Editorial - Volume 17, Issue 1 - January 2015

By the time you read this first issue of the IJMSC for 2015, New Year's resolutions may have come and gone. Our editorial team is committed to carrying on initiatives started in 2014 to enhance the journal's contribution to the field of comprehensive MS care. I am delighted to report that the number of manuscript submissions grew by 100% in 2014 compared to the previous year, during which we had already received a record number of submissions. As a consequence, thanks to the support of the Consortium of Multiple Sclerosis Centers and our publisher, the Delaware Media Group, we have increased our publication frequency from four to six times per year.

Optimizing the management of a chronic progressive disease such as MS requires measuring outcomes prospectively over extended periods of time, but this is difficult to achieve because of obvious practical challenges. The article by Kinkel et al., reporting on data collected 10 years after a clinically isolated syndrome in the CHAMPIONS study, shows that conversion to clinically definite MS and increased disability as evaluated on the Expanded Disability Status Scale are associated with lower quality of life (QOL) scores. These findings, which are similar to those in the previously published 5-year analysis, confirm the importance of preventing further disease exacerbations and progression of disability in order to preserve the well-being of our patients.

The ultimate goal of MS management is to alleviate the negative effect of the disease on functional status and QOL. Mayer et al. report improvement of walking (on performance tests and self-report measures), as well as QOL, in patients using a functional electrical stimulation device for footdrop over a period of 3 months. These patients were already treated with dalfampridine, illustrating the strategy of combining interventions to maximize patient benefits.

Urinary dysfunction is another example of a physical symptom of MS that can profoundly affect QOL. Khalaf et al. conducted a survey on lower urinary tract symptoms and their treatment in over 1000 individuals with MS living in the community. Most of the participants in the study reported at least one urinary symptom, but not all of them had discussed the issue with their health-care provider. Behavioral lifestyle changes were well represented among the most frequently reported interventions, consistent with recommendations from a consensus conference published in this journal in 2012. Even though the survey results suggest that urinary symptoms are not addressed as often as they should be, it is reassuring that a majority of the patients surveyed were satisfied with their current treatment.

Three articles in this issue use different methodologies to help clinicians better understand and address the needs of our patients and their families. McGuire and co-authors found, in a nonrandomized controlled study, that a 10-week psychoeducational wellness program in a group setting led to significant improvement on measures of mood, stress, and pain. Through a literature review, Upton and Taylor call to our attention the fact that men with MS have different needs than women with MS with regard to well-being and mental health, and emphasize the need for gender-specific approaches, particularly with regard to support groups. Based on the outcome of focus group interviews, Nilsagård and Boström stress the need to provide, repeatedly over the course of the disease, pertinent and individualized information to the children of individuals with MS, and to help parents communicate with their children about the illness. The involvement of a health-care provider is important, since the parents themselves often have difficulty adjusting to the consequences of the disease and coping with its unpredictability.

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