The committee feels that each of the research strategies listed below should be actively supported. However, which among them should take priority at any one time should be determined by a mix of scientific opportunity and institutional concerns, which will be different for different organizations, be they federal research sponsors or charitable health organizations. The most productive research strategies for an organization such as the MS Society will be influenced by the activities (or lack thereof) of the relevant federal agencies such as the National Institutes of Health, Agency for Healthcare Research and Quality, Veteran's Administration, and the National Institute on Disability and Rehabilitation Research, as well as those of other private organizations that sponsor research relevant to MS.
This chapter does not include numerous other committee recommendations that cover specific aspects of MS-related research, especially the recommendations dealing with specific symptoms or alternative medicine. These areas of research are covered individually in the pertinent chapters. The recommendations below are for research areas that the committee believes hold the greatest promise for developing treatments that can prevent or cure MS and for improving the lives of people with MS. They are organized into specific recommendations for the following:
research to understand the basic disease mechanisms, and specifically, the cellular and molecular events of MS;
tools for research and diagnosis;
research on new therapeutic approaches;
research toward improving the lives of people with MS; and
programs to promote progress in MS research.
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.
Unpredictability imposes a particularly acute burden on people with MS. They have no way of knowing when a relapse will occur, how impaired they will be, or whether they will recover from the relapse. Yet it is now clear that disease activity precedes relapses. Understanding these pathological changes is the first step toward predicting—at least in the short term—disease progression in individual patients.