
Hosted by Barry Singer, MD · EN

Living with multiple sclerosis brings unique challenges to brain health, but there are powerful steps you can take to support and protect your mind. Exercise not only improves endurance and reduces fatigue, but also helps rewire brain networks to promote resilience. Restorative sleep is essential, as it helps clear inflammation in the brain—so addressing disrupted sleep is a must. Nourish yourself with fruits and vegetables while cutting out sugary drinks and highly processed meats. Strengthen your social connections and lean on your support circle. When it comes to managing stress, discover what works best for you, whether it's music, yoga, meditation, or a favorite hobby. MS can cause the brain to shrink faster than normal—a process called atrophy—so protecting your brain reserves is crucial. Starting with effective disease-modifying therapy is key, but it doesn't stop there. Keep your brain engaged by reading, learning a new language, or picking up an instrument. If you smoke, creating a plan to quit is one of the most important steps you can take to reduce physical and cognitive decline. While MS can be unpredictable, you have the power to shape your brain health and preserve what matters most. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Lisa Doggett MD MPH, family and lifestyle medicine physician, UT Health Austin's Multiple Sclerosis and Neuroimmunology Center Augusto Miravalle MD, Professor and Chief of the Multiple Sclerosis Center, Rush University, Chicago

Figuring out if your multiple sclerosis is changing from the relapsing remitting to the secondary progressive stage can be murky. Signs of progression are discussed like slower walking and worsening memory. The underlying reasons for progression are revealed including nervous system injury, remyelination failure, chronic inflammation and aging. Practical ways to improve progressive symptoms are shared. Successful trials for disease-modifying therapy for secondary progressive multiple sclerosis (SPMS) are highlighted. Tolebrutinib, under expedited review by the FDA, has been shown to slow down progression in SPMS patients by targeting cells in the central nervous system causing chronic inflammation. Introducing our new co-host Jamie Holloman MD from The MS Center for Innovations in Care! Dr. Holloman completed in neurology residency at Washington University, followed by a 3-year fellowship at the Cleveland Clinic. He interviews: Christopher Laganke MD, Founder of the Joanne P. LaGanke MS Center, Cullman, Alabama Barry Singer MD, Director of The MS Center for Innovations in Care, Missouri Baptist Medical Center, St. Louis

Facing the first symptoms and a new multiple sclerosis diagnosis can be terrifying, leaving you with a flood of questions about your future. How do you navigate your career, relationships, and whether to start a family? The uncertainty can be overwhelming, but you don't have to go it alone. Support from loved ones and connections with others living with MS can help light the way. As MS progresses, the mental challenges often intensify. The battle to accept mobility aids—devices that many resist—can feel like a loss, but in reality, they can expand your world. In this episode, we dive deep into the mental strategies to better cope with MS. Two inspiring advocates living with MS describe embracing change, turning their struggles into stories of strength, adaptability and hope. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Ardra Shephard, writer, podcaster and television host based in Toronto, Canada Tyler Campbell, professional inspirational speaker and former college football player from Austin, Texas

In this era of highly effective treatments, early intervention for multiple sclerosis can be life changing. However, the wide range of initial symptoms often leads to many people being undiagnosed or misdiagnosed, leaving them without the proper care for years. In this podcast episode, we'll discuss the early signs of MS and the key tests, such as specific MRI and spinal fluid results, that are crucial for a timely and accurate diagnosis. Criteria to diagnose MS continues to evolve to help make a diagnosis more swiftly and correctly. Specific MRI findings in the brain and spinal cord can allow for an immediate diagnosis of MS with the first attack. Brand-new updates highlight the role of the optic nerve and even offer a path to diagnosing MS in people who show no neurological symptoms. With so much at stake, a timely and accurate diagnosis of MS is more important than ever. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Xavier Montalban MD PhD, Chair of Neurology, Director of CEMCAT (Multiple Sclerosis Center of Catalonia) at Vall d'Hebron University Hospital, Barcelona, Spain Léorah Freeman MD PhD, Assistant Professor, Dell Medical School Department of Neurology, UT Health Austin Multiple Sclerosis and Neuroimmunology Center

The spinal cord serves as the main communication highway between the brain and body. Did you know that 80% of people with multiple sclerosis have spinal cord lesions on MRI? These lesions can disrupt specific neural pathways, leading to common MS symptoms like numbness, weakness, impaired coordination, balance issues, bladder problems, constipation, and sexual dysfunction. For instance, damage to the corticospinal tract on one side of the spinal cord can weaken an arm or leg. A remarkable autopsy study revealed that nearly 90% of people with MS still had active inflammation in the spinal cord. This finding brings new hope for potential treatments, even for older and progressive MS patients. Advances in imaging technology, including more powerful MRI scanners (3 Tesla and higher), are enhancing our ability to see inside the spinal cord, which is as thin as a pinky finger. Improved spinal cord imaging is driving the development of new therapies in clinical trials and helping identify those at risk for worsening disability, ultimately guiding better treatment decisions. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Gabriele De Luca MD DPhil, Professor of Clinical Neurology and Experimental Neuropathology, University of Oxford, United Kingdom Bruce Cree MD PhD, Professor of Neurology at University of California, San Francisco School of Medicine

Awareness of the more uncommon multiple sclerosis symptoms can lead to an earlier diagnosis and appropriate treatment. For instance, experiencing electrical shock sensations when bending the neck forward, known as Lhermitte’s sign, may indicate an attack on the cervical spinal cord. Likewise, excruciating bolts of pain across either side of the face, called trigeminal neuralgia, can be caused by a MS relapse. The MS hug, an unfriendly, squeezing sensation around the torso, can respond to muscle relaxants and nerve pain medications. Some MS symptoms, like tingling in legs, only surface when exercising or overheated (Uhthoff’s phenomenon). Vertigo, a spinning sensation, can be a sign of MS, especially when lasting days and accompanied by other symptoms like gait imbalance, facial numbness and double vision. Brainstem attacks may also lead to swallowing issues and shaky vision. While MS bladder issues are commonly addressed, bowel problems, including constipation, urgency, incontinence and trouble evacuating, should not be overlooked. Overcoming stigma is essential to treat sexual dysfunction. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Mary Ann Picone MD, Medical Director, MS Center at Holy Name Medical Center, Teaneck, New Jersey Bruce Hughes MD, Director of the Ruan Multiple Sclerosis Center, MercyOne, Des Moines, Iowa