How MRI and OCT are Changing Multiple Sclerosis Diagnosis, Prognosis, and Treatment

Day One at MSToronto2026 – and we're taking you inside one of the meeting's headline lectures. Our special MSToronto2026 podcast series continues with Daniel Reich – the MSToronto2026 Lecturer – as he joins host Brett Drummond to reflect on some of the key takeaways from the first full day in Toronto. Then, we go deeper. What if imaging could help us connect the dots in MS - from disease mechanisms to networks to the person living with MS? Fresh from his lecture, Unifying Multiple Sclerosis: Imaging from Teams to Tissue to Biology, Daniel takes the conversation beyond the stage: · What can imaging reveal about the biology driving MS? · How is it changing the way we understand what is happening in the brain? · And where could the next generation of imaging take MS research? Recorded direct from Toronto, our MSToronto2026 series is only getting started. Follow the ECTRIMS Podcast as we bring you new conversations and highlights direct from Toronto throughout the Joint Meeting. --- 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.

The ECTRIMS Podcast is on the ground at MSToronto2026 – bringing you the conversations, insights and highlights as they happen. Kicking off our special MSToronto2026 Joint Meeting Series, Ann Yeh joins host Brett Drummond direct from Toronto to unpack the highlights of Pre-Day. Before the 10th Joint ACTRIMS-ECTRIMS Meeting officially begins, Pre-Day puts the spotlight on paediatric MS and related neuroinflammatory diseases – and some of the important questions shaping the field right now. What stood out? What should clinicians and researchers take away? And which conversations are already setting the stage for the meeting ahead? 🎙️ This is just the beginning. Listen now, and follow the ECTRIMS Podcast throughout MSToronto2026 as we bring you new episodes direct from Toronto across the week. --- LAND ACKNOWLEDGEMENT MSToronto2026 takes place in Toronto, Canada, on the traditional territory of many nations, including the Mississaugas of the Credit, the Anishnabeg, the Chippewa, the Haudenosaunee and the Wendat peoples. Toronto is now home to many diverse First Nations, Inuit and Métis peoples. We also acknowledge that Toronto is covered by Treaty 13 with the Mississaugas of the Credit. --- 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.

Can clinicians identify MS progression as it happens, or does confirming meaningful disability worsening require months of observation? Early recognition of multiple sclerosis (MS) progression is critical to informing clinical decisions. Yet distinguishing genuine disease progression from temporary fluctuations remains one of the challenges in routine MS care. In this episode of the ECTRIMS Podcast, produced in collaboration with the Multiple Sclerosis Journal, host Associate Professor Anneke van der Walt is joined by Professor Helmut Butzkueven (Monash University, Australia) and Professor Tjalf Ziemssen (University Hospital Dresden, Germany) to explore both sides of a timely clinical controversy: Can we detect a progression event in an MS clinic in real time? Drawing on opposing perspectives published in the Multiple Sclerosis Journal, the discussion examines the value and limitations of disability assessments, longitudinal patient registries, digital monitoring tools and patient-reported changes. Can routinely collected clinical data help clinicians recognise progression earlier? How reliable are current measures such as the Expanded Disability Status Scale (EDSS)? And what can clinicians do to identify meaningful change when consultation time and resources are limited? The conversation highlights the importance of balancing early recognition with diagnostic certainty, while keeping the patient's lived experience central to clinical assessment. Read the accompanying publications in the Multiple Sclerosis Journal: YES – Can we detect a progression event in an MS clinic in real time? https://journals.sagepub.com/doi/full/10.1177/13524585251409568 NO – Can we detect a progression event in an MS clinic in real time?https://journals.sagepub.com/doi/full/10.1177/13524585251409547 Accompanying commentary https://journals.sagepub.com/doi/full/10.1177/13524585251409579 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.

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.

What if clinical trials could evaluate multiple treatment approaches at the same time and adapt as evidence emerges? 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.