Editorial - Volume 18, Issue 4 - July 2016

The 2016 Consortium of Multiple Sclerosis Centers (CMSC) annual meeting, which was held a few weeks ago in National Harbor, MD, reached a new attendance record, reflecting the growing interest in multidisciplinary MS care. Over 2100 attendees enjoyed a wealth of educational and research presentations. An IJMSC roundtable on “Writing for Publication” attracted health-care providers from a variety of disciplines and practicing in various parts of the world, who engaged in very lively and fruitful conversations about scholarly publishing.

Similarly, the current issue of the IJMSC illustrates the spectrum of multidisciplinary MS care. While the traditional efficacy metrics for disease-modifying therapies (DMTs) include relapse rate, disability progression, and imaging parameters, clinicians and their patients are interested in the effects of DMTs on symptoms associated with MS, and in management strategies for their potential side effects. Based on several reports of improved fatigue in MS patients treated with natalizumab, Sater and colleagues investigated whether fatigue improvement could be related to enhanced sleep quality. In an uncontrolled observational study, they found improvements in fatigue, sleepiness, and mood after seven infusions of natalizumab, but no significant change in sleep parameters. Halper and colleagues, using a modified Delphi methodology, generated consensus statements regarding the management of flu-like symptoms and injection-site reactions associated with peginterferon beta-1a.

Clinicians involved in the care of MS patients often bemoan the lack of evidence of the effects of symptomatic therapies. While dalfampridine is one of the few symptomatic medications tested in phase 3 clinical trials in MS, its efficacy was demonstrated only on measures of walking used in the clinic; ambulatory activity in the patients' usual environment was not evaluated. Brown and Simnad report on a double-blind placebo-controlled crossover study of over 40 MS patients, which showed no significant change in ambulatory activity measured with accelerometry.

Wellness and the management of comorbidities are increasingly considered a pillar of comprehensive MS management. Newland and colleagues found symptom co-occurrences associated with smoking in individuals with relapsing-remitting MS.

Increasingly, the evaluation of the “value” of the care we provide to individuals is assessed with quantitative and qualitative metrics. Shoemaker and colleagues demonstrate how published quality indicators related to DMT initiation and symptom management (specifically depression, spasticity, and fatigue) can be assessed using patient-reported data in a large registry. Two articles raise questions regarding the validity of previously published self-report scales: Parkerson and colleagues found a different factor structure for the Coping with Multiple Sclerosis Scale, and Strober and colleagues demonstrated that the Perceived Deficits Questionnaire, a measure of self-reported cognitive deficits, correlates with depression, anxiety, and fatigue, but not with performance on cognitive tests.

The IJMSC staff and the CMSC extend our congratulations to the winners of this year's Herndon Award for Outstanding IJMSC Article: Theodore R. Brown, MD, MPH, and April Slee, MS. Their article “A Randomized Placebo-Controlled Trial of Duloxetine for Central Pain in Multiple Sclerosis” was published in the March/April 2015 issue. The award, which is named for IJMSC founding editor Robert M. Herndon, is given by the CMSC for the best article published in the journal during the preceding calendar year, and carries a $1000 stipend to be shared by the coauthors.

Finally, I am pleased to report that the journal has just received news of an award of our own: a 2016 APEX Award for Publication Excellence. This award is given for excellence in professional communications, including graphic design and editorial content. This is the fourth consecutive year that the IJMSC has won this award. We appreciate these signs of recognition of our accomplishments by the media profession.

The editorial team hopes that you will include the IJMSC in your summer readings.