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From the Editor
 The CNI REVIEW is pleased to offer in this issue an updated review of multiple sclerosis (MS) and the superb program for MS provided by the Rocky Mountain MS Center under the directorship of Dr. Allen Bowling.
As a neuro-oncologist with 30 years of experience in the field of oncology, I see a great deal of overlap between the challenges faced in both oncology and MS. In both cases, great progress has been made in treatment, which has been enhanced and accelerated by an explosion of new information regarding the basic biology of the respective diseases. Basic science has demonstrated in the case of cancer that alternations of expression of critical genes are the basis of all cancer. In depth understanding of those genetic alterations causing the malignant behavior of tumors has established a new frontier in cancer treatment in which novel therapies specifically target the under or over expressed genes that underlie the malignancy. Likewise, in MS and related disorders, in which the basic pathology is mediated by the body’s own host defense system, basic research has gotten us close to the critical missing piece of the puzzle—why does this happen and how can it be prevented or stopped?
Knowledge has taken some of the mystery and mystique out of MS and has led to improved, but still imperfect treatment. Just as my career has spanned the curability of previously incurable malignancies, especially in children, it is my belief that Dr. Bowling’s career, deservedly, will span an era in which MS, a frequently devastating and incurable disease of young productive people, will progress from being poorly understood and treated, to completely understood and curable. Just as curability of cancer depends on the elimination of the mythical “last call”, curability of MS will depend upon unraveling the conundrum of how the immune system becomes intolerant of its host central nervous system. In the meantime, patients will continue to benefit from better treatment and support and offered uniquely by the Rocky Mountain MS Center.
Edward B. Arenson, MD
CNI President, Medical Advisory Board
From the Guest Editor
 Multiple sclerosis (MS) is the most common non-traumatic cause of neurological disability in young adults and the most common acquired inflammatory demyelinating disease of the central nervous system. It is unpredictable and extremely variable in severity and the types of symptoms it may cause. Due to its relatively early age of onset, it often strikes people who are in the “prime” of their lives. Due to these factors, MS may have a huge impact on those with the disease as well as their family, friends, and caregivers.
MS appears to be especially common in the Rocky Mountain region. To address the needs of those with the disease, the Rocky Mountain MS Center (RMMSC) was founded in 1978. For nearly 3 decades, the RMMSC has provided a wide array of services for people with MS. Formally, the mission of the Center is to help people living with MS and their families lead a quality life by providing individualized care, support, education, and research. What does this mean in practical terms? From my perspective, a long-standing guiding principle of the Center is to be on the “front lines” with people with MS.
Through the Center and its affiliated programs, we provide:
- high-quality neurological care
- a nationally recognized day enrichment program for those with moderate-severe disease
- counseling services to address psychosocial and emotional needs
- “enhanced” clinical services, including disability evaluations, functional assessments, and bowel, bladder, and sexuality evaluations
- “rehabilitation clinic,” which provides “one-stop shopping” for physiatry, physical therapy, occupational therapy, speech therapy, and counseling
- unique educational services that range from one-on-one to small group to large group programs
- a wide variety of publications, including a quarterly newsletter (Informs), professional publications, and lay articles
- the world’s largest database of MS-relevant alternative medicine information.
In addition to these “front-line” services, the RMMSC houses one of the largest MS tissue banks in the world. The articles in this issue of the CNI Review highlight many of these programs and describe how these programs intertwine with the needs of people with MS. The RMMSC has a long tradition of serving the MS community in the Rocky Mountain region. I am proud to be a part of this organization that provides such valuable and unique services to people with MS.
Allen C. Bowling, MD, PhD
Medical Director, Rocky Mountain Multiple Sclerosis Center
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