Editorial - Volume 17, Issue 6 - November 2015

As the year draws to an end, I am pleased to report that a review of our editorial team's activity and published statistics confirms the continued growth of the journal, as well as its increasing scholarly impact. Further, in a recent survey of CMSC members, the IJMSC was ranked among the top three membership benefits, and a large majority of responders found that the articles published in the journal help them in their MS practice. We have also witnessed a steady increase in manuscript submissions from outside of North America, and in the proportion of articles with authors from more than one country, confirming our international reach. We are very grateful to our readers and contributors, to the CMSC leadership, and to our publisher for helping us fulfill our mission. We also express our thanks to our peer reviewers, who generously give their time to improve the quality of submissions; a list of reviewers who served over the past 12 months appears elsewhere in this issue.

Walking limitations are a common consequence of MS, with a profound impact on daily activities and quality of life. An article in this issue by Fjeldstad and colleagues reports on change in measures of walking speed, walking distance, gait, and balance in 20 patients treated with dalfampridine extended release (dalfampridine-ER). Significant improvements in all of these measures were demonstrated by dalfampridine-ER reinitiation after a 10-day withdrawal period.

Sleep disturbance is an underrecognized consequence of MS that may affect the ability to function during the daytime. Tabrizi and Radfar found that 70% of 217 patients referred to an outpatient MS center reported poor sleep quality, and demonstrated that sleep quality correlates strongly with fatigue severity and quality of life. Nonpharmacologic interventions are recommended in the management of insomnia, but their efficacy is not established in MS. Clancy and colleagues report improvement of total sleep time, fatigue, and depression after cognitive-behavioral therapy in individuals with MS referred to a sleep disorders clinic.

The article by Raissi and colleagues suggests that guidelines and recommendations regarding the management of depression in MS have a positive impact on clinical practice. Among 152 patients attending an MS clinic, over 85% of those with major depression received treatment, including pharmacologic and nonpharmacologic modalities.

Among the socioeconomic consequences of MS, loss of employment is a major concern, since the disease affects individuals at the peak of their productive years. While many factors have been linked to employment status, a better understanding of the effects of combinations of factors would help guide clinical practice. Cadden and Arnett determined that fatigue and cognitive skills, specifically processing speed and memory, mediate the relationship between neurologic disability and employment status.

The comprehensive management of MS includes family members and others who are identified as “care partners” and play an essential role in meeting the daily needs of MS patients. Yet, the needs of these care partners may not be recognized or addressed routinely. McKenzie and colleagues, using data from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, illustrated the impact of caregiving on MS care partners, including their work activity. They found differences in reported consequences of caregiving based on the sex of the care partner, suggesting that an individualized approach to caregiver burden is needed.

Also included in this issue is a list of poster abstract titles from the 5th International Symposium on Gait and Balance in Multiple Sclerosis, which was held at Oregon Health & Science University on September 25–26, 2015, and focused on Fall Detection and Prevention. The full abstracts appear in our online edition at IJMSC.org.

We encourage you to consider submitting a paper for our planned theme issue on “Comorbidities and MS,” guest edited by Ruth Ann Marrie of the University of Manitoba, to be published in late 2016. The deadline for submissions is March 1, 2016. More information appears in an official call for papers published elsewhere in this issue. Also, don't forget to submit your abstracts for the CMSC annual meeting in National Harbor, Maryland, in June 2016. Specific instructions appear in the CMSC's call for abstracts published in this issue.

I wish you pleasant readings, and a peaceful holiday period.