Recommendation 1: Research on the pathological changes underlying the natural course of MS should be emphasized, because it provides the key to predicting disease course in individual patients, understanding the physiological basis of MS, and a basis for developing improved therapeutic approaches.
Recommendation 2: Research should be pursued to identify how neurons are damaged in MS, how this damage can be prevented, and how oligodendrocytes and astrocytes are involved in damage and repair processes.
Recommendation 3: The genes that underlie genetic susceptibility to MS should be identified, because genetic information offers such a powerful tool to elucidate fundamental disease processes and prognosis, and to develop new therapeutic approaches.
Recommendation 4: Because the discovery of an MS pathogen would likely provide the single most important clue for identifying effective treatments, this search must remain a high priority, but it should be conducted using powerful new and efficient methods.
Recommendation 5: Research to identify the cascade of immune system events that culminates in the destruction of myelin should remain a priority.
Recommendation 6: The power of neuroimaging as a tool for basic research and for clinical assessment should be taken advantage of more extensively.
Recommendation 7: Animal models should be developed that more faithfully mirror the features of MS and permit the analysis of how specific molecules and cells contribute to the disease process.
Recommendation 8: Strategies for protection and repair of neural cells, including the use of neuroprotective factors as well as stem cells, hold great promise for the treatment of MS and should be a major research priority.
Recommendation 9: New, more effective therapeutic approaches to symptom management should be pursued, including those directed at neuropathic pain and sensory disturbances.
Recommendation 10: In the absence of any fully effective therapies, integrated approaches for the delivery of currently available therapeutic agents should be investigated.
Recommendation 11: Better strategies should be developed to extract the maximum possible scientific value from MS clinical trials.