when they got MS—yeah, they were in wheelchairs. And it's not like that now, because of research and because we have such great treatments. But there's work to be done. There still is no cure. And I know that between Dr. Mowry’s research and my advocacy, we're going to get this done.

A patient and neurologist discussed personal and professional perspectives on treatment initiation, ongoing research, and patient advocacy in multiple sclerosis. [WATCH TIME: 5 minutes]

A patient and neurologist discussed the importance of individualized treatment strategies and the role of shared decision-making in managing multiple sclerosis. 

Shared Decision-Making Between Patient and Provider in MS Treatment Planning

In this third episode, Mowry and Boschi reflected on the collaborative process of developing a treatment plan for MS following diagnosis. Mowry outlined a stepwise approach that includes setting expectations, conducting baseline testing, and aligning therapy choices with individual patient factors, such as comorbidities, life plans, and preferences. Nicole shared her experience navigating initial treatment decisions, balancing clinical goals with lifestyle considerations, such as travel and needle aversion. The discussion highlighted how mutual understanding and adaptability are key to effective MS management.

: Another question that I have for you both is that there's a lot of talk about the patient-provider relationship. So, what does a decision-making approach look like from the provider and patient perspectives to co-create a treatment plan, ultimately, after having a diagnosis?

: Well, I can give you my perspective as a physician. I usually like to explain to people when we are first meeting—maybe even before we're at the point of being able to think about treatments but where we have decided, "Well, we think we're on the right track in terms of a diagnosis of MS"—just the very high-level rationale for why we use treatments and what different kinds of treatments are for MS.

For example, I like to split the treatments into those that are meant to prevent future things from happening, like future attacks and new spots, compared to treatments that are designed to help people feel better from symptoms that have already developed. Because the MS-specific treatments, to the best of our knowledge, don’t really make old symptoms go away. Instead, they prevent new things from happening. So, I like to set that expectation and then just give a little bit of history of the development of treatments over time.

But a lot of times, before we narrow in on a specific set of treatments to consider, we do need to do some blood tests because certain medications are contraindicated or are more cautionary for people who have abnormal results for one or more of those tests.

And so it can be super overwhelming, by the way. My experience is that it's just a lot of information for people to receive all at once. And so to try to dig in and go through an immunology lesson and discuss every medicine and all the risks and benefits—it's just too much for any one human to receive that information all at once.

So, we set the expectations: What’s the reason for using treatments? We’re going to get these blood tests, we’ll come back, and then let's use the narrowing-down approach based on the blood tests and what we already know that might not be great for that person. Maybe they have migraine or something, or anxiety or depression, and so certain medicines may make those worse—that helps narrow things down. And then also, hear a little bit about people’s life plans. Are they planning on having kids soon? Are they someone who’s going to be traveling a lot? Some people don’t like swallowing pills. We’re all humans. We all have our own things that might make us think more about one particular situation compared to another.

And so, in my estimation, the key is to try to work together to figure out a treatment strategy, but knowing that every time, it’s a conversation. And if the first strategy doesn’t work—because it’s not controlling the MS, or because it’s causing side effects, or other things we weren’t expecting—there’s always a chance to pivot.

That’s the gift of all the research that’s been done: there are now about 25 medications for MS. When I started on this journey in this career a long time ago, there weren’t any—or there was just one that had newly emerged. So, it’s been great.

: Nicole, do you have anything you wanted to add to that?

: Yeah, it was great being able to sit down with Dr. Mowry and discuss what I wanted from treatment—not to have further progression, to essentially stay the way I am. Also, as I mentioned, I love to travel, so something that would fit—we usually travel twice a year—something that would kind of fit into that schedule.

I mentioned my fear of needles, and although we did choose a treatment that involves infusions, I made it very clear that I didn’t want to let my fear of needles stop me from pursuing the best treatment for me. So, I have my first treatment this Friday, and I’m going to get through it.

: Now that’s courage, because I also don’t like needles.

: "Courage" or "courageous" is a good word to describe people with MS. I think maybe one of the hardest things about the human condition is uncertainty. And especially in this phase of diagnosis—getting the diagnosis and starting on that first treatment, and holding your breath—it does take a lot of courage. I’m always in admiration of the people I serve in that respect.

And one of the neatest things, though, is to see somebody at that sort of 6-month mark where they’re like, "Oh, I’ve got this." It’s really a fun transition to witness. And how I say it, from that point on, you’re the teacher, right? Like, you’re the one who’s teaching us.

: Yeah, and I think learning to live with the unpredictability of this disease... I’m someone who’s always been very much a planner, and having to realize that every day for me is going to be a little bit different. Like, for example, yesterday I had a lot of fatigue, but I woke up this morning and I feel fine. So, it’s learning how to live life with an unpredictable disease and trying to manage that while also still doing the things you love.

A patient and neurologist discussed the importance of individualized treatment strategies and the role of shared decision-making in managing multiple sclerosis. [WATCH TIME: 5 minutes]

A patient and neurologist discussed the multistep diagnostic approach for MS, highlighting the importance of early symptom recognition and comprehensive testing. 

Dual Viewpoint on Diagnostic Testing Strategies for Early Multiple Sclerosis

In this second episode, Boschi and Mowry discussed the often subtle and misattributed early signs of MS. Nicole recounted her experience with persistent visual disturbances and nonspecific symptoms like anxiety and fatigue that preceded her diagnosis. Mowry then explained the diagnostic challenges clinicians face because of the heterogeneous and sometimes silent presentation of MS lesions. The discussion highlighted the importance of clinical vigilance and early imaging when unexplained neurological symptoms emerge, particularly in younger adults.

: Thank you both for coming to this discussion to talk about the patient journey with MS. And Nicole, it seems you're still early on your journey. So, we can get started with some of the questions I have here. Nicole, if you want to start us off—what did early symptoms or signs look like for you? What were they initially attributed to, if not MS, in your experience?

: I think the first thing I noticed was a change in my vision. I was having problems with depth perception, and I went to an ophthalmologist. I talked to her about it and also told her that I’ve had depth perception problems since I was a kid. So, she took a look at me and thought that I had strabismus, but she doesn’t treat strabismus, so she sent me to a pediatric ophthalmologist who could treat the misalignment of my eyes. I went to her, and she prescribed prisms for my eyeglasses, and that helped but things still weren’t right, and we couldn’t figure out why. That was last summer.

Fast forward to this fall, my husband and I were going on vacation, and the day before we left, I started having double vision. At first, it went away, and then by the next morning, it was constant, and it lasted for 3 months. So as soon as we got back from that vacation, I made an emergency eye appointment. They were about ready to do eye muscle surgery, and at the last minute, they said, “You should go for an MRI. We’ll do your brain and your eyes. It’ll give us information on the surgery and just make sure there’s nothing else going on.”

Well, that MRI came back, and I immediately saw “suspicion of demyelinating disease, MS.” So I emailed Dr. Mowry because we had met at a previous event in DC. And yeah, that’s where my journey with MS began.

: I guess this is a great lead-in to you, Dr. Mowry, about, what early signs and symptoms look like and what patients bring to you. I’m sure you hear a lot from them about what previous providers, or even primary care doctors, initially thought they had.

: Yes, definitely. MS is known for presenting uniquely in some ways in each individual, so there’s never a story that’s exactly the same as somebody else’s. And that’s what makes each person’s journey unique.

The interesting thing is that, because MS damage can occur pretty much anywhere in the brain or spinal cord—we know, for example, that the optic nerve, which brings back vision, is part of the brain—those spots can show up in any location. Sometimes areas of activity from MS are actually silent, and people don’t know they’re occurring at all. Other times, they occur in an area that creates a specific pattern of symptoms.

So it can be really tricky because various people have different things. And with spots in different areas, the symptoms may vary in severity as well and can last for varying amounts of time, sometimes recovering completely. So somebody finally gets in to see their doctor and says, “Double vision—but it’s gone,” and it doesn’t really rise above the radar as something suspicious for that physician. So it can be a really challenging thing.

Very common symptoms that people think of as classically related to MS are things like a person who’s on the younger side—maybe in their 20s, 30s, early 40s—and they develop, say, numbness that over a few days goes up to the level of their waist, and then gets better. Or weakness and heaviness in the legs that gets worse over several days and then gets better. That sort of thing. Loss of vision in one eye—gradual loss of vision, pain when they move their eyes around. Or things like double vision—not double vision that sticks around when you close one eye or the other, but really that’s present with both eyes open and, again, typically lasting for days but can fluctuate. Some people just sort of notice a little overlap or don’t describe it as quite “double,” so it can be really challenging.

Interestingly, there are a lot of data coming out showing that people with MS, even prior to that first definitive set of symptoms, probably aren’t feeling quite right for several years leading up to their very clear onset symptoms. That’s an area of active research. You can see, for example, in places that track doctor visits, people just start going to the doctor saying, “Not feeling right.” They may have increased anxiety or depression—and I mean, those are really common health problems anyway. So how do you pick up: oh, this person’s anxiety, or depression, or exhaustion seems like a red flag for something more specific, like MS, versus just garden-variety anxiety and depression? It’s really an overwhelming task.

A patient living with MS and MS clinical expert reflected on the varied and often-misdiagnosed early symptoms that can signal the onset of the autoimmune disease. [WATCH TIME: 6 minutes]

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