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Articles

The application was supported by positive data of KYV-101 in patients with stiff-person syndrome treated in Germany under a named-patient treatment option. 

FDA Grants Regenerative Medicine Advanced Therapy Designation to Kyverna's KYV-101 for Refractory Stiff-Person Syndrome

Across a 12-week study, atogepant-treated patients, with and without acute medication overuse, had greater reductions in mean monthly migraine days, monthly headache days, and acute medication use days.

Atogepant Effective in Treating Chronic Migraine With Medication Overuse

Michael Soileau, MD, FAAN, talked about a panel of specialists who discussed the evolution and multidisciplinary treatment of Parkinson disease, emphasizing patient-centered care and advanced therapeutic options.

Transforming the Landscape of Parkinson Disease Care Through Patient-Centric Focus

Mind Moments®, a podcast from NeurologyLive®, brings you an exclusive interview with Douglas Wajda, PhD. [LISTEN TIME: 13 minutes]

Episode 120: Improving Gait in Multiple Sclerosis Through the Neural Sleeve

NeurologyLive joins the CMSC in mourning the loss of founder and CEO,June Halper, MSN, APC-C, MSCN, FAAN.

In Memoriam: A Loving Tribute to June Halper

Videos

The assistant professor at Hunter College talked about the approach of localization to prevent misdiagnoses of multiple sclerosis and ensure patients receive appropriate treatment. [WATCH TIME: 3 minutes]

Optimizing Localization in Multiple Sclerosis Diagnosis: Aliza Ben-Zacharia, PhD, DNP, ANP-BC, FAAN

, has been with the team since September 2022. Follow her on Twitter 

Patricia Clark, CNP, a nurse practitioner at the Cleveland Clinic, talked about a specialized program for hospitalized patients with Parkinson disease that aligns hospital protocols with home medication regimens to improve care.

A Comprehensive Program to Enhance Inpatient Care for Patients With Parkinson Disease

The neuroradiologist at Mayo Clinic discussed the categorization of biomarkers for Alzheimer disease, focusing on core biomarkers specific to the disease and those reflecting related pathologies. [WATCH TIME: 8 minutes] 

Categorizing Biomarker Criteria for Alzheimer Disease Diagnosis and Staging: Clifford R. Jack Jr., 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 (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

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

"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

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.

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

Tiziana Life Sciences’ intranasal foralumab has shown potential in treating nonactive secondary progressive multiple sclerosis through innovative immune modulation.

FDA Grants Intranasal Foralumab Fast Track Designation for Nonactive Secondary Progressive Multiple Sclerosis

With the approved IND, it expands research efforts of equecabtagene autoleucel from other autoimmune conditions like myasthenia gravis and NMOSD.

FDA Clears IND for CAR-T Cell Therapy Equecabtagene Autoleucel in Multiple Sclerosis

Antonella Favit-Van Pelt, MD, PhD, chief medical officer at Helius Medical Technologies, gave perspective on the clinical advantages of the company’s non-implantable device to treat gait in multiple sclerosis.

Utility of Helius’ Neuromodulation System to Treat Gait in Multiple Sclerosis

Gavin Giovannoni, MBBCh, PhD, FCP, FRCP, FRCPath, explored 3 perspectives on self-managing multiple sclerosis (MS): a general consensus, insights from MS-Selfie, and a future technology-based model.

MS Self-Management: What Does It Mean?

 Patricia K. Coyle, MD, talked about the promising potential in ongoing studies assessing BTK inhibitors as treatment for primary progressive multiple sclerosis. 

Potential of BTK Inhibitors for Primary Progressive Multiple Sclerosis: Patricia K. Coyle, MD

"If either of these studies are positive, you will now have a treatment that was penetrating into the [central nervous system] and able to show a benefit in progressive [multiple sclerosis], and I think you will see it widely used."

Although the disease pathology of primary progressive multiple sclerosis (MS) is still not fully understood by clinicians, studies have characterized the condition by compartmentalized inflammation and loss of axons behind a closed blood–brain barrier.

 Before March 2017, there was no effective treatment for the condition despite the “arsenal” of therapies available for relapsing remitting forms of MS. Ocrelizumab (Ocrevus; Roche), the only FDA-approved treatment for primary progressive MS, led to lower rates of clinical and MRI progression compared with placebo in a previously completed phase 3 trial (NCT01194570).

 Despite ocrelizumab’s approval, there remains a need for more effective treatment options.

An emerging therapy class in MS are the Bruton’s tyrosine kinase (BTK) inhibitors. BTK is expressed in B-cells and myeloid cells, which include key progenitors like dendritic cells, microglia, and macrophages. These cells are integral to MS pathogenesis, along with mast cells, making BTK inhibitors relevant to various autoimmune diseases. First-generation BTK inhibitors are currently being used to treat B-cell malignancies and have shown efficacy in modulating B-cells. Prior studies have also shown B-cell depleting therapies were successful as disease-modifying treatments for MS, indicating the potential of BTK inhibitors for treating primary progressive MS and other forms of the disease.

, a professor of neurology at Stony Brook Medicine, recently presented on the diagnosis, clinical course, and management of primary progressive MS in a session at the 

2024 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting

, held May 29 to June 1, in Nashville, Tennessee. After the meeting, Coyle sat down in an interview with 

 to discuss the specific targets of the new therapy class of BTK inhibitors being tested for primary progressive MS. She talked about how the current trials compare BTK inhibitors with existing approved treatments like ocrelizumab. Furthermore, she spoke about the potential impact of early intervention in the silent period of primary progressive MS.

Click here for more coverage of CMSC 2024.

REFERENCES
1. Ontaneda D, Thompson AJ, Fox RJ, Cohen JA. Progressive multiple sclerosis: prospects for disease therapy, repair, and restoration of function. Lancet. 2017;389(10076):1357-1366. doi:10.1016/S0140-6736(16)31320-4
2. Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis. N Engl J Med. 2017;376(3):209-220. doi:10.1056/NEJMoa1606468
3. Airas L, Bermel RA, Chitnis T, Hartung HP, Nakahara J, Stuve O, Williams MJ, Kieseier BC, Wiendl H. A review of Bruton's tyrosine kinase inhibitors in multiple sclerosis. Ther Adv Neurol Disord. 2024 Apr 17;17:17562864241233041. doi: 10.1177/17562864241233041. PMID: 38638671; PMCID: PMC11025433.030056

The professor of neurology at Stony Brook Medicine talked about the promising potential in ongoing studies assessing BTK inhibitors as treatment for primary progressive multiple sclerosis. [WATCH TIME: 3 minutes]

Aliza Ben-Zacharia, PhD, DNP, ANP-BC, FAAN, College talked about the approach of localization to prevent misdiagnoses of multiple sclerosis and ensure patients receive appropriate treatment.

"It's important, I think, to think about localization and also look at the tests that people, that radiologists do. Always question and always make sure that you put the pieces [together] and they make sense to you."

Multiple sclerosis (MS), a chronic neurodegenerative autoimmune disease, has a complex clinical course that is recognized by inflammation, demyelination, and axonal degeneration. Diagnosing the condition most commonly involves localizing lesions in at least 2 separate areas of the central nervous system, which can include the brain, spinal cord, and optic nerves.

Over recent years, the field of MS has made significant progress in the number of treatments available for patients, allowing for more targeted care plans and overall better outcomes. Despite advancements in treatment and more knowledge of biomarkers, the field still experiences challenges with misdiagnosis in the clinical setting.

In recent years, there has been a growing body of research evidence on misdiagnosis and its prevalence in MS. Based on prior data from specialized MS centers, researchers reported that approximately 30% of cases originally referred for MS were diagnosed with a different disease.

 Another study using data from 4 academic MS centers showed that over 50% of patients carried a misdiagnosis for at least 3 years, 70% received disease-modifying therapy, and 31% reported unnecessary morbidity as a direct result.

 These studies prove that a wide range of conditions can be mistaken for an MS diagnosis and if there is pressure for timely diagnosis, this may also increase the risk of misdiagnosis.

, held May 29 to June 1, in Nashville, Tennessee, 

Aliza Ben-Zacharia, PhD, DNP, ANP-BC, FAAN

, an assistant professor at Hunter College Bellevue School of Nursing, presented on clinical pearls and the spinal cord. Following her talk, Ben-Zacharia, a nurse practitioner in New York City, sat down with 

 to discuss steps that providers can take to avoid an MS misdiagnosis when interpreting MRI results. In addition, Ben-Zacharia, who also serves as an assistant professor at 

, spoke about how collaboration between different specialists can help to improve the accuracy of medical diagnoses as well as the importance of verify findings with additional imaging sequences.

REFERENCES
1. Paul A, Comabella M, Gandhi R. Biomarkers in Multiple Sclerosis. Cold Spring Harb Perspect Med. 2019 Mar 1;9(3):a029058. doi: 10.1101/cshperspect.a029058. PMID: 29500303; PMCID: PMC6396336.
2. Yamout BI, Khoury SJ, Ayyoubi N, et al. Alternative diagnoses in patients referred to specialized centers for suspected MS. Mult Scler Relat Disord. 2017;18:85-89. doi:10.1016/j.msard.2017.09.016
3. Solomon AJ, Bourdette DN, Cross AH, et al. The contemporary spectrum of multiple sclerosis misdiagnosis: A multicenter study. Neurology. 2016;87(13):1393-1399. doi:10.1212/WNL.0000000000003152
4. Gaitán MI, Correale J. Multiple Sclerosis Misdiagnosis: A Persistent Problem to Solve. Front Neurol. 2019 May 7;10:466. doi: 10.3389/fneur.2019.00466. PMID: 31133970; PMCID: PMC6514150.

SAP Partners

Aliza Ben-Zacharia, PhD, talked about how to effectively diagnose and treat multiple sclerosis through localization and active listening of the patient's history and symptoms.

Streamlining MS Diagnosis and Treatment Through Effective Localization: Aliza Ben-Zacharia, PhD, DNP, ANP-BC, FAAN

“As an MS expert, everyone has their own system of how they do things and their own patterns and methods, but it is very important to localize. It's helpful for you, as a clinician, to create the plan and think where you're going from there.”

Multiple sclerosis (MS), an inflammatory demyelinating disease, often leads to the formation of brain lesions that can cause various debilitating effects among patients. Previous research utilizing MRI has enabled investigators to study the occurrence patterns of these lesions. These such studies have shown that the nature of the resulting disabilities heavily depends on the location of the lesions in the brain; however, this issue is complex, as increased disability may not always correspond to noticeable changes on MRI scans or a significant increase in lesion burden

 Thus, there is a need for more research on the association between brain lesion location and MS disease severity.

In previous research, the study of lesion localization has yielded significant quantitative results. One notable study reported an association between lesion load and disability score using standard linear regression at every voxel, with areas of significant association estimated through t-statistic map thresholds.

 Subsequent research explored the relationship between average cortical thickness, lesion load, and disability score, revealing that cortical atrophy can occur even in patients with MS who had low disability scores.

 Additionally, 2 other related studies examined the association of gray matter volume reduction with the localization of white matter lesions.

 Therefore, the continued efforts of studying localization can help with informing clinicians on how to appropriately diagnosis MS among their patients.

, assistant professor at Hunter College Bellevue School of Nursing, presented a talk on clinical pearls and the spinal cord in MS. Ben-Zacharia, a nurse practitioner in New York City, sat down with 

 during the meeting to discuss why localization is critical in diagnosing the disease. In addition, Ben-Zacharia, who also serves as an assistant professor at 

, spoke about how clinicians can ensure they make the right diagnosis and avoid misdiagnosis in MS. Moreover, she spoke about the role of listening to patients’ history plays in diagnosing and treating MS.

REFERENCES
1. Eloyan A, Shou H, Shinohara RT, et al. Health effects of lesion localization in multiple sclerosis: spatial registration and confounding adjustment. 

. 2014;9(9):e107263. Published 2014 Sep 18. doi:10.1371/journal.pone.0107263
2. Charil A, Zijdenbos AP, Taylor J, et al. Statistical mapping analysis of lesion location and neurological disability in multiple sclerosis: application to 452 patient data sets. 

. 2003;19(3):532-544. doi:10.1016/s1053-8119(03)00117-4
3. Charil A, Dagher A, Lerch JP, Zijdenbos AP, Worsley KJ, Evans AC. Focal cortical atrophy in multiple sclerosis: relation to lesion load and disability. 

. 2007;34(2):509-517. doi:10.1016/j.neuroimage.2006.10.006
4. Sepulcre J, Goñi J, Masdeu JC, et al. Contribution of white matter lesions to gray matter atrophy in multiple sclerosis: evidence from voxel-based analysis of T1 lesions in the visual pathway. 

. 2009;66(2):173-179. doi:10.1001/archneurol.2008.562
5. Bendfeldt K, Blumhagen JO, Egger H, et al. Spatiotemporal distribution pattern of white matter lesion volumes and their association with regional grey matter volume reductions in relapsing-remitting multiple sclerosis. 

. 2010;31(10):1542-1555. doi:10.1002/hbm.20951

The assistant professor at Hunter College talked about how to effectively diagnose and treat multiple sclerosis through localization and active listening of the patient's history and symptoms. [WATCH TIME: 7 minutes]

Kathy Zackowski, PhD, OTR, talked about the importance of early intervention, interdisciplinary care, and wellness research for improving the quality of life for patients with multiple sclerosis. 

Promoting Early Rehabilitation and Wellness for Patients With Multiple Sclerosis: Kathy Zackowski, PhD, OTR

"We're just trying to really encourage the providers to be aware of this, that there is a whole rehab team that has expertise in these areas and addressing them early gives everyone a baseline of information."

Research indicates that rehabilitation therapy is a valuable component of care for patients with multiple sclerosis (MS), a chronic, debilitating disease marked by the demyelination of central nervous system nerves. Rehabilitation therapy helps patients regain or maintain function and enhances their physical, mental, and social well-being.

 Various forms of rehabilitation therapy are available, including physical rehabilitation methods like balance and gait therapy, speech and respiration rehabilitation, and occupational therapy.

Studies show that the composition of the care team can significantly influence patient outcomes, and both inpatient and outpatient care settings can be beneficial, depending on the patient's needs. Clinicians recommend that patients have a multidisciplinary care team for rehabilitation and undergo regular reassessments to manage evolving symptoms. Research has highlighted the essential components of rehabilitation, which include patient participation in treatment, goal setting with a multidisciplinary care team, and a guiding purpose for the patient that focuses on recognizing their potential and achieving improvements through a personalized plan.

, presented on assessment tools for physical medicine and rehabilitation in occupational therapy at the 

, held May 29 to June 1, in Nashville, Tennessee. At the meeting, Zackowski sat down in an interview with 

 to discuss the key differences between rehabilitation and wellness in the context of MS care. She also talked about how interdisciplinary care contributes to the overall well-being of patients with MS. Moreover, Zackowski spoke about some of the specific lifestyle factors being studied by the National MS Society’s wellness research working group.

REFERENCES
1. Iodice R, Aceto G, Ruggiero L, Cassano E, Manganelli F, Dubbioso R. A review of current rehabilitation practices and their benefits in patients with multiple sclerosis. 

. 2023;69:104460. doi:10.1016/j.msard.2022.104460

The associate vice president of research at National MS Society talked about proactive and early referral to rehabilitation services to effectively manage multiple sclerosis symptoms from the outset. [WATCH TIME: 4 minutes]

Agne Straukiene, MD, discussed how combining advanced therapies with lifestyle modifications can improve outcomes and slow disease progression in MS.. 

Integrating Advanced Therapies and Holistic Management in Multiple Sclerosis Care: Agne Straukiene, MD

"Promoting a brain-healthy and metabolically healthy lifestyle can slow disease progression and enhance the quality of life for [patients] living with multiple sclerosis."

Lifestyle and environmental factors can significantly influence the progression of neurological conditions such as multiple sclerosis (MS). Lack of exercise, poor diet, smoking, excessive alcohol intake, social determinants, medications, poor sleep, and comorbidities can even worsen MS by affecting patients’ brain health and depleting neurological reserves. Beyond disease-modifying therapies, clinicians believe that the approach to MS treatment should entail a "brain-healthy" and "metabolically-healthy" lifestyle to preserve neurological reserves and slow disease progression.

, a group of experts proposed recommendations for self-regulated lifestyle modifications to potentially enhance brain health, directly impact disease progression, and improve outcomes in patients with MS.

 Conducted by senior author Agne Straukiene, MD, and colleagues, the paper highlighted the importance of self-management and adopting a multidisciplinary, collaborative and person-centered care approach that comprises of the healthcare team, the patient’s family and support groups in the community.

, Straukiene, a consultant neurologist at Torbay and Southern Devon Healthcare NHS Foundation Trust, discussed how lifestyle and environmental factors impact the health and disease progression in patients with MS. She also talked about the key recommendations for lifestyle modifications for patients with MS from the recently published paper. Furthermore, she spoke about how advanced therapies can be integrated with holistic management strategies to preserve neurological reserves in patients living with MS.

REFERENCES
1. Giovannoni G, Ford HL, Schmierer K, et al. MS care: integrating advanced therapies and holistic management. Front Neurol. 2024;14:1286122. Published 2024 Jan 30. doi:10.3389/fneur.2023.1286122

The consultant neurologist at Torbay and Southern Devon Healthcare NHS Foundation Trust discussed how combining advanced therapies with lifestyle modifications can improve outcomes and slow disease progression in patients with multiple sclerosis. [WATCH TIME: 4 minutes]

Valerie J. Block, PT, DPTSc, talked about a study that explored the use of commercial wearable devices to monitor and manage bladder dysfunction in MS.

Innovative Wearables to Tackle Bladder Dysfunction in Multiple Sclerosis: Valerie J. Block, PT, DPTSc

"To our knowledge, this was the first study using commercial wearables for patients with MS to help with bladder dysfunction."

Bladder dysfunction (BD) negatively impacts many patients with multiple sclerosis (MS) and patients with other neurological conditions such as by inherent bother, life-threatening infections, and decreased quality of life. In a recent pilot study of patients with MS, findings provided initial insights into the feasibility, validity, and clinical utility of bladder wearables to assess, monitor, and treat BD remotely. These insights included the knowledge of device optimization usage, data cleaning into novel outcomes, and targets for behavioral change in women with MS who have BD.

Among 13 patients with MS who completed the study, the mean use of the wearable device for monitoring BD was 14.1 days. Activities included a clinical postvoid residual (PVR), wearing DFree for at least 3 to 5 days/month over 12 weeks, and a 3-day bladder diary. From raw minute-level device data, 2 measures were generated: home PVR (dPVR) and urinary frequency (dFrequency). All told, Bland-Altman agreement was good between PVR and dPVR, with no systematic bias observed. Similarly, agreement was noted by the authors using all available dPVR data compared with only the first 7 days. Notably, the correlation between urinary frequency and diary-reported frequency was 0.81. Participant feedback reported excellent usability, usefulness, and ease of use as well as highlighted the utility of DFree, which is a small, noninvasive ultrasound patch measuring bladder urine volume for BD self-management.

, held May 29 to June 1, in Nashville, Tennessee, by lead author 

, assistant professor of neurology at UCSF Weill Institute for Neurosciences. Following the meeting, Block sat down in an interview with 

® to discuss the primary barriers to addressing bladder dysfunction in patients with MS. She also talked about how wearable ultrasound devices compare with traditional post-void residual measurements. Furthermore, Block spoke about the potential of future applications of wearable devices that can treat bladder dysfunction in other neurological conditions.

REFERENCES
1. Block VJ, Suskind AM, Guo CY, Poole S, Cutter G, Bove R. Web: A Pilot Study of Wearables for Bladder Monitoring in People With Multiple Sclerosis. Presented at: 2024 CMSC Annual Meeting; May 29-June 2; Nashville, TN. ABSTRACT DMX01.

The assistant professor of neurology at UCSF Weill Institute for Neurosciences talked about a study that explored the use of commercial wearable devices to monitor and manage bladder dysfunction in multiple sclerosis. [WATCH TIME: 6 minutes]

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