RealTalk MS

Cognitive changes in MS—fluctuations in processing speed, memory, and executive function—can significantly impact daily life, yet they're often misunderstood or overlooked in routine clinical exams. This week, we are joined by Dr. Anna Kratz, clinical psychologist and Professor in the Department of Physical Medicine and Rehabilitation at the University of Michigan, to discuss actionable, evidence-based ways to navigate cognitive challenges. 


Dr. Kratz breaks down the latest findings from the CogDetect-MS study, exploring how daily symptom fluctuations, complex medication regimens, and common substances like caffeine and cannabis influence brain fog. She also shares practical compensatory workarounds and introduces a no-cost digital self-management resource, My MSToolKit.
We'll also explain the new framework for describing MS that's been proposed by the International Advisory Committee on Clinical Trials in Multiple Sclerosis.
We're sharing study results that reveal why detecting even a single silent lesion on an MRI should trigger an immediate conversation about stepping up to high-efficacy therapy.
And we'll tell you about 2 advanced MRI markers that can predict future cognitive decline — even in the absence of any relapses or new lesions on MRI.
We have a lot to talk about! Are you ready for RealTalk MS??!

This Week: Maintaining and improving cognitive function  :22
The International Advisory Committee on Clinical Trials in Multiple Sclerosis calls for updating the way MS is described   1:12
A study provides evidence for switching your DMT when there's even a single silent lesion on your MRI   6:53
Scientists identify two MRI markers that can predict future cognitive decline in early relapsing-remitting MS   10:53
Dr. Anna Kratz discusses maintaining and improving cognitive function  15:33 
Share this episode  42:13
Next week  42:33

SHARE THIS EPISODE OF REALTALK MS
Just copy this link & paste it into your text or email: https://realtalkms.com/469
ADD YOUR VOICE TO THE CONVERSATION
I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts!
Email: jon@realtalkms.com
Phone: (310) 526-2283
And don't forget to join us in the RealTalk MS Facebook group!

LINKS
If your podcast app doesn't allow you to click on these links, you'll find them in the show notes at www.RealTalkMS.com
PAPER: Towards a Biologically Informed Description of Multiple Sclerosis Disease Course -- A Roadmap for Transition
https://rdcu.be/fxBw1

STUDY: Treatment Escalation After Clinically Silent MRI Lesions in Relapsing-Remitting Multiple Sclerosis
https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awag252/8741305
STUDY: Paramagnetic Rim Lesions and Choroid Plexus Volume at Diagnosis Are Associated With Cognitive Progression Independent of Relapse and MRI Activity in Early Relapsing-Remitting Multiple Sclerosis
https://onlinelibrary.wiley.com/doi/10.1002/acn3.70448
REGISTER: ECTRIMS Patient Community Day
https://ectrimspatientcommunity.eu
JOIN: The RealTalk MS Facebook Group
https://facebook.com/groups/realtalkms
REVIEW: Give RealTalk MS a rating and review
http://www.realtalkms.com/review

Follow RealTalk MS on X, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com.
RealTalk MS Episode 469
Guest: Dr. Anna Kratz
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Imagine your spouse or significant other has been diagnosed with MS...shortly after you were diagnosed with stage IV colon cancer, and given just a 15% chance of survival. All of a sudden, the roles of patient and care partner are up for grabs -- and they change with almost daily frequency. 


That's exactly the scenario my guest, Kathleen Silva, faced. Kathleen is joining me to discuss how she and her husband, Rick, survived and thrived amid that frightening chaos. (Spoiler alert -- no one died!) 
We'll also tell you about an investigational drug that's the first to promise neuroprotection during an MS relapse.
We're sharing study results that show people with MS who meet the medical criteria aren't jumping on the GLP-1 bandwagon.
We'll provide compelling evidence for anyone with MS to quit smoking. 
And we're breaking down the results of a study that analyzed mortality rates in cases where MS was listed as the underlying cause of death.
We have a lot to talk about! Are you ready for RealTalk MS??!

This Week: When the roles of patient and care partner get turned upside down and inside out  :22
The FDA green lights clinical trials for an investigational drug that promises neuroprotection during an MS relapse   1:08
People living with MS who meet the medical criteria aren't jumping on the GLP-1 bandwagon   5:43
Study results provide startling evidence for quitting smoking if you're living with MS   8:34
In spite of highly effective DMTs, mortality rates for deaths in which MS is listed as the underlying cause are increasing  14:05
Kathleen Silva takes us through the harrowing time in her life when her husband, Rick, was diagnosed with MS shortly after she had been diagnosed with Stage 4 colon cancer and given just a 15% chance of surviving   19:23 
Share this episode  35:12
Next week  36:31

SHARE THIS EPISODE OF REALTALK MS
Just copy this link & paste it into your text or email: https://realtalkms.com/468
ADD YOUR VOICE TO THE CONVERSATION
I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts!
Email: jon@realtalkms.com
Phone: (310) 526-2283
And don't forget to join us in the RealTalk MS Facebook group!

LINKS
If your podcast app doesn't allow you to click on these links, you'll find them in the show notes at www.RealTalkMS.com
STUDY: Use of Semaglutide and Tirzepatide Among People with Multiple Sclerosis
https://journals.sagepub.com/doi/10.1177/13524585261442033

STUDY: Impact of Tobacco and Alcohol Consumption on Disease Progression and MRI In People With Multiple Sclerosis: Results of the Prospective Cohort Study NationMS
https://journals.sagepub.com/doi/10.1177/17562864261464304
STUDY: Racial and Ethnic Trends and Comorbidity Patterns in Multiple Sclerosis Mortality
https://www.neurology.org/doi/10.1212/WN9.0000000000000148
REGISTER: ECTRIMS Patient Community Day
https://ectrimspatientcommunity.eu
JOIN: The RealTalk MS Facebook Group
https://facebook.com/groups/realtalkms
REVIEW: Give RealTalk MS a rating and review
http://www.realtalkms.com/review

Follow RealTalk MS on X, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com.
RealTalk MS Episode 468
Guest: Kathleen Silva
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If you Google the term "shared decision making", you'll find it defined as a collaborative process where patients and clinicians work together to select tests, treatments, and care plans based on clinical evidence and the patient's personal values and goals.
But shared decision-making isn't an automatic happy pill. It takes work, it takes discipline, and it takes a clear understanding of both the patient's and the clinician's roles. This week, Dr. Aliza Ben-Zacharia and Linda Lachman join me to share how shared decision-making has worked for them over the course of their longtime doctor-patient relationship, and how it can work for you.


We have a lot to talk about! Are you ready for RealTalk MS??!

This Week: We're taking a deep dive into shared decision-making  :22
Dr. Aliza Ben-Zacharia and Linda Lachman discuss how they have made shared decision-making work, and what to do if it isn't working for you and your neurologist  2:39
Share this episode  32:05
Next week  32:25

SHARE THIS EPISODE OF REALTALK MS
Just copy this link & paste it into your text or email: https://realtalkms.com/467
ADD YOUR VOICE TO THE CONVERSATION
I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts!
Email: jon@realtalkms.com
Phone: (310) 526-2283
And don't forget to join us in the RealTalk MS Facebook group!

LINKS
If your podcast app doesn't allow you to click on these links, you'll find them in the show notes at www.RealTalkMS.com
JOIN: The RealTalk MS Facebook Group
https://facebook.com/groups/realtalkms
REVIEW: Give RealTalk MS a rating and review
http://www.realtalkms.com/review

Follow RealTalk MS on X, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com.
RealTalk MS Episode 467
Guests: Dr. Aliza Ben-Zacharia and Linda Lachman
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We get more listener emails about diet and MS than almost any other topic. If you're curious about how some of the well-known diets for MS actually stack up, or you're interested in understanding the connection between diet and MS-related fatigue, or you want to know what the biggest obstacle to staying on a new diet is (and this may surprise you), then this is the episode for you.
We're devoting this week's entire episode to my conversation with Dr. Tyler Titcomb, an assistant professor in the Department of Dietetics and Nutrition, and a registered dietitian with a PhD in Nutritional Sciences in the Department of Neurology at the University of Kansas Medical Center.


We have a lot to talk about! Are you ready for RealTalk MS??!

This Week: We're taking a deep dive into diet and MS  :22
Dr. Tyler Titcomb breaks down what you need to know about how diet influences multiple sclerosis and why it plays such a key role.  :54
Share this episode  25:22
Next week  25:41

SHARE THIS EPISODE OF REALTALK MS
Just copy this link & paste it into your text or email: https://realtalkms.com/466
ADD YOUR VOICE TO THE CONVERSATION
I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts!
Email: jon@realtalkms.com
Phone: (310) 526-2283
And don't forget to join us in the RealTalk MS Facebook group!

LINKS
If your podcast app doesn't allow you to click on these links, you'll find them in the show notes at www.RealTalkMS.com
JOIN: The RealTalk MS Facebook Group
https://facebook.com/groups/realtalkms
REVIEW: Give RealTalk MS a rating and review
http://www.realtalkms.com/review

Follow RealTalk MS on X, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com.
RealTalk MS Episode 466
Guest: Dr. Tyler Titcomb
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During his fellowship in the United States, Dr. Avinash Chandra trained to become an MS specialist at a world-class MS center. Then he returned home to Nepal and discovered that MS was largely considered non-existent. But Dr. Chandra knew it wasn't. 
In this week's episode, Dr. Chandra discusses his experience creating a framework for MS care in Nepal that hadn't existed before. He also explains the necessary trade-offs in providing costly medical treatment in a country where the average family of four lives on an income of $500 a month. 


It's been well-established that males living with MS tend to experience faster and more severe disease progression than females. We're sharing results of a study that shows clear differences in healthcare use by sex up to a decade before the onset of MS. 
We'll tell you about a newly published review of 30 years of data measuring the efficacy of autologous hematopoietic stem cell transplantation (aHSCT).
And we're sharing the registration details for ECTRIMS Community Patient Day (it's a free live and online event you won't want to miss!)
We have a lot to talk about! Are you ready for RealTalk MS??!

This Week: MS care in a country that considered MS non-existent  :22
A study analyzed sex differences in healthcare usage between males and females with MS up to a decade before the first MS symptom develops   1:45
30 years of accumulated data show significant benefits of autologous hematopoietic stem cell transplantation in treating relapsing forms of MS   6:17
It's time to support the National MS Society's $119.6 million active investment in MS research   9:32
Dr. Avniash Chandra discusses MS care in Nepal  12:43 
Share this episode  35:40
Next week  36:01

SHARE THIS EPISODE OF REALTALK MS
Just copy this link & paste it into your text or email: https://realtalkms.com/465
ADD YOUR VOICE TO THE CONVERSATION
I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts!
Email: jon@realtalkms.com
Phone: (310) 526-2283
And don't forget to join us in the RealTalk MS Facebook group!

LINKS
If your podcast app doesn't allow you to click on these links, you'll find them in the show notes at www.RealTalkMS.com
STUDY: Sex Differences in Healthcare Use Before the First Multiple Sclerosis-Related Demyelinating Event
https://www.msard-journal.com/article/S2211-0348(26)00396-2/fulltext

PLAIN ENGLISH SUMMARY: Sex Differences in Healthcare Use Before the First Multiple Sclerosis-Related Demyelinating Event
https://tremlettsmsresearchexplained.wordpress.com/2026/07/22/sex-differences-in-healthcare-use-before-the-first-multiple-sclerosis-related-demyelinating-event-explained
LISTEN: Dr. Helen Tremlett Discusses the MS Prodrome
https://realtalkms.com/321

STUDY: Autologous Stem Cell Transplantation for Multiple Sclerosis
https://pubmed.ncbi.nlm.nih.gov/41482159
REGISTER: ECTRIMS Patient Community Day
https://ectrimspatientcommunity.eu
SUPPORT: National MS Society Research
https://nationalmssociety.org/research
JOIN: The RealTalk MS Facebook Group
https://facebook.com/groups/realtalkms
REVIEW: Give RealTalk MS a rating and review
http://www.realtalkms.com/review

Follow RealTalk MS on X, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com.
RealTalk MS Episode 465
Guest: Dr. Avinash Chandra
Privacy Policy