57 msfocusmagazine.org body weight, eating a healthy diet, getting vitamin D levels checked, avoiding cigarettes, and using appropriate safety gear when working with toxic substances. Drug may block death of brain cells in MS Researchers at the University of Alberta discovered a unique process of brain cell death that affects the cells that are most vulnerable in MS.After identifying the process called pyroptosis, orfierydeath, the researchers were able to block the enzyme in the brain that is responsible for it, using a drug that could potentially treat MS. The study was published in the journal PNAS. Dr. Thrower: Prior to 1998, many thought MS was a purely demyelinating disease with little thought given to the damage we now know occurs to the nerve fibers, or axons, themselves. The exact mechanism of how demyelination, axonal damage, and neurodegeneration all come together remains unclear.The discovery of a previously unknown mechanism of oligodendrocyte death, a “fiery death” no less, could be truly big news indeed. The tested drug, VX-765, inhibits Caspace-1 and is in testing for some forms of epilepsy. In the mouse model of MS, VX-765, appeared to help prevent disability. Stay tuned. Disappearing lesions may predict disability development For decades, clinicians treating MS have interpretedtheappearanceofneworexpanding brain lesions on magnetic resonance imaging scans as a sign that a patient’s disease is getting worse. Now, after conducting both a five-year study and a 10-year study, MS researchers in theJacobs School of Medicine and Biomedical Sciences at University at Buffalo are finding that it may be the atrophy, or disappearance of these lesions into cerebrospinal fluid, that is a betterindicatorofwhowill develop disability. Thefive-yearstudywaspublishedintheJournal ofNeuroimaging.Thefindingsfromthe10-year study were presented at the annual meeting of the American Academy of Neurology. Dr. Thrower: MRI remains one of our most useful tools in the diagnosis and management of MS. The most obvious abnormality on MRI for people with MS is the “white matter lesion.” Healthcare providers, researchers and people with MS frequently focus on these areas of demyelinationwithquestionslike;“Howmany?’ and “Any new ones?” Maybe these are not the most important questions though. Disability in MS has actually been shown to correlate better with measures of neurodegeneration like black holes and atrophy. This current study emphasizes that point. FDA approves Gilenya for pediatric relapsing MS The U.S. Food and DrugAdministration has approvedGilenya(fingolimod)forthetreatment of children and adolescents from 10 to less than18yearsofagewithrelapsingformsofMS, making it the first disease-modifying therapy approved for these patients. This expands the age range for Gilenya, which was previously approved for patients aged 18 years and older with RMS. Dr.Thrower:The management of pediatric MS has been one of the great unmet needs, along withtreatingprogressiveformsofMSandneural repair. MS usually begins in early adulthood, but we are increasingly aware that MS may also strike children.The approval of Gilenya for children between ages 10 and 18 represents thefirstsuchtreatmentoptionforkids.Children cannot be treated like “little adults” and hope- fully more treatment options will be targeted at this group in the future.