Multiple Sclerosis: Current Status and Strategies for the Future

EXECUTIVE SUMMARY INTRODUCTION The U.S. National Multiple Sclerosis Society Recent Advances in MS Origin of the Study Previous Reviews of MS Research Programs The IOM Committee and Its Mandate How the Committee Carried Out its Task Organization of the Report References CLINICAL AND BIOLOGICAL FEATURES The Clinical Picture: Symptoms, Disease Course, Variation, And Diagosis Underlying Disease Mechanisms Animal Models of MS References CHARACTERISTICS AND MANAGEMENT OF MAJOR SYMPTOMS Cognitive Impairment Depression Spasticity and Weakness Ataxia and Tremor Bladder and Bowel Dysfunctions Visual Disturbances Fatigue Sexual Dysfunction Pain References DISEASE MANAGEMENT AND MEASUREMENT Living with MS Measuring Functional Status and Quality of Life Assistance Information and Communication Health Care References STRATEGIES FOR FUTURE RESEARCH ON DISEASE MECHANISMS Technologies and Research Strategies References FUTURE STRATEGIES FOR THERAPIES Strategies for Disease Modification Challenges in MS Clinical Trials Shared Resources References BUILDING AND SUPPORTING THE RESEARCH ENTERPRISE Research Funding Human Resources Infrastructure Clinical Trials Biotechnology and Pharmaceutical Firms Health Care Research Role of Voluntary Health Organizations References RECOMMENDATIONS Etiology and Pathogenesis Tools for Research and Diagnosis Therapeutics Health Status and Quality of Life Research Enterprise References APPENDIXES A Committee and Staff Biographies B List of Expert Consultants C Workshop Agendas D Kurtzke's Expanded Disability Status Scale E Drugs Used in the Treatment of MS F U.S. Social Security Administration's Criteria for Qualifying as Disabled from MS G Treatments That Have Been Claimed to Be of Benefit in MS INDEX

Janet E. Joy and Richard B. Johnston, Jr., Editors, Committee on Multiple Sclerosis: Current Status and Strategies for the Future, Board on Neuroscience and Behavioral Health