Impressions from ECTRIMS 2019

It’s so inspiring to walk through hallways packed with thousands of researchers whose sole focus is MS. That’s what ECTRIMS (European Committee for Treatment and Research in MS) meetings are like. This year’s meeting in Stockholm a few weeks ago involved almost 10,000 of us!
I’ve been attending ECTRIMS for many years, and I’m always encouraged by what I see and hear.
With 2,000 lectures and talks to choose from, I’m bound to have missed some important ones. But a couple stood out for me, and I wanted to share them with you below. Please feel free to browse slide presentations, brief summaries (abstracts) and posters at the ECTRIMS online library, or follow links to specific studies provided below.
People are getting diagnosed with MS faster than ever, reducing what can be an agonizing wait for answers. Researchers looked back decades in the Swedish MS Registry to compare how long it took to diagnose MS using different diagnostic criteria introduced over the years. In the 1980s and 90s, it took an average of about 6 years to be diagnosed. Today, using refined methods, most are diagnosed within one year. Getting diagnosed at an earlier stage of the disease can enable earlier treatment and better outcomes for many (Abstract and Presentation 99).
Can exercise slow MS? This question was the theme of an invited talk by Dr. Ulrik Dalgas of Aarhus University in Denmark. He talked about what is known and not yet known about maximizing benefits of exercise for people with MS. For example, he noted previous studies suggesting that exercise can delay an MS diagnosis, protect brain volume, protect against relapses, and may provide short-term improvements in fatigue, pain, depression, balance, and walking ability.
He noted that exercise can help with fitness, which can help reduce the likelihood of other disorders such as cardiovascular disease, which when layered onto MS, can make MS worse. He says that exercise should be treated as a “medicine” to be prescribed as soon as a person is diagnosed with MS. But since everyone’s MS is different, the “dose” and type of exercise needs to be customized to fit an individual’s situation (Presentation 172).
What’s happening with studies on gut bacteria? Many of us have heard from previous studies on the difference in gut microbiome in those that have and don’t have MS—and the hope that probiotic approaches may help calm disease activity. But deciphering what’s the best mix of gut bugs is still going on. I was intrigued by a report from a massive study underway by the International MS Microbiome Study, which involves researchers from many different cities in the U.S. and Europe. They’re collecting stool samples from 2,000 people with MS, paired with 2,000 of their own household members who don’t have MS.
Early findings suggest there is wide variation in microbiome between cities and individuals, but those from the same household had more similarities than random pairs. These findings aren’t surprising, but they provide important preliminary information that will help these collaborators tease out which differences are relevant to MS disease activity (Abstract and Presentation 223).
A lot of people smoke cigarettes or use cannabis to help them cope with stresses and MS symptoms. I was particularly struck by two studies that suggest these behaviors can make some symptoms worse. One study found that cigarette smokers tended to do worse on cognition tests than those who quit or never smoked (Poster P461). Another study split up people who were having cognitive problems who used cannabis at least 4 days a week. One group abstained for 28 days and the other group continued. In just that short month, those who went off cannabis had significant memory and other improvements compared to those who continued heavy use (Poster P542).
The energy and urgency of conference attendees was really apparent, and it gives me hope that many more advances are in the wings.

Read more highlights from ECTRIMS 2019 here.

Enjoy a podcast from day three of ECTRIMS 2019 with the National MS Society's executive vice president of research, Bruce Bebo.
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Kathleen Zackowski

Dr. Kathleen Zackowski has conducted research on rehabilitation approaches for MS and other disorders for more than 15 years. She just joined the Society’s research team as senior director of patient management, care and rehabilitation research after working as a clinician and researcher at the Kennedy Krieger Institute and Johns Hopkins University School of Medicine. She is working to grow the Society’s research focused on clinical care and rehabilitation, and wellness strategies.