Current MS Research with Dr. Agusto Miravalle
Watch the full presentation: Current MS Research with Dr. Agusto Miravalle
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This presentation was part of the Chicago Wellness for MS Forum held Saturday May 18, 2024
The goal for all patients should be No Evidence of Disease Activity (NEDA) with no disability progression, and no relapses. Markers for acute inflammation that causes lesions and relapses include neurofilament light. Biomarkers for progression include Glial fibrillary acidic protein (GFAP.)
MS medication fight acute inflammation and preventing new lesions and relapses. They are very important in the beginning of the disease. The earlier the intervention, the better the outcome for patients. Neurologists are moving away from the escalation approach where they start with a less effective treatment and ramp up if it doesn’t work and moving toward an early intensive approach where the most effective medication is prescribed earlier in the disease course. The early intensive approach lowers EDSS score compared to those who start a highly effective medication later in their disease course.
Artificial intelligence in MS
Imaging is an area where AI is being used to identify active lesions to understand the inflammation process, especially for slowly enhancing lesions. AI can more easily identify if and how lesions are growing than the human eye. AI will also more easily be able to compare brain volume loss compared to healthy aging and change in brain volume over time.
Subclinical biomarkers through a blood test can capture underlying inflammation information even before the clinical relapses occur. Using only an MRI or symptoms presentation as evidence of disease activity is retrospective rather than understanding what’s happening in real time using biomarkers.
Neurogenisis
Exercise, mindfulness meditation, and music therapy help grow new neurons and improve memory and brain power. Synaptic plasticity is training the brain to teach neurons to modify the strength of their connection. Compensatory sprouting and regeneration are two ways the neurons improve their connection once damaged. Long term potentiation increases the number of receptors on each neuron to be able to improve brain function. If you don’t use certain pathways the receptors will be down regulated and the pathways will be diminished, so use it or lose it when it comes to exercise and other movements.
Dr. Agusto Miravalle is the Chief of the MS and Neuroimmunology Division and Associate Professor of Neurology at Rush University, Chicago. Dr. Miravalle is a board-certified neurologist who sub-specializes in Multiple Sclerosis.
Dr. Miravalle received his Medical Degree from the University of La Plata, Argentina. He completed his Neurology Residency training at Loyola University, Chicago where he served as Chief Resident of Education. He subsequently completed a Neuroimmunology Fellowship at Harvard University in Boston and a Fellowship in Medical Education at the University of Rochester, New York. Dr. Miravalle is the recipient of the 2012 American Neurological Association Medical Education Fellowship Award, 2015 American Academy of Neurology Research in Education Award, and 2015 American Board of Psychiatry and Neurology Faculty Education Innovation Award.
Dr. Miravalle has been involved in both clinical and science based research in the field of Multiple Sclerosis and Neuroimmunology. He is a member of many professional societies and advisory boards. He is frequently invited as speaker at national and international meetings. He has published numerous scientific articles and serves as a consultant to various scientific organizations.
