Editorial - Volume 23, Issue 2 - March 2021

Spring is here and full of promise for increasing connection and returning to some activities put on hold for the past year. We are excited about seeing colleagues and friends at the 2021 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, which has been rescheduled as a hybrid meeting in Orlando during the last week of October. We are also excited about our two new editorial board members— Carrie Sammarco and Beverly Layton—and grateful for many years of generous service from Mary Filipi and Megan Weigel, who are rotating off the board.

Readers may notice the diversity of perspectives represented on the editorial board. A journal dedicated to comprehensive MS care requires expertise in neurology, psychology, nursing, rehabilitation, and mental health. Canadian and European board members provide insight into practices and research of international interest. The range of topics covered in this issue underscores the need for such a unique editorial board and the need for reviewers representing the disciplines involved in caring for persons with MS. We welcome new reviewers and appreciate all reviewers who contribute their time and expertise to the journal.

Disease-modifying therapy decisions and the implications of magnetic resonance imaging findings are hot topics of discussion between persons with MS and their neurology care team. Vieira and colleagues analyzed claims data for the impact of switching from an injectable disease-modifying therapy to oral fingolimod or another injectable agent. Although this does not predict response for an individual patient, these real-world data are potentially helpful in discussions about switching therapy. Likewise, the presence or absence of spinal cord lesions does not predict outcome for an individual patient with MS. Saini and colleagues described the prevalence of spinal cord lesions in a Saskatchewan population. In their cohort, patients with spinal cord lesions were more likely to attain significant disability at a younger age than patients without spinal cord lesions.

A person’s experience with MS, including time to diagnosis after onset of symptoms, coping with the diagnosis, and symptoms affecting quality of life, is as individual as response to therapy or disability progression, although there may be similarities in certain groups. Through semistructured interviews of African American women with MS, Stuifbergen and colleagues observed commonalities in their experiences that may help in development of resources specific to the interaction between African American culture and coping.

Many persons with MS begin physical therapy to improve mobility. Sessford and colleagues described a tailored mobility exercise program plus a counseling intervention for persons with impaired mobility. Improvements in several measures of mobility seen in this small group suggest this as an area for additional study. The work of Alonso and colleagues reminds us that mobility impairment is only one component of MS-related disability. In their Argentinian cohort, upper limb dexterity rather than lower limb speed was more closely associated with Expanded Disability Status Scale score and more strongly associated with depression. Assessing upper limb function is an important component of MS care.

Vision symptoms can also be disabling, and, even though these symptoms are common, modifiable risk factors for vision loss are not completely understood. Abbatemarco and colleagues found no association between vitamin D level and measures of visual function in a cohort with primary or secondary progressive MS. Some persons with MS report disabling language-related symptoms such as word-finding difficulty and impaired understanding of verbal language. This issue’s continuing education paper, by El-Wahsh and colleagues, describes assessment for language impairment and the association with other symptoms, quality of life, and social network variables.

Comprehensive MS care is truly a multidisciplinary team sport with valuable contributions from every member of the care team. We look forward to sharing more updates in each area of MS care in upcoming issues.