Editorial

Abstract

As we close out another busy year in caring for patients with multiple sclerosis (MS), the current issue of IJMSC offers another set of articles covering a broad range of topics relevant to MS clinicians and researchers.One important article deals with the initial diagnosis of MS, which is a critical step in defining subsequent treatment approaches, whether these are pharmacologic, rehabilitative, or a mixture of the two. Dr. Lalan and colleagues of the University of Mississippi Medical Center in Jackson contribute to our understanding of how to differentiate neuromyelitis optica (NMO) from MS using magnetic resonance imaging. Given that NMO is treated differently than more standard forms of MS, and that NMO patients may even worsen if given standard disease-modifying agents used in MS, this differentiation between the two entities is critical. The authors offer guidelines that are helpful to all MS clinicians, but especially to those who may not have seen this rarer form of demyelinating disease on a regular basis.Once the diagnosis of MS is established, the next step for an MS clinician is generally to consider whether a disease-modifying agent is appropriate and, if so, which one. An important subsequent step is to make sure that the patient is compliant with this agent. Dr. Dhib-Jalbut of the UMDNJ–Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues describe the effect of a focused training and education program using specialized nurses on compliance with interferon beta-1b in patients with early-onset MS. The program seemed to be effective in increasing patients' adherence to disease-modifying therapy.We have two contributions on specific areas of symptom management in this issue, one being a discussion of the use of a comprehensive pain management program in MS, and the other being a listing of poster presentations at a recent symposium on gait and balance in MS. While some clinicians continue to believe that MS does not cause pain, MS patients clearly experience pain from the disease as well as from multiple other causes, and most MS clinicians feel ill-equipped to effectively help patients with their pain. Dr. Sullivan and colleagues at the Cleveland Clinic in Cleveland, Ohio, describe the experience of MS patients who have chronic pain and have been enrolled in a comprehensive chronic pain rehabilitation program at the Cleveland Clinic. The authors demonstrate that MS patients can have significant improvements in pain, depression, and functioning, with results similar to those experienced by non-MS patients. Dr. Zackowski of the Johns Hopkins University School of Medicine in Baltimore, Maryland, and colleagues have organized a symposium on gait and balance in MS for a couple of years now, and we have the pleasure of including a list of the poster abstract titles from the most recent conference in the print issue, with the full abstracts published in our online edition at IJMSC.org. We are glad to help achieve a wider audience for their excellent work on this important topic.We are particularly pleased to have a contribution from a colleague in Jordan, Dr. Hamed of the University of Jordan in Amman, which discusses the real-life experience of MS patients and how environmental factors hinder their attempts to integrate into the wider community. Dr. Hamed also discusses the potential role for occupational therapists as well as others in planning intervention programs for patients with MS. Although the study involved Jordanian MS patients, the findings are equally applicable to other countries.Closing out this issue are two helpful contributions regarding caregivers of people with MS. Ms. Gupta of Kantar Health in Princeton, New Jersey, along with colleagues at EMD Serono and Pfizer, compares the reported burden of caregiving for MS patients and Alzheimer's disease patients, finding that MS caregivers have a much heavier load in some areas. This interesting study has important implications for policymaking as well as raising our awareness of caregiving issues. Ms. Preissner and colleagues of the University of Illinois at Chicago discuss the difficulty of doing research involving MS caregivers and how to get around these issues in order to advance such research and then develop educational programs to assist the caregivers, who are so crucial to the lives of our MS patients.We also want to remind you that the deadline for submitting abstracts for the Fifth Cooperative Meeting of the Consortium of Multiple Sclerosis Centers and the Americas Committee for Treatment and Research in Multiple Sclerosis, to be held in the spring of 2013, is December 31, 2012. Enjoy the rest of 2012, and we at IJMSC wish you all a very happy New Year!