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Multiple Sclerosis Lecture Series: MS 101


Multiple Sclerosis Lecture Series: MS 101 Banner

  • Overview
  • Faculty
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Date & Location
Tuesday, May 31, 2022, 12:00 AM - Friday, May 30, 2025, 11:59 PM, On Demand

Overview

Internet Enduring Material sponsored by Stanford University School of Medicine. Presented by the Stanford University School of Medicine's Department of Neurology and Center for Continuing Medical Education.

Have you encountered a patient with Multiple Sclerosis? This disease affects 2.8 million people worldwide, with a disproportionate number in the United States. Listen to recent research that has increased understanding of the connection between Epstein-Barr Virus and Multiple Sclerosis. Topics discussed include the basics of Multiple Sclerosis genetic predisposition, risk factors, potential triggers, and ways to modify behavior and diet to reduce disease progression.


Registration
     Release Date: May 31, 2022
     Expiration Date: May 30, 2025
     Estimated Time to Complete: 35 minutes 
     Registration Fee: FREE 

Credits
AMA PRA Category 1 Credits™ (0.50 hours), Non-Physician Participation Credit (0.50 hours)

Target Audience
Specialties - Allergy, Immunology, & Rheumatology, Neurology
Professions - Fellow/Resident, Non-Physician, Physician, Student

Objectives
At the conclusion of this activity, learners should be able to:

  1. Summarize the epidemiology of Multiple Sclerosis.
  2. Recognize risk factors associated with Multiple Sclerosis.
  3. Recall the connection between the gut microbiome and Multiple Sclerosis.

Accreditation

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 0.50 AMA PRA Category 1 CreditsTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 


Additional Information

Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography

Alfredsson, Lars, and Tomas Olsson. “Lifestyle and Environmental Factors in Multiple Sclerosis.” Cold Spring Harbor Perspectives in Medicine 9, no. 4 (April 1, 2019): a028944. https://doi.org/10.1101/cshperspect.a028944.
Alotaibi, Suad, Julia Kennedy, Raymond Tellier, Derek Stephens, and Brenda Banwell. “Epstein-Barr Virus in Pediatric Multiple Sclerosis.” JAMA 291, no. 15 (April 21, 2004): 1875–79. https://doi.org/10.1001/jama.291.15.1875.
“Anti-Epstein–Barr Virus Antibodies as Serological Markers of Multiple Sclerosis: A Prospective Study among United States Military Personnel - KL Munger, LI Levin, EJ O’Reilly, KI Falk, A Ascherio, 2011.” Accessed May 9, 2022. https://journals.sagepub.com/doi/10.1177/1352458511408991.
Ascherio, Alberto, and Kassandra L. Munger. “EBV and Autoimmunity.” In Epstein Barr Virus Volume 1: One Herpes Virus: Many Diseases, edited by Christian Münz, 365–85. Current Topics in Microbiology and Immunology. Cham: Springer International Publishing, 2015. https://doi.org/10.1007/978-3-319-22822-8_15.
Bjornevik, Kjetil, Marianna Cortese, Brian C. Healy, Jens Kuhle, Michael J. Mina, Yumei Leng, Stephen J. Elledge, et al. “Longitudinal Analysis Reveals High Prevalence of Epstein-Barr Virus Associated with Multiple Sclerosis.” Science 375, no. 6578 (January 21, 2022): 296–301. https://doi.org/10.1126/science.abj8222.
Camara-Lemarroy, Carlos R., Luanne M. Metz, and V. Wee Yong. “Focus on the Gut-Brain Axis: Multiple Sclerosis, the Intestinal Barrier and the Microbiome.” World Journal of Gastroenterology 24, no. 37 (October 7, 2018): 4217–23. https://doi.org/10.3748/wjg.v24.i37.4217.
Cekanaviciute, Egle, Bryan B. Yoo, Tessel F. Runia, Justine W. Debelius, Sneha Singh, Charlotte A. Nelson, Rachel Kanner, et al. “Gut Bacteria from Multiple Sclerosis Patients Modulate Human T Cells and Exacerbate Symptoms in Mouse Models.” Proceedings of the National Academy of Sciences 114, no. 40 (October 3, 2017): 10713–18. https://doi.org/10.1073/pnas.1711235114.
Cosorich, Ilaria, Gloria Dalla-Costa, Chiara Sorini, Roberto Ferrarese, Maria Josè Messina, Jayashree Dolpady, Elisa Radice, et al. “High Frequency of Intestinal TH17 Cells Correlates with Microbiota Alterations and Disease Activity in Multiple Sclerosis.” Science Advances 3, no. 7 (n.d.): e1700492. https://doi.org/10.1126/sciadv.1700492.
“Disability Statistics.” Accessed May 9, 2022. https://www.disabilitystatistics.org/.
Duscha, Alexander, Barbara Gisevius, Sarah Hirschberg, Nissan Yissachar, Gabriele I. Stangl, Eva Eilers, Verian Bader, et al. “Propionic Acid Shapes the Multiple Sclerosis Disease Course by an Immunomodulatory Mechanism.” Cell 180, no. 6 (March 19, 2020): 1067-1080.e16. https://doi.org/10.1016/j.cell.2020.02.035.
Goodin, Douglas S. “The Epidemiology of Multiple Sclerosis.” In Handbook of Clinical Neurology, 122:231–66. Elsevier, 2014. https://doi.org/10.1016/B978-0-444-52001-2.00010-8.
Handel, Adam E., Alexander J. Williamson, Giulio Disanto, Lahiru Handunnetthi, Gavin Giovannoni, and Sreeram V. Ramagopalan. “An Updated Meta-Analysis of Risk of Multiple Sclerosis Following Infectious Mononucleosis.” PLOS ONE 5, no. 9 (September 1, 2010): e12496. https://doi.org/10.1371/journal.pone.0012496.
Hedström, Anna K, Tomas Olsson, and Lars Alfredsson. “High Body Mass Index before Age 20 Is Associated with Increased Risk for Multiple Sclerosis in Both Men and Women.” Multiple Sclerosis Journal 18, no. 9 (September 1, 2012): 1334–36. https://doi.org/10.1177/1352458512436596.
Hernán, Miguel A., Michael J. Oleky, and Alberto Ascherio. “Cigarette Smoking and Incidence of Multiple Sclerosis.” American Journal of Epidemiology 154, no. 1 (July 1, 2001): 69–74. https://doi.org/10.1093/aje/154.1.69.
National Multiple Sclerosis Society. “How Many People Live with MS?” Accessed May 9, 2022. https://www.nationalmssociety.org/What-is-MS/Who-Gets-MS/How-Many-People.
Kamm, Christian P., Bernard M. Uitdehaag, and Chris H. Polman. “Multiple Sclerosis: Current Knowledge and Future Outlook.” European Neurology 72, no. 3–4 (2014): 132–41. https://doi.org/10.1159/000360528.
Kasper, L. “The Gut Microbiome Affects the Progression of Disease in a Murine Model of Secondary Progressive MS.” Accessed May 9, 2022. https://onlinelibrary.ectrims-congress.eu/ectrims/2016/32nd/146305/lloyd.h.kasper.the.gut.microbiome.affects.the.progression.of.disease.in.a.html.
Lanz, Tobias V., R. Camille Brewer, Peggy P. Ho, Jae-Seung Moon, Kevin M. Jude, Daniel Fernandez, Ricardo A. Fernandes, et al. “Clonally Expanded B Cells in Multiple Sclerosis Bind EBV EBNA1 and GlialCAM.” Nature 603, no. 7900 (March 2022): 321–27. https://doi.org/10.1038/s41586-022-04432-7.
Lee, Yun Kyung, and Sarkis K. Mazmanian. “Has the Microbiota Played a Critical Role in the Evolution of the Adaptive Immune System?” Science 330, no. 6012 (December 24, 2010): 1768–73. https://doi.org/10.1126/science.1195568.
Levin, Lynn I., Kassandra L. Munger, Eilis J. O’Reilly, Kerstin I. Falk, and Alberto Ascherio. “Primary Infection with the Epstein-Barr Virus and Risk of Multiple Sclerosis.” Annals of Neurology 67, no. 6 (2010): 824–30. https://doi.org/10.1002/ana.21978.
Ligouri, M., M.G. Marrosu, M. Pugliatti, F. Giuliani, F. De Robertis, E. Cocco, G.B. Zimatore, P. Livrea, and M. Trojano. “Age at Onset in Multiple Sclerosis.” Neurological Sciences 21, no. 2 (December 1, 2000): S825–29. https://doi.org/10.1007/s100720070020.
Lill, Christina M. “Recent Advances and Future Challenges in the Genetics of Multiple Sclerosis.” Frontiers in Neurology 5 (2014). https://www.frontiersin.org/article/10.3389/fneur.2014.00130.
Manouchehrinia, Ali. “Tobacco Smoking and Disability Progression in Multiple Sclerosis: United Kingdom Cohort Study | Brain | Oxford Academic.” Accessed May 9, 2022. https://academic.oup.com/brain/article/136/7/2298/277962?login=false.
Science. “Multiple Sclerosis Genomic Map Implicates Peripheral Immune Cells and Microglia in Susceptibility.” Accessed May 9, 2022. https://www.science.org/doi/10.1126/science.aav7188.
Munger, Kassandra L., Tanuja Chitnis, and Alberto Ascherio. “Body Size and Risk of MS in Two Cohorts of US Women.” Neurology 73, no. 19 (November 10, 2009): 1543–50. https://doi.org/10.1212/WNL.0b013e3181c0d6e0.
MS International Federation. “Muscular Sclerosis International Federation.” Accessed May 9, 2022. https://www.msif.org/.
Negrotto, Laura, Mauricio F. Farez, and Jorge Correale. “Immunologic Effects of Metformin and Pioglitazone Treatment on Metabolic Syndrome and Multiple Sclerosis.” JAMA Neurology 73, no. 5 (May 1, 2016): 520–28. https://doi.org/10.1001/jamaneurol.2015.4807.
Nourbakhsh, Bardia, and Ellen M. Mowry. “Multiple Sclerosis Risk Factors and Pathogenesis.” CONTINUUM: Lifelong Learning in Neurology 25, no. 3 (June 2019): 596. https://doi.org/10.1212/CON.0000000000000725.
MS International Federation. “Number of People with MS | Atlas of MS.” Accessed May 9, 2022. https://www.atlasofms.org/map/united-states-of-america/epidemiology/number-of-people-with-ms.
Ochoa-Repáraz, J., D. W. Mielcarz, Y. Wang, S. Begum-Haque, S. Dasgupta, D. L. Kasper, and L. H. Kasper. “A Polysaccharide from the Human Commensal Bacteroides Fragilis Protects against CNS Demyelinating Disease.” Mucosal Immunology 3, no. 5 (September 2010): 487–95. https://doi.org/10.1038/mi.2010.29.
Parodi, Benedetta, and Nicole Kerlero de Rosbo. “The Gut-Brain Axis in Multiple Sclerosis. Is Its Dysfunction a Pathological Trigger or a Consequence of the Disease?” Frontiers in Immunology 12 (2021). https://www.frontiersin.org/article/10.3389/fimmu.2021.718220.
Peterson, Eva. “Smoking Is Associated with Increased Disease Activity during Natalizumab Treatment in Multiple Sclerosis.” Accessed May 9, 2022. https://journals.sagepub.com/doi/10.1177/1352458518791753.
Pugliatti, Maura, Stefano Sotgiu, and Giulio Rosati. “The Worldwide Prevalence of Multiple Sclerosis.” Clinical Neurology and Neurosurgery 104, no. 3 (July 1, 2002): 182–91. https://doi.org/10.1016/S0303-8467(02)00036-7.
Robertson, N. P., M. Fraser, J. Deans, D. Clayton, N. Walker, and D. A. S. Compston. “Age–Adjusted Recurrence Risks for Relatives of Patients with Multiple Sclerosis.” Brain 119, no. 2 (April 1, 1996): 449–55. https://doi.org/10.1093/brain/119.2.449.
Sadovnick, A. D., H. Armstrong, G. P. A. Rice, D. Bulman, L. Hashimoto, D. W. Party, S. A. Hashimoto, et al. “A Population-Based Study of Multiple Sclerosis in Twins: Update.” Annals of Neurology 33, no. 3 (1993): 281–85. https://doi.org/10.1002/ana.410330309.
Smestad, C., L. Sandvik, N. I. Landrø, and E. G. Celius. “Cognitive Impairment after Three Decades of Multiple Sclerosis.” European Journal of Neurology 17, no. 3 (2010): 499–505. https://doi.org/10.1111/j.1468-1331.2009.02889.x.
Souberbielle, Jean-Claude, Jean-Jacques Body, Joan M. Lappe, Mario Plebani, Yehuda Shoenfeld, Thomas J. Wang, Heike A. Bischoff-Ferrari, et al. “Vitamin D and Musculoskeletal Health, Cardiovascular Disease, Autoimmunity and Cancer: Recommendations for Clinical Practice.” Autoimmunity Reviews 9, no. 11 (September 1, 2010): 709–15. https://doi.org/10.1016/j.autrev.2010.06.009.
Sundqvist, E., P. Sundström, M. Lindén, A. K. Hedström, F. Aloisi, J. Hillert, I. Kockum, L. Alfredsson, and T. Olsson. “Epstein-Barr Virus and Multiple Sclerosis: Interaction with HLA.” Genes and Immunity 13, no. 1 (January 2012): 14–20. https://doi.org/10.1038/gene.2011.42.
Sundström, P. “Smoking Worsens the Prognosis in Multiple Sclerosis.” Accessed May 9, 2022. https://journals.sagepub.com/doi/10.1177/1352458508093615.
Wallin, Mitchell T., William J. Culpepper, Jonathan D. Campbell, Lorene M. Nelson, Annette Langer-Gould, Ruth Ann Marrie, Gary R. Cutter, et al. “The Prevalence of MS in the United States: A Population-Based Estimate Using Health Claims Data.” Neurology 92, no. 10 (March 5, 2019): e1029–40. https://doi.org/10.1212/WNL.0000000000007035.
Zigmond, Michael J., Lewis P. Rowland, and Joseph T. Coyle. Neurobiology of Brain Disorders: Biological Basis of Neurological and Psychiatric Disorders. 1st ed. Elsevier, 2015.

For activity related questions, please contact
     Name: Holly Meyer
     Title: CME Coordinator
     Email: [email protected]

For CME general questions, please contact 
 
   Email: [email protected]



Mitigation of Relevant Financial Relationships


Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education.

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Member Information
Role in activity
Nature of Relationship(s) / Name of Ineligible Company(s)
Lucas B. Kipp, MD
Stanford Hospital & Clinics
Course Director, Faculty
Grant or research support-Roche/Genentech|Grant or research support-Biogen Idec
Faculty Photos
Ruth Adewuya, MD
Managing Director
Stanford University
Planner
Nothing to disclose
Jamie McDonald, MD
Stanford Health Care
Reviewer
Nothing to disclose

This educational activity is supported in part by an educational grant from Novartis Pharmaceuticals Corporation.

Multiple Sclerosis Lecture Series: MS 101 Recording
INSTRUCTIONS:  Click the Launch Video button to watch the video on YouTube. Next, click the Claim CME button. Attest to your participation, view results, and complete the evaluation. After successful completion, your credit transcript will be available to view and download immediately in MY CE portal. 

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