56 msfocusmagazine.org Researchers find well-being differs with age in MS A study by researchers from NYU and the Kessler Foundation shows that with aging, individuals with MS exhibit less severe depressive symptoms and better quality of life than their younger counterparts. These findings are consistent with the trend toward improvement in well-being with age in the general population. The article was published in Rehabilitation Psychology. Dr. Thrower: Maybe there really are golden years ahead. The results of this study are a bit surprising. As people with MS age, many reported a better quality of life. I suspect there may be many factors at play here. These may include emotional maturity, financial stability, better support mechanisms, and a change in the MS itself. Let’s look at that last factor. As people with MS age, some will transition from relapsing remitting MS to secondary progressive MS. While the label of secondary progressive MS sounds frightening, it may be associated with a more predictable quality of life. The uncertainty of relapses can be disruptive and anxiety-producing. In contrast, people with secondaryprogressive MS maynot experience relapses and the progression maybeveryslow. Researchers describe new subtype of MS Researchers have described a new subtype of multiple sclerosis that features neuronal loss, but no demyelination of the brain’s white matter. The findings by Cleveland Clinic researchers support the concept that neuro- degeneration and demyelination can occur independently in MS, and underscore the need for more sensitive MRI techniques for evaluating brain pathology in real time and monitoring treatment response in patients with the disease. The findings were published in the journal Lancet Neurology. Dr. Thrower: Just when we thought that the immunologyof MSwas complex enough, now we may have a new wrinkle. Dr. Bruce Trapp and his team at Cleveland Clinic have been at the forefront of our understanding of MS pathology for years. Theirs was the group that described axonal damage in MS in a pivotal 1998 study. This led healthcare providers to adopt a more proactive approach in starting people with MS on immunomodulatory therapies. In this newstudy, his team describes something outside the ordinary in a group of people with MS. Traditionally, we think of MS as being an attack of the immune system on the myelin insulation of nerve fibers or axons. This is felt tothenleadtoasecondaryaxonaldegeneration. Now Dr. Trapp and his team seem to have found a subset of people with MS who have intact myelin with degenerating axons. This form of MS has been labeled myelocortical MS and appears the same on MRI to traditional demyelinating MS.This raises manyquestions. Medicine & Research Doctor’s Notes The Doctor’s Notes column includes analysis from Ben Thrower, M.D., MS Focus senior medical advisor. Dr. Thrower draws from the top news stories of the quarter and explains what the news means to you, the person with MS.