Editorial - Volume 14, Issue 1 - January 2012

As those of us in the temperate zones of the Northern Hemisphere look forward to the warmer days of spring and summer, and the renewed growth and energy brought by the improved weather, here at the IJMSC we are entering a new and exciting era. In January 2010, we inaugurated our online manuscript submission and tracking system, eJournalPress, which has resulted in increased efficiency as well as greater capacity in our peer review system. This spring, we are launching a new, full-featured electronic edition of our journal, with the anticipated benefits of increased “discoverability,” searchability, and overall visibility. In a commentary in this issue, Annette Theuring, our managing editor, discusses the tremendous advantages of this new endeavor to readers, authors, and researchers. Our new site will be located at http://ijmsc.org and will also be accessible through the Consortium of Multiple Sclerosis Centers (CMSC) website at www.mscare.org. The current issue, plus the previous volume (2011), will be available in both HTML and PDF formats on the new website, and we will be gradually adding the older issues in a searchable PDF format over the coming months.

Of the seven articles in the current issue, four are concerned primarily with disease-modifying therapies (DMTs), whereas the remaining three cover a variety of topics from the natural history of multiple sclerosis (MS) to general health issues in MS patients and, finally, gait analysis in early MS and clinically isolated syndrome (CIS). Of the articles on DMTs, three discuss various aspects of the use of the injectable medications, particularly side effects and adherence, while the fourth examines patient experience with natalizumab. From Kuwait, Drs. Alroughani and Thussu of Amiri Hospital in Kuwait City bring an international perspective to the universal problem of adherence to medications. They report on the adherence level as measured in a survey of patients in their community, while emphasizing the need to investigate the reasons for lack of adherence in order to reduce it. They also emphasize the role of the multidisciplinary team in managing this issue. Thomas Stewart, a physician's assistant at the Rocky Mountain MS Center in Westminster, Colorado, and his colleague Dr. Tran of the Colorado School of Public Health, University of Colorado Anschutz Medical Campus, examine the difficult subject of injection-site reactions in MS patients, which certainly can reduce adherence to prescribed therapies. They also reaffirm the role of education of patients and outline some strategies for anticipating which patients are more likely to experience injection-site reactions. Drs. Kim and Foley of the Ferkauf School of Psychology of Yeshiva University in New York, with their colleagues at the Multiple Sclerosis Comprehensive Care Center of Holy Name Medical Center in New Jersey and the CMSC, investigated depression as a possible side effect of the interferon injectable DMTs. Although depression is very common in people with MS, this study found no statistically significant relationship between treatment with interferon medications and level of depression.

The fourth article in the current issue discussing DMTs in MS provides a qualitative but informative assessment of patients' experience in being treated with natalizumab. The authors, Ms. Miller, Ms. Karpinsky, and Dr. Jezewski, who were all at the State University of New York, Buffalo, at the time of the research (Ms. Miller has recently left that institution), interviewed relapsing-remitting MS patients regarding their experiences and summarized the results.

Dr. Patten and colleagues at the University of Calgary in Alberta, Canada, discuss the day-to-day issues affecting MS patients and their needs for increased community services. The services they identify as most lacking are in basic functions such as meal preparation, housework, shopping, and chores. They also note that despite a high level of impairment, many people with MS maintain strong participation in society. In a contribution from Belgium, Dr. Roodhooft of the Nationaal Multiple Sclerosis Centrum in Melsbroek describes the spectrum of visual difficulties found in a sample of 284 MS patients in his clinic. This article reminds us of the wide variety of visual issues that confront our patients as well as the need to obtain proper ophthalmologic and optometric care for them. To round out the issue, Dr. Knox and colleagues of the University of Saskatchewan in Saskatoon, Canada, describe their gait study of patients with early relapsing-remitting MS or CIS, reporting that sophisticated gait analysis measuring step-length variability detected walking abnormalities even in this very mildly affected population.

Lastly, we would like to encourage all of you to attend the upcoming annual meeting of the CMSC, to be held May 30 through June 2 in San Diego, in cooperation with the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS). As always, we anticipate a productive and fun meeting learning about how to better care for our MS patients in our differing but collaborative roles.