This video features a panel discussion from the ECTRIMS 2025 conference on modern strategies for preserving brain health in patients with Multiple Sclerosis (MS). Chaired by Prof. Gavin Giovannoni, the panel includes neurologists Dr. Riley Bove and Dr. Leorah Freeman, along with patient ambassador Stanca Potra. The discussion advocates for a paradigm shift in MS care, moving beyond disease-modifying therapies to a holistic and proactive model focused on long-term brain health and enabling patients to "age well." Key topics include the critical role of lifestyle modifications (diet, exercise, sleep), the neurologist's responsibility to lead these conversations, and innovative care models like integrated lifestyle medicine specialists and shared medical appointments. The panel also addresses often-overlooked areas crucial for brain health, such as proactive management of menopause, screening for comorbidities like sleep apnea, and addressing social determinants of health like loneliness and poverty. The session concludes with a call to action for healthcare professionals to "walk the talk" by prioritizing their own brain health.
Protecting Brain Health in MS: A Holistic Approach to Patient Care
0:32 The Goal: Aging Well with MS: The session's objective is to shift the focus of MS care beyond disease management to a holistic approach that optimizes long-term brain health, allowing patients to thrive.
2:27 A Realistic Expectation: Dr. Leorah Freeman asserts that with early diagnosis, high-efficacy treatments, and a focus on lifestyle, it is a realistic goal for patients with MS to reach old age with a healthy brain.
3:23 A Patient's Perspective on Proactive Care: Patient ambassador Stanca Potra highlights a common issue: patients often address lifestyle factors like diet and stress reactively, only after a problem arises, rather than using them as a preventive tool for long-term well-being.
5:23 Expanding the Neurologist's Role: The panel argues that MS neurologists should take the lead in brain health discussions rather than deferring to primary care. Dr. Freeman describes an innovative model at her center that integrates a lifestyle medicine specialist and uses shared medical appointments to provide coaching and peer support.
9:07 Proactively Managing Menopause: Dr. Riley Bove emphasizes the need to educate women in their 40s about menopause, as its symptoms (fatigue, cognitive changes, sleep loss) significantly overlap with MS and can be mistaken for disease progression.
11:00 Addressing Social Determinants: The discussion underscores the importance of social factors. Loneliness is a major issue, and environmental barriers, such as an unsafe neighborhood, can prevent patients from engaging in physical activity.
14:22 The Power of Community and Empowerment: Stanca Potra explains that support groups are vital for creating a community that empowers patients to take charge of their self-care and feel confident raising important questions with their neurologists.
15:23 Key Supplements and Nutrition: In addition to a healthy diet like the Mediterranean or MIND diet, the panel notes that supplements such as Vitamin D, Omega-3s, CoQ10, and magnesium can be beneficial for heart health and managing symptoms like fatigue and anxiety.
16:44 The Need for Comprehensive Screening: The panel stresses that brain health is connected to whole-body health. Neurologists should proactively screen for overlooked conditions common in MS, including sleep apnea, poor foot health (especially in disabled patients), and gynecological issues.
21:10 A Call to Action for Clinicians: Prof. Giovannoni concludes that for healthcare providers to be credible advocates for brain health, they must "walk the talk" by actively managing their own diet, exercise, sleep, and mental well-being.