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Research and Clinical Trials

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Neurology and Neuroscience

Multiple Sclerosis

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Multiple sclerosis (MS) is a chronic disease in which the body's immune system attacks the myelin – the fatty sheath covering and insulating the nerve fibers that carry signals from the brain to other parts of the body. Nerve signals traveling through these damaged areas are distorted or interrupted, causing the symptoms that people with MS experience. Most patients (85 percent) initially have a "relapsing-remitting" form of the disease in which patients experience relapses (also called attacks, flares, or exacerbations) interspersed with periods of remission (few or no symptoms).

At NewYork-Presbyterian Hospital, we provide comprehensive care for people with MS using a coordinated multidisciplinary approach. Specialists from different fields – including neurology, urology, psychiatry and neuropsychology, rehabilitative medicine, physical and occupational therapy, neuroradiology, neurosurgery, pain management, neuro-ophthalmology, clinical social work, and nursing – work as a team to care for each patient. We use the latest diagnostic methods and therapies to maximize function, improve quality of life, and increase independence for each patient.

NewYork-Presbyterian offers care and conducts research for multiple sclerosis at:

  • The Columbia University Multiple Sclerosis Clinical Care & Research Center, which is affiliated with the New York City Chapter of the National Multiple Sclerosis Society
  • The Judith Jaffe Multiple Sclerosis Clinical Care & Research Center at NewYork-Presbyterian/Weill Cornell Medical Center, which provides services for patients with multiple sclerosis, optic neuritis, and other autoimmune, inflammatory demyelinating disorders of the central nervous system

Symptoms

MS causes a variety of symptoms that may vary from patient to patient, depending on the course of the disease. During a relapse, patients may experience blurred or double vision, muscle weakness, numbness, tingling, balance problems, or dizziness. Other symptoms may include trouble walking, hearing loss, and trouble speaking. Some patients experience depression and cognitive problems, such as difficulty with concentration, attention, memory, and judgment.

Diagnosis and Monitoring

The diagnosis of MS requires a thorough evaluation of a patient's symptoms through a physical examination (including assessment of the frequency of symptoms), a neurological exam, magnetic resonance imaging (MRI), evoked potentials (which assess brain signaling), spinal tap, and blood tests to rule out other causes of the symptoms.

At NewYork-Presbyterian, an outstanding group of neuroradiologists uses advanced imaging technologies – including high-resolution MRI and optical coherence tomography (used by ophthalmologists to measure the retinal nerve fiber layer) – to monitor MS progression and guide treatment decisions.

Medical Treatment

There is no cure yet for MS. However, there are strategies to modify the disease course, treat attacks, manage symptoms, and improve function and mobility. Because MS is such a variable disease, treatment for each patient is highly individualized. For most patients, treatment is likely to include some combination of medications, such as:

  • Drugs that modify the course of the disease, including beta interferons (Avonex®, Betaseron®, Extavia®, and Rebif®); glatiramer acetate (Copaxone®); natalizumab (Tysabri®); teriflunomide (Aubagio®); fingolimod (Gilenya™); and mitoxantrone (Novantrone®)
  • A variety of therapies to alleviate the daily symptoms of MS, including the first symptomatic therapy approved to improve walking in individuals with MS: dalfampridine (Ampyra®)
  • Intravenous anti-inflammatory corticosteroids to speed recovery from a relapse

Rehabilitation

Most people with MS find that their symptoms are best managed when they combine medication with rehabilitation, exercise, and/or lifestyle modifications. Physical and occupational therapists can help people with MS to:

  • Improve, strength, mobility, balance, and posture
  • Manage fatigue and pain
  • Maintain skills essential to a good work and home life

NewYork-Presbyterian offers comprehensive rehabilitation services for people with MS. Physiatrists, occupational and physical therapists, speech-language pathologists, therapeutic recreation specialists, and rehabilitation nurses provide a variety of services, including rehabilitation, home modification evaluations, speech and swallowing evaluations, and communication assessments.

Over time, some patients with MS become increasingly disabled, and may need devices such as canes and wheelchairs. Rehabilitation specialists help patients obtain and learn to use these assistive devices.

Research

Patients have the opportunity to participate in clinical trials at NewYork-Presbyterian Hospital assessing new therapies for MS to limit disease progression and restore function. Clinical researchers also collaborate with molecular biologists, immunologists, and neuroscientists to:

  • Examine the molecular basis of the myelin degeneration that occurs in people with MS
  • Identify molecular targets for new therapies
  • Develop new imaging methods to visualize and quantify nerve cells, myelin, and inflammation in MS
  • Develop potential therapies to promote the regeneration of myelin
  • Define the environmental causes of MS

Clinical Trials

NYP/Weill Cornell
NYP/Columbia

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