Detecting Progression in Multiple Sclerosis With Wearables and Imaging: Jacqueline Nicholas, MD, MPH

WATCH TIME: 3 minutes

"Many of us, including myself, still feel that actually listening to the patient is the most important tool because the patient will tell you what's happening."

Advancements in multiple sclerosis (MS) management are being propelled by the integration of modern tools and frameworks. Emerging digital health technologies, such as virtual reality and e-Health platforms, provide innovative ways to assess and treat MS-related fatigue, offering adaptable solutions tailored to individual patient needs. In addition to these tools, advanced imaging and diagnostic methods are transforming clinical practice, paving the way for more personalized and effective management strategies. Together, these developments reflect a broader shift toward precise, patient-centered care in MS treatment.

This evolving approach was the focus of a symposium at the 2025 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, held February 27 to March 1, in West Palm Beach, Florida. The symposium explored the growing recognition of MS as a disease spectrum, emphasizing the importance of early, informed treatment decisions to address both relapsing and progressive forms. Experts discussed the limitations of many disease-modifying therapies in halting progression and examined the role of emerging biomarkers and novel therapies in optimizing disease management. Chaired by Stephen Krieger, MD, FAAN, and featuring speakers such as Jacqueline Nicholas, MD, MPH, and Enrique Alvarez, MD, PhD, participants engaged in case-based discussions to refine clinical strategies, improve patient-centered care, and incorporate more effective monitoring tools.

During the Forum, Nicholas, system chief of neuroimmunology and multiple sclerosis at OhioHealth, shared her insights in an interview with NeurologyLive^®, emphasizing the challenge of detecting gradual MS progression, particularly smoldering inflammation, which is often overlooked in traditional clinical assessments. She highlighted the potential of digital biomarkers, such as wearables, to capture continuous, real-world data on mobility, sleep, and symptom changes outside of clinic visits. Additionally, she discussed advancements in imaging techniques, including AI-driven MRI analysis and the identification of paramagnetic rim lesions and central vein signs, which promise to enhance MS diagnosis and ongoing patient monitoring.

Click here for coverage of 2025 ACTRIMS Forum.

REFERENCES
1. Krieger K, Nicholas J, Alvarez E. Time for a Reset: Using Modern Tools and Frameworks to Reengineer Multiple Sclerosis Management. Presented at ACTRIMS Forum 2025; February 27 to March 1; West Palm Beach, Florida. SS3.