Managing symptoms of MS – new approaches in research and clinical care

Symptom management and rehabilitation are two areas of research that are breaking new ground in multiple sclerosis. This was reflected at the endMS Conference when, for the first time ever, a separate session was created to include presentations focused on these areas. As one would expect, as research in symptom management and rehabilitation advances in MS, so to would treatments that manage the physical aspects of MS versus the underlying disease which is the main goal of disease-modifying therapies. Symptom management and rehabilitation strategies offer a holistic, comprehensive approach to MS care, and they involve collaboration between a diverse, interdisciplinary team of health professionals.

World leading MS expert and neurologist Professor Alan Thompson from the University College London discussed the importance of symptom management research for mobility, vision, and cognition – all functions which are dramatically impaired in MS. He emphasized the value in determining the right ‘outcome measure’ for use in MS clinical trials to effectively measure the benefits of a particular treatment. Outcome measures can include changes in: walking, learning and memory, disability, quality of life, etc. Identifying and validating the right outcome measures will allow future studies to assess the benefits of symptoms management treatments which can then be used in the clinic. Many studies also include ‘patient-related outcome measures’ which are treatment benefits that are reported by the study participants through questionnaires.

Prof Thompson talked about the benefits of exercise in MS, particularly resistance and endurance training. He listed several ongoing clinical trials observing the effectiveness of exercise, many of which show improvements in muscle strength, learning and memory and no serious adverse effects (click here to read about one recent pilot trial in Germany that demonstrated a positive effect of exercise in a small group of people with progressive MS). Prof Thompson also listed a number of candidate symptom management therapies (Fampiridine, cannabinoids, intrathecal baclofen, and several others) which are currently being evaluated for their ability to manage symptoms such as spasticity, bladder dysfunction, motor disturbances, and cognitive impairment.

Prof Thompson said something very important during his talk that I wanted to share on the blog. He stated that symptom management and treatments for progressive MS are the two top priorities for individuals affected by MS. His hope is that the research we heard about at the conference involving basic science, a term which refers to research conducted in the lab to determine the biological nature of MS, will translate into effective treatments today. This message resonated with me, and made me think back to the Research Priorities Discussions. During the discussions we heard from many people impacted by MS, who said that accelerating the pace of research to enable the development of treatments and a cure for people living with MS is of critical importance and where they would like to see research efforts focused upon in the near future.

Photo credit: DOUGBERRY (iStockphoto)

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