The committee supplemented its expertise through a series of background papers and three workshops. The background papers were written for the committee by experts on the different complications of MS such as pain, fatigue, and bladder problems (see Appendix B for the list of expert consultants). Each workshop was organized as a combined information-gathering and brainstorming session on one of the following themes: new technologies and research on the mechanism of disease in MS, new opportunities for the treatment of neurological disease, and research toward improving the quality of life for people with MS (see Appendix C for a list of workshop participants). To supplement the committee members' own experience treating MS patients, they also met with several people—some of whom have MS themselves—who work with MS patients in a variety of nonresearch settings, including nursing, outdoor adventures, and the Jimmie Heuga Center, an exercise and life-style management facility for people with MS.
Among the important audiences for this report are the architects and developers of multiple sclerosis research programs. The report covers a broad spectrum of MS research, ranging from strategies to develop treatments that impede the disease process, to treatments for specific symptoms, to research aimed at promoting successful adaptations to the illness including optimizing the abilities of people with MS to function in their daily lives. Throughout the study, the committee sought to identify windows of opportunity for research, such as those created by new discoveries about the self-repair mechanisms of the brain or new disease-specific changes in gene activation. The committee also sought to identify research needs where the windows of opportunity are less transparent, such as the development of evidence-based approaches for addressing the varied information needs of people with MS and for treating the fatigue and pain that so often accompany MS.
Ultimately, however, this report is for people with MS. It represents another chapter in the efforts of the National Multiple Sclerosis Society to conquer MS. Thus, the report also attempts to provide a readable, comprehensive review of what is currently known about MS, what needs to be learned, and the promises that research holds in the near future.
Chapter 2 reviews what is known about the clinical and biological aspects of MS, including possible causes of the disease and the destructive mechanisms that leave the brain and spinal cord unable to perform their normal functions. It also reviews the research tools that hold the greatest promise to reveal those underlying disease mechanisms.