Thankfully, the range of available disease-modifying therapies for relapsing MS has greatly expanded in the last 20 years, ranging from mild and very safe treatments to powerful medications carrying significant risks. The optimal approach to treatment is not well defined: Is it better to start with the strongest medicine early and stop it if side effects are significant, or start with the mildest medicine and escalate only if needed? Is it safe to de-escalate after starting strong? Is there an age at which stopping therapy is indicated? Are there prognostic tests to predict disability and guide medication selection? The Corinne Goldsmith Dickinson Center for Multiple Sclerosis is involved in several multi-center clinical trials and observational studies gathering clinical data to answer these questions

Scientists in this research area include:

• Michelle Fabian, MD
• Ilana B. Katz-Sand, MD
• Fred Lublin, MD
• Aaron Miller, MD
• Sylvia Klineova, MD
• James F. Sumowski, PhD

One of the major challenges in the clinical management of multiple sclerosis is preventing, stopping and reversing the progressive stage of the disease. While best available therapies can modestly slow the rate of worsening, novel therapeutic strategies are needed to more effectively stop ongoing disease progression and even repair the damage that has already been done. Researchers at Mount Sinai are involved in clinical trials testing new therapies for progressive multiple sclerosis. In the laboratory, researchers are studying how crosstalk between infiltrating immune cells and resident cells of the brain and spinal cord might drive the pathophysiologic mechanisms of progressive disease. Immune monitoring and single cell sequencing approaches are used to study cell signatures during the relapsing-remitting and progressive stages of an animal model of autoimmune spinal cord demyelinating disease.

Scientists in this research area include:

• Stephen Krieger, MD
• Sam Horng, MD, PhD
• Ilana B. Katz Sand, MD
• Fred Lublin, MD
• Aaron Miller, MD

Preclinical research in animals supports a critical role for diet, sleep, exercise and the gut microbiome in modifying the onset and severity of autoimmune demyelinating disease. Researchers at Mount Sinai are studying the potential benefits of the Mediterranean diet on cognitive function, disability and biological aging in MS and other neuroinflammatory disorders. In the laboratory, researchers are testing how changing the microbiome in both animal models and patients may protect against inflammatory activity.  Our goal is to generate rationally designed bacterial communities for the prevention, treatment and/or cure of multiple sclerosis and other CNS inflammatory and neurodegenerative diseases.

Scientists in this research area include:

• Ilana B. Katz Sand, MD
• Sammita Satyanarayan, MD
• James Sumowski, PhD
• Stephanie Tankou, MD PhD

Researchers at Mount Sinai are developing and using innovative, high-resolution, non-invasive imaging techniques to optimize diagnosis and treatment in MS as well as to better understand the pathophysiology of both relapsing-remitting and progressive disease. A major goal of these tools is to identify novel anatomical features, disease markers and prognostic factors in MS.

Scientists in this research area include:

• Erin Beck, MD PhD
• Sarah Levy, PhD