MS Living Well: Key Info from Multiple Sclerosis Experts

Many people living with multiple sclerosis are interested in whether vitamins, supplements, or nutrition can play a supportive role in long-term brain and immune health. Two areas that have received growing research attention are alpha-linolenic acid, a plant-based omega-3 fatty acid found in foods like flaxseed and walnuts, and vitamin D, a hormone-like nutrient involved in immune regulation that is often low in people with MS. With so much information online, it can be difficult to know what is truly supported by research versus what is based on personal stories or assumption. New studies are helping us understand these topics more clearly. We explore new insights from large-scale cohort studies and randomized clinical trials assessing the potential role of alpha-linolenic acid and high-dose vitamin D supplementation in early MS. Biomarker-based findings show an association between higher alpha-linolenic acid levels and reduced relapse risk and disability progression over long-term follow-up. The D-Lay MS trial demonstrated a reduction in disease activity in people living with MS receiving high-dose vitamin D early in their condition. Jamie Holloman MD, neurologist at The MS Center for Innovations in Care, interviews: Marianna Cortese MD PhD, Senior Research Scientist, Department of Nutrition at Harvard T.H. Chan School of Public Health Professor Éric Thouvenot, Head of the Neurology Department, Nîmes University Hospital, France

The quest to repair the damage caused by multiple sclerosis is gaining momentum, with scientists working to restore lost function and slow progression by rebuilding myelin—the protective coating of nerve cells. Within the brain and spinal cord, immature myelin-making cells called OPCs hold promise, but need the right signals to mature into oligodendrocytes and repair MS lesions. Researchers are also studying the role of microglia, the immune cells that clear debris but can turn destructive, with drugs like BTK inhibitors potentially tilting them toward repair. Early attempts at remyelination drugs such as opicinumab and elezanumab showed promise in animals but ultimately failed in human trials, underscoring the challenge. Still, reasons for optimism are emerging: clemastine, a common antihistamine, showed signs of remyelination in optic neuritis, while PIPE-307—a compound inspired by green mamba snake venom—is in Phase 2 trials. Even novel approaches like gold nanoparticles are being studied to boost oligodendrocyte energy and repair capacity. The path is complex, but progress is accelerating—bringing remyelination therapies closer to becoming a real option for people living with MS. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Veronique Miron PhD, MS Research Chair at St. Michael's Hospital and Professor of Immunology at The University of Toronto Robert Glanzman MD, Board-certified neurologist and Chief Medical Officer of Find Therapeutics

Stem cells have the extraordinary ability to transform into different types of cells and renew themselves—offering new hope in the treatment of multiple sclerosis. One of the most advanced approaches—autologous hematopoietic stem cell transplantation (AHSCT)—involves collecting a patient's own bone marrow stem cells, using chemotherapy to wipe out their faulty immune system, and then reinfusing the stem cells to help rebuild it. A more aggressive "myeloablative" approach can effectively halt relapses and new MRI activity but carries serious risks, including life-threatening infections. A gentler "immunoablative" method reduces these risks but allows for a return of MS activity in up to 25% of patients. AHSCT is typically reserved for younger individuals with aggressive relapsing disease and moderate or milder disability. Mesenchymal stem cells—derived from fat, bone marrow support tissue, or dental pulp—have shown mixed results. A large international trial found no benefit when delivered intravenously, although the treatment was safe. However, a smaller study using repeated injections into the spinal fluid showed disease stabilization in most participants. New research is now exploring neural stem cells, which may help protect and repair the brain and spinal cord. A recent Phase 1 trial involving 15 people with secondary progressive MS found reduced inflammation in blood and spinal fluid markers and less brain shrinkage on MRI scans following neural stem cells given into the spinal fluid spaces of the brain. Tune in as we unpack the science, the risks, and the exciting future of stem cell therapies in MS. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Stefano Pluchino MD PhD, Clinical Professor of Regenerative Neuroimmunology, Honorary Consultant in Neurology, University of Cambridge, UK Mark Freedman MD, Professor of Medicine in the field of neurology, University of Ottawa, and Director of the Multiple Sclerosis Research Unit, Ottawa Hospital, Canada

Living with multiple sclerosis brings unique challenges to brain health, but there are powerful steps you can take to support and protect your mind. Exercise not only improves endurance and reduces fatigue, but also helps rewire brain networks to promote resilience. Restorative sleep is essential, as it helps clear inflammation in the brain—so addressing disrupted sleep is a must. Nourish yourself with fruits and vegetables while cutting out sugary drinks and highly processed meats. Strengthen your social connections and lean on your support circle. When it comes to managing stress, discover what works best for you, whether it's music, yoga, meditation, or a favorite hobby. MS can cause the brain to shrink faster than normal—a process called atrophy—so protecting your brain reserves is crucial. Starting with effective disease-modifying therapy is key, but it doesn't stop there. Keep your brain engaged by reading, learning a new language, or picking up an instrument. If you smoke, creating a plan to quit is one of the most important steps you can take to reduce physical and cognitive decline. While MS can be unpredictable, you have the power to shape your brain health and preserve what matters most. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Lisa Doggett MD MPH, family and lifestyle medicine physician, UT Health Austin's Multiple Sclerosis and Neuroimmunology Center Augusto Miravalle MD, Professor and Chief of the Multiple Sclerosis Center, Rush University, Chicago

Facing the first symptoms and a new multiple sclerosis diagnosis can be terrifying, leaving you with a flood of questions about your future. How do you navigate your career, relationships, and whether to start a family? The uncertainty can be overwhelming, but you don't have to go it alone. Support from loved ones and connections with others living with MS can help light the way. As MS progresses, the mental challenges often intensify. The battle to accept mobility aids—devices that many resist—can feel like a loss, but in reality, they can expand your world. In this episode, we dive deep into the mental strategies to better cope with MS. Two inspiring advocates living with MS describe embracing change, turning their struggles into stories of strength, adaptability and hope. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Ardra Shephard, writer, podcaster and television host based in Toronto, Canada Tyler Campbell, professional inspirational speaker and former college football player from Austin, Texas

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

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

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

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

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.

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.

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.