Editorial

Abstract

As 2013 draws to a close, so too does my time as Editor in Chief of IJMSC. I would like to thank the many people who helped the journal make such good progress in the last 5 years: our editorial staff, Annette Theuring and Maria Stadtler; our Editorial Board; June Halper, Executive Director of the Consortium of Multiple Sclerosis Centers (CMSC); the CMSC's Board of Governors and staff; and our publishing partners, Joseph D'Onofrio, Frank Marino, and designer Jim Ticchio. We are also grateful 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. Francois Bethoux will begin his term as Editor in Chief in January 2014, but he is already planning steps to ensure continued success and growth of the journal.This issue of IJMSC covers a variety of topics of interest to MS care providers. Two articles on disease-modifying therapies (DMTs) cover both ends of the DMT spectrum, one discussing the second-oldest FDA-approved medication, and the other concerning one that is now under FDA review. Dr. Fox of the Mellen Center for Multiple Sclerosis at the Cleveland Clinic, with colleagues from several other institutions, used the North American Research Committee on Multiple Sclerosis (NARCOMS) database to look at treatment discontinuation and disease progression with injectable DMTs. They noted that among those who remained on the same DMT for 5 years or more, intramuscular interferon beta-1a was associated with a lower risk of patient-reported MS progression than the other injectable therapies. As they point out, further studies are needed to assess the impact of selection bias on these findings.The other DMT article concerns alemtuzumab, which is currently under FDA review for use in MS and recently received approval in the European Union. While this medication is promising, its use would require an extensive risk management and mitigation program. Ms. Caon of Wayne State University, along with geographically dispersed colleagues, reviews current efficacy and safety results for this agent and describes the expanding roles of MS nurses as new MS treatments such as alemtuzumab emerge, particularly in the education of patients, their families, and health-care providers who do not specialize in MS.Our two articles on symptoms in MS cover what Dr. Elliot Frohman of the University of Texas calls the “tops and tails” of MS symptom management: cognition and bladder management. Drs. Barker-Collo and Purdy of the University of Auckland in New Zealand address the problem of determining the reliability of an individual's change over time on commonly used neuropsychological tests, such as the Adjusting–Paced Serial Addition Test. This work is valuable given the importance of repeated assessments and the fact that individuals' responsiveness to treatment effects can be lost in group analyses. At the other end of symptom management, Dr. Burks of Florida International University and his multidisciplinary, international group also looked at measurement, but this time of bladder symptoms. They developed a screening tool for MS patients that examines symptoms from both urologic and neurologic perspectives, thus enhancing practitioners' care in both areas.Finally, Dr. Buchanan of Mississippi State University (now at Ohio State University) and colleagues at Indiana University discuss employment among informal caregivers assisting people with MS. Their work highlights the special difficulties presented by patients who have cognitive impairment and thus require more assistance in the home, limiting the employment opportunities of their caregivers.Also included in this issue is a list of poster abstract titles from a recent symposium on gait and balance in MS, the latest in a series of such symposia organized by Dr. Kathleen Zackowski of the Johns Hopkins University School of Medicine and colleagues. The full abstracts appear in our online edition at IJMSC.org.As a brief update on the journal's efforts to improve our online discoverability and visibility, I am pleased to report that the CMSC has signed a participation agreement with PubMed Central (PMC), the US National Library of Medicine's archive of freely accessible literature in the life sciences, to include the journal's full-text articles in its database. Beginning in early 2014, all articles published in IJMSC since the Spring 2011 issue will be accessible in PMC, with citations and abstracts retrievable through searches in PubMed. We look forward to this increased exposure, which we hope will help advance research in MS care and ultimately benefit our patients.We hope that you find the articles in this issue valuable, and I thank you for the privilege of bringing research in MS care to you over the last few years. Don't forget to submit your abstracts for the CMSC annual meeting in Dallas, and have a happy New Year!