The ECTRIMS Podcast

Prof. Sandra Vukusic has been named the 2026 recipient of the Rachel Horne Prize for Women's Research in MS.

In this special episode of the ECTRIMS Podcast, Sandra joins prize founder Rachel Horne and host Brett Drummond to mark the announcement and explore the research behind the recognition.

Sandra reflects on a career dedicated to improving the health and care of women living with multiple sclerosis, beginning with early research into pregnancy and postpartum relapse and evolving to encompass family planning, disease-modifying treatment, breastfeeding, menopause and wider aspects of women's health.

The conversation explores important evidence that women living with MS may be undertreated compared with men, including the potential influence of anticipated pregnancy on treatment decisions. Sandra also discusses how advances in research are helping women living with MS make choices about treatment and family life that were once considered impossible.

Rachel shares why she established the Rachel Horne Prize, the persistent gaps she saw in research addressing women's health in MS, and her hope that one day women's health will simply be an integral part of MS research and care.

A special conversation celebrating scientific achievement, progress — and the work still to come.

In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Prof. Jeremy Chataway of University College London and Prof. Daniel Ontaneda of Cleveland Clinic about multi-arm, multi-stage clinical trials and their potential to make MS research more efficient and responsive.

The episode comes at an especially timely moment. This week, interim results from the OCTOPUS trial showed that alpha-lipoic acid will progress to the next stage of the trial, while the metformin arm will be stopped. These results provide an early demonstration of the adaptive approach discussed in this episode — although the conversation itself was recorded before the interim results were available.

Together, they discuss:

• How multi-arm, multi-stage trials differ from traditional clinical trial designs
• Why these approaches could be particularly valuable in progressive multiple sclerosis
• How a single trial framework can allow promising treatments to advance while less promising approaches are stopped
• The potential benefits for recruitment, participant experience and reducing the time between trial phases
• The statistical and practical challenges involved in designing and running these complex studies
• How interim outcomes, imaging and biomarkers could help identify promising treatments earlier
• What the OCTOPUS trial is investigating — and how its design is being used to evaluate potential treatments for progressive MS
• Whether the same approach could be used to accelerate the development of remyelination and repair therapies

As the first OCTOPUS interim results now show, the adaptive design discussed in this episode is not simply theoretical. This episode offers a particularly relevant look at the thinking behind the trial and the methodology being used to determine which treatments should move forward and which should not.

This podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases, Bristol Myers Squibb, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.

The blood–brain barrier is a highly specialised interface that regulates the movement of cells, molecules and nutrients between the circulation and the central nervous system.

But what happens when this critical barrier becomes dysfunctional in multiple sclerosis?

In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Prof. Elga de Vries of Amsterdam UMC and MS Center Amsterdam about the evolving science of blood–brain barrier dysfunction in MS.

They explore how the blood–brain barrier functions in health, how its disruption relates to immune cell infiltration and inflammatory disease activity, and why research increasingly suggests these changes may remain relevant across different stages of MS.

The conversation also looks at innovative blood–brain barrier-on-a-chip models, how existing MS treatments interact with the barrier, and emerging approaches designed to transport therapies more effectively into the CNS.

Finally, they consider an intriguing future direction: could strengthening the blood–brain barrier itself become part of the therapeutic strategy for MS?

This podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases, Bristol Myers Squibb, Roche, Sanofi, and UCB.

Can growing amounts of real-world MS data help clinicians predict disease progression and make more personalised treatment decisions?

In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Dr. Will Brown from Cambridge University and Dr. Carmen Tur from CEMCAT about the rapidly evolving field of predictive modelling in multiple sclerosis.

They explore why MS is particularly difficult to predict, from its biological and clinical heterogeneity to the lack of sufficiently sensitive, specific and widely available biomarkers. They also discuss how increasingly rich, long-term datasets are allowing researchers to study disease outcomes, treatment journeys and populations traditionally underrepresented in clinical trials.

The conversation examines the methodological challenges that come with real-world data, including missing data, non-random treatment allocation, clinical outcome selection and bias, as well as the opportunities and limitations of AI and machine learning.

Finally, they ask what must happen before predictive models can enter routine clinical care — including robust external validation, calibration, interpretability, equitable representation and evidence that using these tools actually improves clinical decisions and long-term patient outcomes.

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This podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases, Bristol Myers Squibb, Novartis, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.

Technology is opening new possibilities for how multiple sclerosis is monitored, treated and managed.

In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Prof. Ellen Mowry of Johns Hopkins University and Prof. Letizia Leocani of Vita-Salute San Raffaele University about how innovative medical technologies could transform MS research and clinical care.

Together, they explore:

• How artifical intelligence, wearable devices and digital biomarkers could help monitor MS progression
• The potential to capture fatigue, cognition, pain, mood, sleep and other symptoms between clinical visits
• How passive monitoring could provide a more complete picture of everyday life with MS
• The growing role of virtual rehabilitation, digital therapies and other technologies in bringing care into people's homes
• Why digital biomarkers require rigorous research and validation before being used in clinical trials

From earlier detection of disability progression to more accessible rehabilitation and personalised symptom management, this episode examines both the opportunities and challenges of using technology to improve MS care.

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This podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases, Bristol Myers Squibb, Novartis, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.

Could multiple sclerosis one day be detected before symptoms appear? And if so, should we be actively screening people who are at higher risk?

In this episode of the ECTRIMS–MS Journal collaboration series, host Prof. Anneke van der Walt, Controversies Editor at the Multiple Sclerosis Journal, is joined by Prof. Helen Tremlett (University of British Columbia) and Prof. Ruth Ann Marrie (Dalhousie University) to debate one of the most important emerging questions in MS research.

Helen argues that targeted screening should begin now—but only within carefully designed research studies—to better understand how MS develops before clinical symptoms appear. Ruth Ann argues that while prevention is the ultimate goal, the science, ethics and healthcare systems are not yet ready for widespread screening.

Together they discuss:

· Whether MS is entering a new era of prevention research

· What lessons can be learned from Parkinson's disease and radiologically isolated syndrome (RIS)

· The ethical and psychological impact of identifying people at risk before symptoms develop

· How screening programmes could improve—or worsen—health inequalities

· What research is still needed before screening could ever become part of routine clinical practice

Although they argue opposing positions, both experts agree on one important point: preventing MS is an achievable ambition—but only if research proceeds carefully, ethically and equitably.

This MS Journal Controversies article series has been made open access for the next month for ease of reading.

• "Yes" – High-risk populations should be screened for MS
• "No" – High-risk populations should not yet be screened for MS
• "Commentary" – High-risk populations should not yet be screened for MS

Note: This episode is part of the MS Journal Controversies in MS series, where experts debate opposing viewpoints on important unresolved questions in MS research. The positions argued do not necessarily represent the authors' personal opinions, but rather present the strongest evidence supporting each side of the debate.

Where someone lives can profoundly influence their multiple sclerosis journey.

While advances in diagnosis and treatment have transformed MS care in many parts of the world, millions of people still face significant barriers to diagnosis, specialist care and life-changing therapies.

In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Dr. Fiifi Duodu and Prof. Alfredo Damasceno about the realities of managing MS patients in diverse healthcare settings and what can be done to improve equity worldwide.

Together, they discuss:

🔹 Why MS diagnosis can take years in some regions, and how the revised 2024 McDonald Criteria are influencing earlier MS diagnosis

🔹 The impact of limited access to neurologists and MRI

🔹 Barriers to disease-modifying therapies and anti-CD20 treatments

🔹 The role of regional initiatives such as AFRICTRIMS and BCTRIMS

🔹 Why greater diversity in MS clinical trials matters

This episode highlights both the challenges and the remarkable progress being made to improve MS care across the globe.

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This ECTRIMS podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases. Bristol Myers Squibb, Novartis, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.

Welcome to MS Research Briefs, a new ECTRIMS podcast series delivering an expert guided tour of important new studies in multiple sclerosis research.

In each episode, leading MS experts will take a small number of recently published studies and go beyond the headline findings – exploring what the research shows and how it may influence clinical practice and future discovery.

In this inaugural episode, Prof. Alan Thompson and Prof. Olga Ciccarelli discuss two studies exploring how advanced MRI biomarkers and machine learning may transform the diagnosis and prognosis of multiple sclerosis.

• Paramagnetic Rim Lesions and Development of Clinical MS in Radiologically Isolated Syndrome.JAMA Neurology. 2026;83(3):250–258.
• Machine learning-based combination of the central vein sign, cortical lesions and paramagnetic rim lesions: a web-based tool for the diagnosis of multiple sclerosis.Brain Communications. 2026;8(2):fcag079.

• Can paramagnetic rim lesions identify individuals with radiologically isolated syndrome (RIS) who are most likely to develop clinical MS?
• Why do paramagnetic rim lesions appear to be stronger prognostic biomarkers while the central vein sign remains a powerful diagnostic biomarker?
• Can machine learning models combining MRI biomarkers outperform traditional dissemination-in-space criteria?
• What role might advanced MRI biomarkers play in future diagnostic criteria and treatment decisions?
• How close are we to AI-supported diagnosis and automated biomarker detection in routine clinical practice?

As advanced MRI biomarkers move from research tools towards clinically meaningful decision-making, this episode explores one of the most important developments in contemporary MS research.

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This ECTRIMS podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases. Bristol Myers Squibb, Novartis, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.

Vitamin D and multiple sclerosis have been linked for decades, but how strong is the evidence – and what does it mean for clinical practice?

In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Prof. Eric Thouvenot from University Hospital of Nimes and Dr. Deborah Mason from Christchurch Hospital about the evolving science behind vitamin D and MS.

Together, they explore:

• Why vitamin D deficiency is associated with increased MS risk
• The influence of latitude, sunlight exposure and genetics
• How vitamin D affects immune regulation and inflammation
• Findings from recent vitamin D supplementation trials

As researchers continue to investigate vitamin D's role in MS, this episode provides a balanced look at what we know, what remains uncertain, and what it means for patient care.

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This ECTRIMS podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases. Bristol Myers Squibb, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.

In this episode of the ECTRIMS Podcast, recorded in collaboration with the Multiple Sclerosis Journal "Controversies in MS" series, host Prof. Anneke van der Walt moderates a discussion between Prof. Andy Solomon and Prof. Enrique Gómez on one of the most debated developments in modern multiple sclerosis diagnosis.

Together, they explore:

• Why misdiagnosis remains a major challenge in MS care • The role of the central vein sign (CVS) and paramagnetic rim lesions (PRLs) in improving specificity • Whether expanding diagnostic sensitivity may increase false positives • The practical realities of implementing advanced MRI biomarkers globally • The importance of radiology training, implementation science, and AI-assisted imaging • How clinicians should approach MRI interpretation in real-world practice

This conversation examines the balance between earlier diagnosis, diagnostic accuracy, and equitable implementation of emerging diagnostic tools across different healthcare settings.

This episode is part of the MS Journal Controversies in MS series on The revised 2024 McDonald criteria can solve the misdiagnosis problem in MS. The accompanying Yes, No, and Commentary articles are available to read open access for the next month, compliments of MS Journal.