IJMSC December 2025 Research Roundup

December brought diverse offerings from the pages of the International Journal of MS Care (IJMSC).

The Impact of Attentional Focus on Gait in Adults With Multiple Sclerosis: A Preliminary Investigation

Michael VanNostrand, PhD; Myeongjin Bae, PhD; and Susan L. Kasser, PhD

Research indicates that individuals with multiple sclerosis (MS) often experience reduced walking automaticity, requiring them to consciously allocate cognitive resources to maintain stability. This study examined different attentional conditions and found that attentional switching—the ability to shift focus between tasks—elicits the greatest deficits in gait quality, particularly increasing stride length variability. These effects are further exacerbated at faster walking speeds, where divided attention has a significant impact on gait speed.

“There’s No Magic Pill”: A Multimethods Qualitative Study Exploring Routine Fatigue Care in People With Multiple Sclerosis

Emma O'Connor, MSc; Sophie Fawson, PhD; Tom Sanders, PhD; Tracy Finch, PhD; Nicole Dodsworth, MSc; Harriet Waine, MSc; Olivia Tamburro; Jennifer A. Freeman, PhD; Pam Bostock, MSc, DipCOT; Wendy Hendrie, PhD; and Rona Moss-Morris, PhD

This study found that the clinicians in the United Kingdom surveyed generally relied on people with MS to self-report their fatigue symptoms. While behavioral treatments like cognitive behavioral therapy and exercise are evidence-based and effective, they are infrequently offered compared to less effective energy conservation strategies. Health care professionals often "trickle" fatigue advice through various disciplines, leading to inconsistent interpretations of management techniques. To bridge this research-to-practice gap, the authors recommend implementing standardized, formal screening measures and providing specialized training for clinicians in evidence-based behavioral interventions.

From Disability to Capability: Trajectory of Healthy Aging From the Perspective of People With Multiple Sclerosis

Narges Agha Mirkarimi, MSc; Maryam Keramat Kar, PhD; Hossein Mozhdehipanah, MD; and Farnoosh Rashvand, PhD

People aging with MS face a complex trajectory where age-related functional decline is superimposed on MS-related disabilities, often occurring 15 to 30 years earlier than in the general population. The individuals interviewed for this qualitative study prioritize maintaining physical function and independence as core components of healthy aging. They often adopt a capability approach, consciously developing their physical capacity through healthy lifestyle choices, such as exercise, a healthy diet, and stress management. Fostering healthy aging in people with MS may benefit from interventions that empower them to maintain their functional abilities throughout their lifespan.

Attitudes of Neurologists Toward the Potential Role of Serum Neurofilament Light Chain Measurement in Treatment Decision-Making for People With Radiologically Isolated Syndrome

José E. Meca-Lallana, MD; Gustavo Saposnik, MD; Rocío Gómez-Ballesteros, MSc; José M. García-Domínguez, MD; Luis Querol, MD; Lamberto Landete, MD; Virginia Meca-Lallana, MD; Luisa M. Villar, PhD; Eduardo Agüera, MD; Ana B. Caminero, MD; Sergio Martínez-Yélamos, MD; Nicolás Medrano, MD; Jorge Maurino, MD; and Enric Monreal, MD

Serum neurofilament light chain (sNfL) has emerged as a reliable biomarker for predicting the conversion from radiologically isolated syndrome to MS, yet its utility is not yet fully integrated into clinical decision-making. The authors of this study offered neurologists in Spain a simulated high-risk scenario and found that nearly 60% hesitated to initiate disease-modifying therapy, even when presented with elevated sNfL levels and other risk factors. Suboptimal decision-making was most common among neurologists not exclusively dedicated to MS care, suggesting that a lack of specialization impacts the adoption of emerging evidence. The authors emphasize the need for standardized sNfL protocols and educational initiatives to improve the management of asymptomatic individuals at high risk for MS.

Recruitment of African American Adults With Multiple Sclerosis Into Randomized Controlled Trials of Exercise Training: Lessons Learned From Project TEAAMS

Whitney N. Neal, PhD; Denise Gomez, BA; Victoria Flores, PhD; Edson Flores, MPH; Mitzi J. Williams, MD; Dominique Kinnett-Hopkins, PhD; Dorothy Pekmezi, PhD; and Robert W. Motl, PhD

African American individuals with MS are significantly underrepresented in exercise research, often due to a lack of culturally tailored recruitment resources and reliance on a single recruitment avenue like specialty clinics. These authors, part of Project TEAAMS, demonstrate that a multipronged, multifaceted strategy is essential for successful engagement of this demographic. Key success factors included leveraging MS organizations and virtual platforms, using culturally appropriate marketing materials, and employing a diverse research staff that reflects the experiences and values of the target community. The study highlights that moving beyond traditional methods to include community-based outreach is necessary to diversify MS rehabilitation research.

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