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Issue: #13January 2013

MSResearchUpdateMS Research Update


MRIs predict the risk for MS at the sign of a first attack

Clinically isolated syndrome (CIS) describes a first symptomatic neurologic episode that is consistent with multiple sclerosis (MS) and lasts at least 24 hours. Symptoms are those commonly found in MS and may include optic neuritis, sensory or motor signs, partial myelitis and bladder or bowel dysfunction.  



In the January issue of Neurology®, a research team reported findings from an investigation of the spinal cord's involvement in diagnosing CIS as MS according the McDonald 2010 criteria

, and in predicting conversion to clinically definite MS (CDMS). In patients presenting brain symptoms (non-spinal CIS), who did not fulfill McDonald brain MRI criteria, having a spinal cord lesion was associated with a higher risk of conversion to CDMS (odds ratio: 14.4; 95%) and shorter time to conversion (hazard ratio: 51.4; 95%).  



This indicates that spinal cord lesions help diagnose MS and can predict conversion to CDMS, especially in patients with non-spinal CIS who do not fulfill brain MRI criteria.


Another recent study of brain MRIs found that the location of lesions may predict the conversion of CIS to multiple sclerosis. The study reviewed 1,165 CIS cases and found that CDMS developed in 26 percent of patients within one year. Patients who converted to CDMS had more lesions, but in fewer areas of the brain. Lesions were more concentrated in projection, association and commissural tracts of thewhite matter, particularly those that travel across fibers involved in motor function and close to the corpus callosum.


These findings suggest that both the presence of spinal cord lesions and location of brain lesions could help doctors predict CDMS in people with CIS.




Although it is currently impossible to predict with certainty which individuals will go on to develop clinically definite MS (CDMS), MRI is a powerful tool that helps separate high-risk vs. low-risk patients with CIS. Conventional MRI at the time of CIS can reveal lesions similar to those seen in MS, which increases the individual's future risk of a second clinical attack and a diagnosis of CDMS. Efforts to identify predictors of conversion from CIS to CDMS are important as they can help inform early treatment decisions. Spinal cord (SC) lesions are frequently found in multiple sclerosis (MS), but are rare in healthy aging and cerebrovascular patients.


It is not surprising that a higher baseline of brain lesion load is associated with early conversion to CDMS, but the relevance of anatomic lesion location to early conversion to CDMS in patients with different types of onset is novel. Results were similar overall when controlling for lesion volume. The review of brain MRIs, however, is limited by the short-term clinical follow-up of patients with CIS, and therefore longer follow-up times could be more informative in terms of long-term prognosis.




Peiqing Qian, M.D.


Multiple Sclerosis Center at Swedish Neurosciences Institute


MSCenterResearchMS Center Research


The MS-Vitamin D Connection 


The MS Center at Swedish is part of an investigation over the potential connection between Vitamin D levels and MS. The two-year study will look at the effects of taking a higher daily dose of Vitamin D (5,000 IU) compared to taking the normal amount recommended by the Institute of Medicine (600 IU). The goal of the study is to determine whether a higher dose may lower the risk of MS attacks or worsening. Research is sponsored by the National MS Society.


Learn more about our research and clinical trials, or call an MS Center research coordinator at 206-320-2200.

NewCenterOpenCall for Submissions: 2013 MS Art Show 



We are pleased to announce we're now accepting submissions for the 4th Annual Multiple Sclerosis Center Art Show. Save the date for July 6-7, 2013 at the Seattle Center Armory (formerly Center House).  


The MS Center invites all artists touched by MS and living in the Pacific Northwest to submit their work. If you've been diagnosed with MS, are a caregiver, family member, friend or colleague, we encourage all artists to get involved. The show's goal is to enhance wellness and quality of life through art for individuals affected by the disease.


To apply:

Entries are due no later than May 31st. Artists are encouraged to submit their work early to guarantee display at this year's show.  


For more information or to volunteer, visit or contact

DrQianMS Center News


MS Roadshow Coming to Tacoma


The MS Center at Swedish focuses on treating the whole person. Whether you are newly diagnosed or looking for more information to help improve your health, the MS Roadshow offers a look at the latest information to help you live well with MS.


The MS Center at Swedish will make its first Roadshow stop of 2013 in Tacoma on Friday, February 1. The treatment team will present this half-day workshop, with topics including:

  • MS 101 and Research Updates
  • Exercise and Rehabilitation
  • Employment and MS
  • Social Security and Disability
  • Cognitive Issues
  • Bladder and Bowel Issues

For more information or to register, visit or call 206.991.2099.


MSNewsMS News Digest

Cerebellar differences in Relapsing-Remitting MS


Researchers studying cerebellar signs in patients with Relapsing-Remitting Multiple Sclerosis (RRMS) may have learned about a distinct clinical subtype of the disease. A study found that RRMS patients with damage to the cerebellum had more problems with attention and language compared with those who did not. Both groups had similar neurodegenerative patterns in the bilateral thalami, confirming this part of the brain was involved with the functional changes associated with or resulting from RRMS. Researchers concluded that more severe or widespread cerebral damage may be a sign of a distinct clinical subtype of RRMS. Full abstract.


MS Center on Everyday Healthedh


Everyday Health has a new video series on living well with MS, featuring local individuals sharing their journey with MS and health insights from experts from the MS Center at Swedish.

MSEventsMS Center Programs & Events


MS Roadshow, Tacoma

Friday, Feb. 1, 2013 | 12:30 - 5 p.m. | Courtyard Marriott Downtown, Tacoma

Experts from the MS Center present this free traveling workshop of multiple sclerosis education and information. Register at


Introduction to Yoga

Feb. 19 | 1-2 p.m. | MS Center 

An informal, informational session about adaptive yoga and its benefits for multiple sclerosis. Learn what classes offered at the MS Center and which would be the best fit for you. Come with your questions about yoga practice for MS.

Patient Exercise Hours

Mondays, 8:30 a.m. - 12:30 p.m. | MS Center

A free, convenient and safe way to work out with MS. Please call to sign up.    


Music Therapy
Thursdays, Jan. 10 - Mar. 7 | 2:30-3:30 p.m. | MS Center

Free and open to non-Swedish patients and caregivers/partners. Call to register.

Beginners Aerobics with Bobbie Severson, ARNP

Wednesdays, Jan. 30-Mar. 20 | 1-1:45 p.m. | MS Center

Beginners aerobic exercises to improve function and motion. Free! Call to register.


Chair Aerobics with Bobbie Severson, ARNP

Wednesdays, Jan. 3-Mar. 20 | 2-2:45 p.m. | MS Center

Aerobic activity for those who prefer seated exercise. Free! Call to register.


Beginner's Gentle Yoga 

Thursdays, Feb. 28-Apr. 4 | 11 a.m.-12:30 p.m. | MS Center

Free for new students and open to non-Swedish patients and caregivers/partners. Call to register.


Stretch & Strengthen Yoga

Thursdays, Feb. 28-April 4 | 5:30 - 7 p.m. | MS Center

A more vigorous yoga workout for people living with MS. Requires ability to transition between standing and the floor without assistance. Open to non-Swedish patients. $12/class or $60/series. Call to register.


Social Security and Disability Workshop

March 21, 2013 | 6:15-8:30 p.m. | SECC at Swedish Cherry Hill

Learn about SSDI, when to apply and how to strengthen your application. Free. Call Alan Wittenberg, MSW, RC, 206-320-3830.


Coping Skills Group

Thursdays, 8 consecutive weeks | MS Center 

Led by MS psychologist Michelle Toshima, Ph.D., and Bobbie Severson, ARNP. Call Mike Taylor, PCC, 206-320-8223.  


To register for a class, contact Kate Floyd206.991.2099.