Celebrating Brain Awareness Week by understanding Brain Health in MS

32794072843_6d027dc9a0_oBrain Awareness Week, happening this year from March 12 to 18, is a global campaign organized by Dana Alliance for Brain Initiatives to increase awareness of the benefits of brain research while promoting public interest in neuroscience research. In recognition of this week, I’m discussing brain health in multiple sclerosis with a focus on the MS Brain Health Report. Titled Brain Health: Time matters in multiple sclerosis, the report offers evidence-based recommendations focused on diagnostics, therapeutic strategies, and improving access to treatment. It was developed by a group of international experts in MS under the guidance of Dr. Gavin Giovannoni, Chair of Neurology at the Barts and The London School of Medicine and Dentistry. The MS Society of Canada was one of the many organizations to endorse the recommendations made in the report.

The MS Brain Health Report is divided into six key chapters focusing on: (1) the burden of MS; (2) speeding up diagnosis; (3) early interventions to maximize brain health; (4) monitoring and treating MS; (5) acting quickly on disease activity; and (6) approaches to understand cost-benefits of treatments. Together, these chapters make up an extensive summary! Below are some key points from each section to give a flavour of the Report.

  1. The Burden of MS
  • The brain, spinal cord and optic nerve are affected in MS by the body’s own immune system. This leads to disabilities and cognitive impairment.
  • Young adults in the prime of their life are the most common group of people to be diagnosed with MS. The symptoms and relapses make a marked impact on the quality of life and ability to work or study.
  • Besides the toll it may take on personal health, MS also results in increased personal and economic costs. Many times, burden falls on the family members that become caregivers to those that have MS.
  1. Speeding up Diagnosis
  • Individuals should have access to a neurologist with a specialty in MS. Earlier diagnosis of MS means that treatment can be initiated sooner.
  • Two components are essential to MS diagnosis: brain imaging and clinical assessments. Due to advances in these areas, the rate of diagnosis is 10 times faster compared to the 1980s.
  • Delays still occur between the first clinical symptoms to diagnosis of MS, which could be reduced by raising awareness of MS and improving access to specialist as well as improving the diagnostic procedures in place.
  • Value should be placed on educating the public and primary physicians about the importance of early diagnosis and the need to improve access to a MS-specific neurologist, and adopt the latest diagnostic criteria that allows for early diagnosis.
  1. Early Interventions to Maximize Brian Health
  • While we are waiting for a cure, the next important aspect of managing MS is to reduce disease activity and preserve the brain as much as possible. Hence, early intervention is vital.
  • Disease-modifying therapies (DMT) and lifestyle interventions have shown to reduce disease activity. If a DMT is ineffective, a rapid switch to another DMT is a crucial aspect of managing the disease.
  • Individuals with MS should make an informed and shared decision with their healthcare team. Discussions should include lifestyle factors, limitations, and risk-benefits of treatments prior to initiation of a treatment.
  1. Monitoring and Treating MS
  • Regular monitoring of the disease activity is important in managing MS so that suboptimal treatments can be identified.
  • Regular results from clinical exams and brain imaging enable for a personalized treatment approach. These results will also inform regulatory bodies, payers and clinicians on therapeutic strategies for MS.
  1. Acting Quickly on Disease Activity
  • There is an increase in the number of DMTs available for the treatment of relapsing-remitting MS. Therefore, if a particular DMT is showing sub-optimal results, it is important to speak with the person’s healthcare team about switching to a different DMT.
  • As more DMTs become available, the mechanism of actions differs. Changing to a DMT with a different mechanism of action may prove more effective. Also, there is evidence to suggest switching to a newer DMT may be beneficial.
  • People with MS should have improved access to therapies so that treatments can be tailored to an individual’s MS. Regulatory bodies, insurance companies, and payers need to provide more access to treatments.
  1. Approaches to Understand Cost-Benefits of Treatments
  • Current reimbursement agencies consider the costs of healthcare and not the effectiveness of a DMT. This may lead to suboptimal treatment as DMTs that are not considered cost effective may also result in the greatest economic benefit.
  • Additional financing models should be explored.

Strategies such as early diagnosis and treatments, monitoring of MS and switching if treatments lack efficacy, and having access to a full-range of DMTs can potentially reduce long-term costs associated with MS while also slowing progression of MS.

While I tried to summarize this extensive, 86-page document in one blog, I highly encourage you to read the full report here. Want something a bit shorter? Click here for a one-page summary on the report.

Continuing to raise brain awareness– not just this week but throughout the year–is important in learning about and promoting research that could have an impact on all people living with conditions that effect the brain.

 

 

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