“I am reassured that 55% of MSers expect and effective neuroprotective therapy to stabilise of improve their disability progression; this is a realistic expectation and something that may be achievable with the strategies that are currently being pursued by various research groups across the world.”
“The corollary is that 45% of MSers are expecting to improve or recover function; this is a hard ask and is probably beyond what neuroprotective strategies can offer; i.e. treatments that prevent further nerve loss. To improve or restore function we need neurorestorative strategies; these are a long way off!”
Prof G; what is the point of slowing down progression? We will all still end up in wheelchairs. We want to be cured and to get back to normal.
Re: "what is the point of slowing down progression?"Most DMTs that are licensed in RRMS do just this; slowing progression even it is by a small amount can make a big difference over a time-frame of several years. Improvements in disease outcomes are usually incremental and therefore anything that positively impacts on disease outcomes must be welcomed. It appears that you are from the glass half-empty camp! We need to try be positive and upbeat; that in itself will help.
Aha I setect a difference between neuroprotective and neuroresorative, am I right?
Prof G, when you say "improve their disability progression," does tbat mean perhaps some marginal improvement in basic functionality such as improved balance or better typing with fingers?Sure, I'm all for some improvement but I wish they could come sooner rather than later. I also wish estimated dates could be give.I just want to have something to look forward to, something to keep going for. Just want some good news for a change.
Re: "Aha I setect a difference between neuroprotective and neuroresorative, am I right?"That is correct; neuroprotection is stopping nerves from dying and neurorestoration is replacing lost nerves and their connections and regaining lost function. Neuroprotection in progressive MS in unlikely to result in recovery of function as progressive MSers have usually exhausted the nervous system's ability to recover. In relapsing MS neuroprotection may allow recovery of function as the compensatory mechanism are not exhausted and allow other systems to compensate. These definitions are important as they establish the framework for treatment and what can be expected from a treatment.
Re "Prof G, when you say "improve their disability progression," does tbat mean perhaps some marginal improvement in basic functionality such as improved balance or better typing with fingers?"That is correct; there is some improvement in function but not back to normal. It could be a moderate or even a large improvement. This is sometimes seen in MSers with highly-active RRMS; suppressing inflammation allows the brain and spinal cord time to recover and regain some of the function. Whether the latter is due to restoration of lost nerves or compensation by existing or other nerve pathways is a moot point.