Now
Federal research
program takes
aim at MS
by Lorna Smedman
•;National MS Society activists
led efforts to increase medical
research funded through the
Department of Defense.
•;Innovative projects include
efforts to understand MS
pain symptoms and studies
of repair strategies in the lab
and in people with MS.
Over the past five years, the National MS Society has led
advocacy efforts to garner more
federal funds for MS research
through the Congressionally
Directed Medical Research
Programs (CDMRP). More
than $17 million has been
allocated to MS research through
the CDMRP, which utilizes
Department of Defense funds
for high-risk, high-reward
medical research. Here are a few
examples.
A clearer picture of MS pain
While working on a pain study
at Dartmouth Medical School
a few years ago, imaging expert
and Society grantee Heather
Wishart, PhD, was particularly
struck by the fact that people
with MS often reported high
levels of pain, even when they
were on treatment for pain.
Although more than half of
people with MS experience
The innovative research projects that focus
on MS seek to improve assessment of and
develop novel treatments for veterans and
civilians living with MS.
uncomfortable burning,
tingling, shooting or stabbing
sensations, the origins of
MS pain remain murky and
treatment is often inadequate.
With funding from the
CDMRP, Dr. Wishart and her
team are developing and testing
the first functional MRI (
fMRI)-based pain “metric” tailored
specifically for patients with MS,
to better track and understand
MS pain. Pain metrics use a
pain intensity scale to assess
an individual’s subjective
experience, and the responses
are then correlated with fMRI
scans, which provide pictures
of changes in brain activity.
fMRI scans have been used to
better understand pain in other
conditions, such as chronic
lower back pain and migraines,
but until now, no such research
had been done with MS.
The team’s first task was to
establish an MS pain metric
using the least possible amount
of stimulation. “We wanted
a procedure that would allow
us to effectively measure pain
processing in MS without
it being uncomfortable for
participants, which is important
if fMRI pain imaging is to
become part of the normal
protocol along with MRI,” Dr.
Wishart said. Her team fine-tuned a procedure that involves
applying small degrees of blunt
pressure to the thumbnail—just
enough to be registered as mildly
painful. The simultaneous fMRI
reveals which regions of the
brain are being activated, and to
what degree.
Having a verifiable way
to measure an individual’s
experience with MS pain
could improve communication
between people and their
physicians, provide clinicians
with an objective way to track
this symptom over time, and
help researchers evaluate the
effectiveness of therapies.
fMRI can also reveal how the
disease affects the structure
of the brain and help explain
how these changes cause the
painful sensations that are such
a common and debilitating
symptom of the disease.
Unlocking the door to
myelin repair
Some damaged brain and spinal
cord tissue has the potential to
restore itself, but in MS, repair
is impeded. CDMRP awarded
a collaborative grant to Nitin
Karandikar, MBBS, MD, PhD,
whose field is immunology,
and Qing “Richard” Lu,
