ECTRIMS Berlin – Daily Digest, Day 1

11 October, 2018

Dr Lisa Melton, Head of Research at MS Research Australia, is in Berlin to attend the 34th Congress of the European Committee for Treatment and Research in MS (ECTRIMS). This is the largest global conference on MS. As well as attending the conference sessions and reporting back for us, Dr Melton is attending meetings with our partners in the International Progressive MS Alliance, MS International Federation and other collaborators.

With some resounding local music and a little bit of magic, ECTRIMS President, Professor David Miller from London, and local convening Committee Chair, Professor Reinhard Hohlfeld from Munich, today welcomed over 9,400 clinicians and researchers to the 34th ECTRIMS Congress. The conference will see over 260 presentations delivered together with more than 1,500 posters presented either physically or via an e-poster.

It never fails to fill me with awe and excitement to see the sheer number of clinicians and researchers gathered in one room with the sole focus of improving treatment and advancing research in MS.

The history and future of MS research

And the room was certainly full to overflowing to hear distinguished neurologist Professor Alistair Compston from the University of Cambridge UK deliver his wonderful opening lecture on the history of MS research and where we will go to from here in the digital age of big data and machine learning. He reflected on how the work in clinical, neuropathology and immunology fields has delivered a platform for understanding MS based around inflammation, demyelination and nerve degeneration. Now with the maturation of the fields of genomics, clinical data gathering and imaging, merged with the tools of artificial intelligence, we are poised to deliver better prognosis, understand the variability of MS in individuals and ultimately deliver personalised medicine for everyone with MS.

Cognition and cognitive rehabilitation

With so many sessions running in parallel it is impossible for me to bring you all the developments discussed at the conference, but other highlights for me today included an excellent session on cognition in MS. We heard that exercise is an effective tool for cognitive rehabilitation in MS and that if designed well, brain training can be effective to target the cognitive deficits in people with MS. Young researchers presented their work on the best ways to measure cognitive decline and to predict who is most likely to experience it, so that interventions can be targeted to those who need it. There was an emphasis on how brain processing networks, rather than single areas of damage, can influence cognitive function.

The power of data

There was an excellent session on the power of ‘real-world’ data, gathered from the clinic that showcased Australia’s great strength in this field. Associate Professor Tomas Kalincik from the University of Melbourne discussed how this type of data can be used to better understand treatment outcomes in day to day use of MS medications, beyond the carefully controlled clinical trials. Clever statistical techniques and large volumes of data can help tease apart and predict treatment outcomes, even though MS can be very variable. But Italy’s Maria Pia Sormani pointed out the pitfalls that can also be found in clinical data, particularly geographical differences and data gathered at different times, which can lead to false conclusions. However, she showed that knowing the pitfalls and working around them can provide important information on the mechanisms of MS. Young Australian researcher Nathanial Lizak used big data to show that continuing treatment even following a diagnosis of secondary progressive MS can still prevent disability accumulation. Melbourne’s Tim Spellman showed how big data can answer the questions coming directly from health authorities on how to get the best effect out of therapies, including making choices about when it might be appropriate to switch treatments.

What’s happening inside the brain?

On the pathology of MS, we heard from USA researcher, Professor Bruce Trapp about his recently described new subtype of MS. This subtype is determined by looking under the microscope in post-mortem tissue, but on clinical examination, in life, it appears the same as typical MS. Under the microscope, the subtype has unique features of demyelination and neuron loss in the cortex, and what look to be white matter lesions on MRI, are in fact areas of axonal swelling and damage. The discovery highlights that loss of neurons in the cortex of the brain can occur independently of white matter damage, shedding more light on how MS progresses, and how we might need to target different mechanisms to prevent both myelin damage and neuronal damage.

Imaging in MS

Another fantastic session was the Young Investigator session on the field of imaging. This session provided much hope for future techniques that will better monitor, predict and define MS. New techniques were described that will refine our existing use of MRI to track pathology, measure ‘brain ageing’ and distinguish MS from other brain diseases.

Global exchange and building the next generation of MS researchers

My day concluded with an inspiring function celebrating the recipients of Fellowships from ECTRIMS and the MS International Federation. These young researchers have come from all corners of the globe to learn and collaborate with international centres of excellence in MS research. The fellowships promote improvements in MS research and clinical care for people with MS, regardless of where they live.

I’m looking forward to more inspiration and learning tomorrow!

You can also follow Dr Melton’s updates from ECTRIMS via Twitter @lisameltonMSRA

 

Dr Lisa Melton

@lisameltonMSRA

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