Winter 2013 Newsletter - Mount Sinai Hospital

MSInteractions
ISSUE
Winter
2013
25th Edition
Volume 10 (1)
Dr. Fred Lubin
A Word
From
Our
Director
AS WE ENTER THE
winter months,
notice the drop in
temperature, the early
darkness of evening,
the end of one year
and the beginning of
another, it gives us
time to review what
has happened in 2012
and what we can look
forward to in 2013.
In this newsletter we
say goodbye to Mount
Sinai’s former logos
and welcome the
new “branding” and
renaming the Medical
School, which is now
the Icahn School of
Medicine at Mount
Sinai, yet we will still
be the Mount Sinai
Medical Center. You
will soon see our
cards and coats will
signify this logo or
“branding”change.
We are debuting
our own rebranding
and initiating a new
newsletter format.
Please let us know
what you think.
— continued on page 2
Dr. Aaron Miller
Despite Sandy,
Changing the Future
Symposium a
Resounding Success
THE 4TH ANNUAL MULTIPLE SCLEROSIS SYMPOSIUM,
“Changing the Future: New Trends in Multiple Sclerosis Research
and Treatment,” presented by the Corinne Goldsmith Dickinson
Center for MS, brought together the MS Center’s team with
other clinicians, scientists, and healthcare professionals for
a day-long review of the latest happenings in MS treatment,
clinical trials, and future therapies.
Despite concerns that Hurricane Sandy and the NYC Marathon
might cause traffic and other delays, hundreds of interested
MS patients, caregivers, and family members came out to the
beautiful Grand Hyatt at Grand Central on November 4 th , 2012
for the free event, which was cosponsored by the National MS
Society, New York City-Southern NY Chapter (NMSS).
Video of the event will be available on
www.mountsinai.org/mscenter in the coming weeks.
Guests began arriving around 8:00am to register and later to
hear lectures that ranged from MS basics to potential future
therapies in the pipeline. Several new treatment options are
now or will soon be available, and our CGD physicians wanted to
give attendees the most up-to date information available about
these options.
Dr. Aaron Miller, Medical Director of the CGD Center for MS,
was again the program director of the Changing the Future
Symposium and served as Master of Ceremonies. The first
speaker was Michelle Fabian, MD, an MS attending physician
at the CGD Center, who helped “break the ice” by providing a
review of MS fundamentals.
In her presentation MS: Back to the Basics, Dr. Michelle Fabian,
continued on page 4
Corinne Goldsmith Dickinson Center for Multiple Sclerosis • 5 East 98th Street, First Floor

continued from page 1
The Hess Center for Science and Medicine
officially opened its doors. It is touted to
provide a new age of collaboration between
researchers and practitioners that “can change
the face of medicine.” This initiative highlights
Mount Sinai’s efforts to optimize the skills and
technological breakthroughs of those at
Mount Sinai to investigate exciting possibilities
in scientific research that might produce
future promises and possible cures for all
diseases, and for us in particular, the cure
for multiple sclerosis.
Our Keynote article presents a review and
pictures of our Fourth Annual Symposium—
Changing the Future: New Trends in Multiple
Sclerosis Research and Treatment, which was
held at the Hyatt Hotel at Grand Central, on
Sunday, November 4, 2012. Despite Hurricane
Sandy and a last minute cancellation of the
NYC Marathon, the Symposium went on. The
event was a particular success because of the
challenges that it faced. The Symposium was
co-sponsored by the National MS Society,
New York City-Southern NY Chapter and,
offered for free thanks to the generous
support of educational grants from -- Acorda
Therapeutics, Inc., EMD Serono Symposia USA,
Inc., Genzyme, A Sanofi Company, Questcor
Pharmaceuticals, Inc., and Teva Neuroscience,
Inc. (Please see the article and pictures on
pgs. 1,4-6).
Another important lead item is the article
about the second oral MS medication approved
by the Food and Drug Adminstration, called
Aubagio (please see p.7).
We report recent fundraising events that
have been intiated to bring more money into
the CGD Center and continue to foster the
collaborative model that defines who we are.
True to this model, we do not make money
precisely because our philosophy emphasizes
the needs of the patient rather than the
number of patients seen in a day. We are very
A Word From Our Director
dependent on the “kindness of strangers” as
well as the kindness of those who know of our
work or who have benefitted from the work
that we do. In line with that, we are enclosing
a donor envelope to provide an “easy” way
for you to let us know how you feel. While
everyone is grateful for a large donation, we
also appreciate the smaller donations because
they often represent a high percentage of the
donor’s actual giving capacity. We give thanks
for everyone’s support.
Two other fundraising events occurred in
September—The MS Hope for a Cure Poker
Tournament and in October—The NMSS Bike
Ride. The MS Hope for a Cure 8 th Poker
Tournament did quite well and helps support
research and educational programs and
scholarships for individuals affected by MS.
Please see the outcome of the event and Save
the Date for next year—October 10, 2013, (p.15).
There is also a touching story from an MS
patient’s husband, who talks about their 2012
ride and what it means to him (pgs.10-11). Our
own nurse practitioner, Gretchen Mathewson
also participated in the MS Bike ride and
reports on her adventures (p.8).
On November 7 th , shortly after the Center’s
Fourth Annual Symposium, Audrey Goldsmith
Kubie debuted the First Annual Mah Jongg and
Canasta Fundraiser. The article and pictures
from this event are featured on p.9.
The CGD Center’s 11 th Annual Dance Party—Save
the Date—Thursday, March 14, 2013—also begs
your attention to come see what all the fun is
about—please see the evite on p. 3.
The NMSS Annual MS Walk will occur on
Sunday, April 28 th , 2013. We hope we can
encourage many of you to join the Mount Sinai
CGD Team. Please note, there are many dates
to keep in mind and mark down so you too can
participate.
2
MSInteractions • Winter • 2013 2013

The Challenge Grant anonymously offered at
the Tenth Annual Dance has almost reached its
goal of $100,000—we are currently at $95,000.
We thank all of you who have helped meet
that challenge and help us double the monies
offered to provide support for the work we
are doing.
In keeping with our regular features, we
have the social workers’ tip of the month
(see p.8). We list the After-Hours Seminars
for the months January-May 2013, which
have been generously sponsored by Novartis
Pharmaceuticals (p.16).
We have congratulations to offer to Gretchen
Mathewson, who passed her MS Certification
exam (see p.8) and to Sabrina Phipps (p.12) for
becoming certified as a medical assistant and
for assuming new responsibilities in the Center
to help with prescriptions and to triage medical
issues directed toward the doctors and nurse
practitioners. We also get to welcome the
newest member of the CGD family. Christine
Hannigan gave birth to CJ Alonso (please see
his adorable picture on p.11).
Another ”regular” feature, the CGD News
Briefs, allows us to share the latest adventures
and accomplishments of our CGD community
(please see pgs. 6,7,10-11,13,16).
We are always eager to hear your feedback.
Please let us know features you might like to
hear about or seminars you would like us to
present. We are also trying to go “green” and
would appreciate learning your email addresses
so we can “effortlessly” let you know about
upcoming talks and events. Please feel free to
send us your email address—
donna.polisar@mssm.edu
Wishing you and yours a happy and healthy
New Year.
Fred D. Lublin, MD, FAAN
Saunders Family Professor of Neurology
Director, The Corinne Goldsmith Dickinson
Center for Multiple Sclerosis
Please
join us
for a
fun filled
evening
Winter 2013 2013 • MSInteractions
• 3
#
#

Despite Sandy, Changing the Future
Symposium a Resounding Success
continued from page 1
discussed common symptoms of multiple sclerosis, how
it is diagnosed, what subtypes of MS exist, and pointed
out some known risk factors for MS. Dr. Fabian reminded
us that MS is the most common demyelinating disease of
the central nervous system known today. While there is
no known cause of MS, reflecting on current findings, Dr.
Fabian said that out of all possible risk factors for MS, the
only modifiable potential risk factors currently known are
Vitamin D and smoking. There have been multiple studies
associating smoking with the risk of a faster progression
once a person has MS. Thus, the importance of MS patients
quitting smoking remains paramount.
Dr. Stephen Krieger, attending physician at the CGD MS
Center at Mount Sinai and Assistant Professor of Neurology
spoke next on MS: Mythbusters. Dr. Krieger described why
it is very important for MS patients and families to get the
best possible information and studies on MS There are
many rumors and much misinformation in the world, partly
thanks to the internet. In terms of why MS lends itself to
myths, Dr. Krieger pointed out that the uncertainty and
fear about MS leads to many half truths occupying the MS
information landscape. One myth Dr. Krieger discussed
was the myth that Aspartame, an artificial sweetener
was an MS causing agent. While emails circled the world
detailing the specifics of how Aspartame was the cause of
one person’s MS, the truth was that studies did NOT show
this correlation, and that this was most likely a marketing
ploy by a rival artificial sweetener company to hurt
Aspartame’s business. This is just one of several examples
of misinformation. Dr. Krieger encouraged everyone to be
vigilant in their research and to always talk to their doctors
before making any decisions regarding changes in their
treatment or routine, especially if driven by information not
obtained from their doctor.
Next, Dr. Patrizia Casaccia, Director of the Center for Myelin
Repair in the Friedman Brain Institute at Mount Sinai and
also Professor of Neuroscience, spoke about research in
MS and asked whether the course can be modified. She
focused on how breakthroughs in MS treatment were
continued on page 5
4
MSInteractions • • Winter 2013

possible through the study of genetics
and understanding affected cell activity.
Dr. Casaccia had several interesting and
eye-opening videos that showed, on a
cellular and molecular level, the process
by which cells usually work and how MS
breaks down that process, causing many
symptoms and problems from which MS
patients suffer. An important message
she shared was that research in the field
of myelin repair, and how manipulating
cell functions will play a vital part in
better understanding MS. Ultimately, she
concluded we will be able to treat MS
better and, even one day, prevent and
cure it.
Dr. John DeLuca, VP of Research for
the Kessler Foundation and Professor of
Physical Medicine at NMDNJ-New Jersey
Medical School gave a very interesting
presentation on an emerging area within
MS treatment, Cognition in MS. Cognition
generally refers to our brain’s ability to
remember things (memory) and function
normally (cognitive reasoning). For
decades, during Dr. DeLuca’s professional
career, he noted that MS researchers
and doctors falsely believed that MS did
not seriously affect cognitive function.
Over the years, however, as research has
progressed and our ability to test in this
area has increased, research shows a
large percentage of MS patients suffer
a noticeable amount of damage in their
cognitive abilities. Dr. DeLuca said that
research and developments in this area
would be a driving force for helping MS
sufferers halt the damage being done
to cognitive systems, and also allow for
treatments to repair that damage as well.
After a delicious complimentary lunch, Ilana
Katz Sand, one of the CGD MS Center’s
Sylvia Lawry MS Physician Fellows, spoke
on Current Disease Modifying Therapies.
Dr. Katz Sand highlighted the options
available to treat various aspects of MS.
This includes disease modifying therapies,
of which there are 8 approved therapies to
treat exacerbations, to improve recovery
from exacerbations, to improve function,
(such as walking speed), and symptoms.
Her presentation was well received. Many
knew some of the current treatment options
available but before her talk had not had
this comprehensive overview to look at and
decide which treatment options were best
for them individually.
CGD MS Center Director and Saunders
Family Professor of Neurology, Dr. Fred
Lublin presented information concerning
methods for treating progressive forms of
MS. Dr. Lublin has seen thousands of MS
patients and understands their desire for
improved treatments. Dr. Lublin highlighted
areas where research already has provided
breakthroughs in our understanding and
treatment of MS, such as the importance
of immune function, the role of genetics
in MS, environmental factors, reduction in
potential infectious agents, new imaging
advances and a renewed focus on myelin
regeneration and repair. He pointed out
that there is an international push to make
forms of progressive MS one of their
highest priorities. There is a worldwide
effort to develop experimental models,
study strategies, as well as symptom
management and rehabilitation. It is vital
to find funding to support more research.
Aliza Ben-Zacharia, DrNP, Doctor of Nurse
Practitioning at the CGD MS Center at
Mount Sinai, provided a broad overview of
MS symptoms and their management. MS
symptoms are numerous and interrelated.
She pointed out that treating the many
symptoms of MS is as difficult a challenge
as modifying the disease course itself.
continued on page 6
Winter 2013 • • MSInteractions
5

Proper management of symptoms,
especially neurological symptoms, can
improve MS patients’ quality of life. She
focused on how symptoms interact with
each other. Sometimes patients can be
caught in a “symptomatic cycle” in which
fatigue may affect cognition and mood,
which can lead to depression, and further
promote fatigue and cognitive dysfunction,
which may foster even more depression
and fatigue. Her presentation focused on
effective symptom management, which
comes from a team approach.
Our final presenter was the day’s Master
of Ceremonies, Dr. Aaron Miller, Medical
Director of the CGD MS Center and
Professor of Neurology, who spoke on The
Promise of Future Therapies. Dr. Miller
discussed several drugs and treatment
options that are currently being researched.
Among them are better strategies to treat
progressive MS, as Dr. Lublin had discussed.
He also spoke about therapies to repair
damage to the nervous system. The hope
is that many of these breakthroughs are
only a few years away from being brought
to the market. Dr. Miller encouraged
everyone to look into new clinical trial
options and to consider taking part in this
important area of discovery. This is an
exciting time for MS therapeutics, with the
hope for a considerable reduction in the
risk for exacerbations and, a renewed focus
on trying to develop better strategies for
treating progressive disease.
The Corinne Goldsmith Dickinson Center
for MS acknowledges generous educational
grants from the following companies.
Without their support the day would not
have been possible.
• Acorda Therapeutics, Inc.
• EMD Serono Symposia USA, Inc.
• Genzyme, A Sanofi Company
• Questcor Pharmaceuticals, Inc.
• Teva Neuroscience, Inc.
CGD NEWS BRIEFS
Michelle Fabian, MD
n Neurology Director – Humanities in
Medicine program
n Neurology Director – Neuroscience
elective Clerkship
n Brain and Behavior – Small group leader
n Longitudinal Clinical Experience –
Small group leader
LET’S HEAR IT FOR THE GIRL!!
In a newsletter in 2011, we talked about a
patient, Ali Salama, who had been honored
by the National Multiple Sclerosis Society
(MS Interactions, Fall 2011—you can read
it online). In that article, we showed her
surrounded by shoes, for she is a fund raiser
AND a fashionista.
In addition to the work she has done and
continues to do, she also has
been involved in a Fox News
segment with Dr. Miller.
For 2013, Ali promoted a
Soul Cycle fund raiser for
MS, Sunday Feb. 10th,
2013 at Soul Cycle East,
East 83rd St. and 3rd Ave.
Ali Salama’s Spin for MS
Addendum: Her goal was $10,000 –
she raised over $12,600!!!
6
MSInteractions • • Winter 2013

Second Oral MS Medication
AVAILABLE TO PATIENTS
Teriflunomide (Aubagio®) became the second
oral drug available for the treatment of relapsing
forms of multiple sclerosis in the United States
when it was approved by the U.S. Food and Drug
Administration in September.
Teriflunomide is a tablet administered once a day.
The drug was approved in two dosage forms, 7 mg
and 14 mg. However, the results of the two Phase
3 trials, which led to the approval of the drug,
indicated that the higher dose is more effective
with little increase in side effects.
In the first Phase 3 trial, known as TEMSO,
the 14 mg dose showed a 31.5% reduction in
the annualized relapse rate (average number
of relapses per year) compared to placebo and
a nearly 30% reduction in the development of
sustained disability progression. Patients taking
the higher dose of teriflunomide also experienced
substantially less additional disease on MRI. In
the second trial, known as TOWER, teriflunomide
reduced the annualized relapse rate by 36.3% and
disability progression by 31.5%.
Teriflunomide was generally well tolerated.
Some patients experienced gastro-intestinal
side effects such as nausea and diarrhea, but this
rarely was severe enough for them to discontinue
participation in the trials. In addition, some
patients reported mild hair thinning, which
generally occurred early, with hair growing back
even if the drug was continued. Patients who
are treated with teriflunomide also need blood
tests regularly to check for elevation of liver
enzymes, which is seldom severe. The medication
carries a Category X pregnancy rating, which
means that women taking teriflunomide must
practice effective contraception in order to avoid
pregnancy while on the drug.
steering committee that advised Genzyme (a
Sanofi Company) during the development of
teriflunomide. The CGD Center for MS has also
participated in clinical trials of teriflunomide.
Teriflunomide joins fingolimod as currently
available oral agents for relapsing forms of MS.
A third oral agent, currently known as BG-12, is
expected to be approved by the FDA this spring.
Dr. Fred Lublin, Director of the CGD Center for
MS, commented, “Teriflunomide offers a valuable
additional therapeutic option for the treatment
of MS. Many patients will clearly prefer to take
oral, rather than injectable, medications. With the
expected approval of BG-12 in the first quarter of
2013, we are excited to have so many possibilities
to discuss with our patients.”
CGD NEWS BRIEFS
Aaron E. Miller, MD
n His younger daughter, Caroline,
was Admitted to the Bar
n International Risk Management
Meeting-Paris
n Pharmaceutical All-day Teaching
at the Center
n ECTRIMS—International MS Meeting
in Lyon, France
n Patient Friends & Family Event at MSSM,
Oct 23rd
n Phenotype Meeting in Washington, DC
n He was on FOX News
Dr. Aaron Miller, Medical Director of the CGD
Center for MS, served as a member of the
Winter 2013 • • MSInteractions
7

Gretchen Matewson, NP
CONGRATULATIONS,
GRETCHEN!!
8
Gretchen has participated
in two important events
since our last newsletter.
She has successfully passed
the International MS
Nurses exam and is now
an officially Certified MS
Nurse Practitioner. Yeah,
Gretchen.
Gretchen’s second feat was
to ride with her husband
Tom in the NY MSSM Bike
Ride, along with many
friends and neighbors and
rode 30 miles. In addition
to raising $1500, she
reports that the ride proved
fabulous and inspirational.
MSInteractions • Winter 2013
SOCIAL WORKERS’
TIP OF THE MONTH:
A Resource Guide for
Getting Around New York
A patient recently brought to our attention a guide
that is distributed by the Mayor’s Office for People
with Disabilities (thanks Bob!). It lists all the accessible
accommodations, site seeing, arts and entertainment,
museums, dining, nightlife and sports. Although the
guide is being updated and hard copies are no longer
available- you can print the guide or obtain all the
information on the website:
www.nyc.gove/html/mopd/downloads/pdf/accessibility_
guide.pdf.
Their phone number is 212-788-2830 if you have any
questions.
One great tip, for example, while accessible taxi’s can be
hailed on the street, there is a phone number that can be
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ipsum, have aliquam heard elementum is that you semper can non, generally dignissim get vitae one neque. within Etiam 10
rhoncus, minutes diam if you in sagittis call dictum, 311 or 212-639-9675, elit lectus auctor diam, or the non Taxi porttitor and
tortor massa vitae nibh.
Limousine Commission directly at 718-666-4067.
Duis mattis, nisl at iaculis commodo, dui elit consectetur tellus, nec
malesuada sem dui vulputate urna. Aliquam vel mi nulla. In pellentesque
mauris et leo commodo at tempus enim venenatis.

1ST
ANNUAL MAH JONGG
AND CANASTA
BENEFIT LUNCHEON
ON NOVEMBER 7 TH , 2012
nearly a hundred guests
attended the first CGD
Mah Jongg and Canasta
Benefit Luncheon at the
Yale Club in Manhattan,
New York City. This first
Audrey Goldsmith Kubie
time event was done in
cooperation with the CGD MS Center and
Mount Sinai Special Events and was chaired
by Mrs. Audrey Kubie, who is an MS Center
Advisory Board Member and daughter to
one of our Center’s benefactors, Mr. Clifford
Goldsmith. It was a very special event.
This unique fundraiser brought together
experienced and beginner Mah Jongg and
Canasta Players to play in both games
in a beautiful environment. All proceeds
benefitted the CGD Center for MS. All
funds raised will be used to improve further
our patient care.
Before the games began, CGD Center
Director, Dr. Fred Lublin and Medical
Director, Dr. Aaron Miller spoke to guests
about the Center. They thanked everyone
for their participation of this debut initiative
and for their support of MS research and
treatment. Mr. Clifford Goldsmith and his
wife, Katherine were also in attendance at
the event (please see their pictures below).
In addition to
playing some
intense and
challenging
Mah Jongg
and Canasta
matches among
friends, guests
were also
treated to a
special plated
lunch from the Yale Club. Throughout
the games, guests were able to take part
in some “retail therapy” offered by DKF
Limited, who had brought trunks full of
their finest boutique items for everyone
to peruse and purchase. A percentage
of sales were donated to the CGD MS
Center. As if that were not enough, event
chair Audrey Kubie organized an elaborate
Silent Auction that offered dozens of lovely
gifts and Mah Jongg merchandise being
auctioned for unbelievably low prices.
These gifts were
all contributed
by companies
and individuals
who were eager
to support the
CGD MS Center.
Efforts such as
this one help
garner monies
to provide
resources for
Dr. Fred Lublin, Audrey Goldsmith Kubie,
Dr. Aaron Miller
The Yale Club prior to festivities
treating patients with MS and conducting
research to find a cure for MS in the near
future. All of the funds from the Silent
Auction and ticket sales were donated
to the CGD Center and we are extremely
grateful to everyone who attended,
donated their time, materials or energy,
and supported the first Annual Mah Jongg
and Canasta Luncheon in any way. We look
forward to starting a tradition and having
an even better turn out next year!
Alexandra Goldsmith Fallon, Katherine Goldsmith, Clifford Goldsmith,
Audrey Goldsmith Kubie
Winter 2013 • MSInteractions
9

MS Bike Ride-Oct. 21, 2012
ONE PARTNER’S STORY
By Richard Pieper
Dr. Fred Lubin
CGD NEWS BRIEFS
Fred D. Lublin, MD
n Monthly Journal Club
with Residents
n University of Florida—CME
Course Director
n Barcelona MS Workshop
n AAN Mentoring
n International Risk
Management Meeting-Paris
n Pharmaceutical All-day
Teaching at the Center
n EJ’s Poker Tournament -
October 4 th
n ECTRIMS—International
MS Meeting in Lyon, France
n Patient Friends & Family Event
at MSSM, Oct 23 rd
n Phenotype Meeting in
Washington, DC
n NMSS Federal Activism in
Washington ,DC
n Piper Jaffrey 24 th Annual
Healthcare Conference Panel
n Charcot Meetings in
Marbella, Spain
Merrill Hesh and Richard Pieper of the
Vicious Cyclers
WHEN I TAKE A MOMENT
to sit down, and empty my
mind of the persistent calls
of chores and work, I feel
immense gratitude for the
past year. I am grateful that,
with medication, my wife’s
MS has been “quiescent;”
I am grateful that our
children have been loving
and understanding of her
struggle; I am grateful that
Merrill (Hesch) has been
so determined and fiercely
focused on her exercise
and physical therapy; and I
am grateful that our friends
have been so supportive of
Merrill’s efforts to regain
mobility and maintain a
positive spirit. Those who
are reading should consider
this a heartfelt “Thank You.”
This past weekend Merrill and I rode 27 miles here in the City,
making our way under the bridges and down the East River
Esplanade, picking a path through the throngs that clogged
the sidewalks in Battery Park, where the bike path has not
yet been completed, and then cruising up the Hudson River
Park bikeway to 57 th Street, where we crossed to Columbus
Circle and on into Central Park. Merrill is completely alive on
her bike, and only when she dismounts can you notice the
irregularity in her gait as she pushes it beside her.
On Sunday when we rode we stopped for a moment as we
entered the corner of the Park. The sun was raking the pylon
of Magonigle’s Maine Memorial, and always the conservator,
I remarked on the failure of the resin-based composites that
had been applied to the Tennessee pink limestone. It was
a beautiful day, and the Park drive was alive with cyclists,
10
MSInteractions • • Winter 2013

pedicabs, carriages, and strollers competing
for a clear path. Before setting out again
Merrill and I agreed to meet at “our spot” on
the lawn by the small lake at the edge of the
Park near 102nd Street.
Merrill found me there lying on the lawn near
a sketching class, by a bench where a couple
from Brazil on holiday with their young
daughter sat resting from their own bike
ride. I offered to take their photo together,
and after the father inquired where we were
from, I remarked that Merrill and I had first
stopped on our bicycles at this spot the
summer we met in 1979. “A good history” he
said in halting English.
As we talked, a young sleep-deprived
woman with six-month old boy-girl twins
came and sat at the bench next to us. Merrill
engaged her in conversation, remarking that
we had boy-girl twins as well, but noting that
she hardly remembered the early years; she
had been so perpetually tired that the time
was just a blur. I smiled at the reminder that
periodically life presents us with challenges
that we confront, adapt to, survive, and move
beyond, and then years later can scarcely
recall. Looking back at the past five years, I
feel as if we have emerged at the other end
of a long tunnel; we are back in the sunlight
now, and can hardly remember the times in
the dark.
Thank you for your friendship and support.
FUNDRAISING UPDATE—Merrill and her
husband, Richard, are members of the
Vicious Cyclers. Thanks to many visiting girl
friends from Ithaca, Albany, Cold Spring,
and Rye, as well as NYC, the Vicious Cyclers
raised $22,728 and were the 7 th team in the
Friends and Family Category. Richard raised
$1,480 and Merrill raised $6,370. Now Merrill
reports riding once a weekend—marathon
or not—30 miles from home to Central Park,
around twice and home. She says the ride is
a joy for her. She is even loading up on cycle
wear for the winter months.
CGD NEWS BRIEFS
Sylvia Klineova, MD
n Passed her Neurology Boards and is now a
Board Certified Neurologist
n She is taking a Masters in Clinical Research at
the Icahn School of Medicine at Mount Sinai
Gretchen Mathewson, NP
n Finished her 6 mos. Dystel Nursing Fellowship
and has started working full-time as of
Dec 1, 2012
Please Welcome the Newest Member
of the CGD Family
Christopher Joseph Alonso, affectionately nicknamed, CJ,
was born on 8/22/12 at 4:59pm. The proud parents are
Christine Hannigan, one of our Senior Research Coordinators,
and Chris Alonso—everyone is some form of Chris. He
weighed 7lbs, 1oz and was 20” long. Despite being wiped out
in Hurricane Sandy, the family is doing well and is buoyed by
their happy little bundle of joy. We all wish them well.
Winter 2013 • • MSInteractions
11

CGD FACULTY PRESENTS
At the Consortium of Multiple Sclerosis Centers
(CMSC) Meeting and the European Committee
for Treatment and Research in Multiple Sclerosis
(ECTRIMS) Congress in 2012
By Stephen Krieger, MD
In June 2012, faculty of the
CGD Center for MS made
several presentations at the
Annual Consortium of Multiple
Sclerosis Centers (CMSC)
Meeting, held this past year
in San Diego, California.
Several presentations of
results from Dr. Fred Lublin’s
CombiRx clinicial trial (which
compared Avonex, Copaxone,
and the combination of the
two medicines together)
were made at CMSC. The
top-line results – that either
medicine alone was as good
as the combination of the
two medicines at preventing
MS relapses -- had been
presented previously at
the AAN Meeting in April
2012. At CMSC, Dr. Lublin’s
collaborator Dr. Stacy
Cofield presented new
information from this trial
evaluating Qualify of Life for
patients treated with these
medications, finding that
these important outcomes
remained remarkably stable
for the great majority of
patients over the 3-year
duration of the trial.
Other presentations of
the CombiRx data by Dr.
Lublin’s collaborator Dr. Jerry
Wolinsky looked at novel ways
of using MRI scans to predict
clinical outcomes for patients,
as well as new techniques
for evaluating how MS
medications can prevent the
loss of brain volume known
as brain atrophy. Members
of the CGD faculty and staff
including Dr. Lublin and CGD
Research Manager Tarah
12
PLEASE MEET
Sabrina Phipps,
Certified MA
(Medical Assistant)
Sabrina Phipps has been with Mount Sinai
since 1996. She started in the department
of Surgery and became a medical assistant
for the Department of Neurology, Division
MSInteractions • • Winter 2013
of Movement Disorders in 1999. When
Movement Disorders moved down to the
first floor of 5 East 98 th Street, she was
“shared” by the Division of Movement
Disorders and the MS Center. In 2012, both
Centers—the Robert and John Bendheim
Center for Parkinsons & Movement
Disorders and the Corinne Goldsmith
Dickinson Center for Multiple Sclerosis
realized we each needed our own MA. As
a result, Sabrina became dedicated to the
needs of the MS patients. In her new role,
she went to school and became a certified
MA—Congratulations to her. She is now in

Gustafson ran a well-attended
symposium called “MS Clinical
Trials: From Inception to
Closeout.” This symposium
was created to present to
other clinical researchers
and investigators across the
country some of the crucial
lessons learned from running
the CombiRx trial. In this way,
Dr. Lublin and the CombiRx
team were able to share new
insights regarding how to best
design and perform clinical
trials in MS, to maximize other
researchers’ ability to arrive
at clinically meaningful results
that can better the lives of
people with MS.
Also at CMSC, Dr. Krieger
presented a platform
presentation “Emergency
Department Visits Before
the Diagnosis of Multiple
Sclerosis” on behalf of a
CGD research team including
Dr. Rebecca Farber (our
2013 MS fellow), colleague
Dr. Megan Alcauskas,
and research coordinator
Christine Hannigan. This
project examined visits to
the Emergency Department
made by patients before they
were found to have MS, and
revealed that in close to 40%
of patients the diagnosis
of MS was not made at the
time of the initial symptoms.
The presentation concluded
that ED visits for neurologic
symptoms are an important
opportunity to diagnose and
treat a first attack of MS, and
there is room to make the
diagnosis even more rapidly.
Dr. Corey McGraw, our 2012
fellowship graduate, along
with Dr. Krieger also presented
a poster with an update on
“The Food Critic Who Couldn’t
Taste and Eight Other Cases
of Dysgeusia in Multiple
Sclerosis.” This project
continued our evaluation
of “loss of taste” as a rare
symptom of MS, and refined
our finding that this symptom
results from an MS lesion in
a very particular part of the
brainstem responsible for
conveying taste information
to the brain. Encouragingly,
most cases of this symptom
resolve completely.
On the educational front, Dr.
Lublin co-chaired and Drs.
Miller and Krieger joined as
teaching faculty an annual
educational program called
MASTER-MS, designed for
young neurologists interested
in learning more about care
and research in MS. This twoday
symposium at the start of
the CMSC meeting provided a
terrific cutting-edge overview
for 30 people entering our
field. Finally, DrNP Aliza Ben-
Zacharia and Dr. Krieger ran a
two-part educational program
on “Clinical Neuroanatomy in
Multiple Sclerosis” for nurses,
physician assistants, physical
therapists and other allied
health members dedicated
to caring for people with
multiple sclerosis. Dr. Krieger
was honored and humbled
to find that Dr. John Kurtzke,
a pioneer in the field of MS
research, attended
this program.
continued on page 14
charge of answering the prescription calls
and for triaging calls meant for the doctors,
nurses and social workers. She also helps
out by obtaining prior authorizations. We
are lucky to have her and we know you
have probably already felt her big smile
when you call her line and speak with her.
CGD NEWS BRIEFS
Stephen Krieger, MD
n Challenges of Relapse Management—
MSAA—Sept 2012
n PRIME Live Training Practicum—Sept 2012
n Keynote speech about
Community Health for NMSS—Abyssinian
Baptist Church, NY—Sept. 2012
n Chair AAN Education Committee—Oct. 2012
n Ectrims Poster with Dr. Katz Sand—Oct. 2012
n CGD 4th Annual Symposium at the Grand
Hyatt—Nov. 2012
n PRIME MS CME Program—Nov. 2012
n Projects in Knowledge—AAN Highlights 2012
n Consortium of MS Centers (CMSC)—online
CME Course
Winter 2013 • • MSInteractions
13

continued from page 13
The faculty from the CGD
Center was also active at this
year’s European Committee
for Treatment and Research in
Multiple Sclerosis (ECTRIMS)
Congress, in October 2012.
Held in Lyon, France, this
meeting attracted 6,800
attendees from across
Europe and the world, and
was the second-largest MS
conference on record. The
scientific program was a very
full one, including platform
sessions with state-of-theart
topical reviews followed
by presentations of new
research. Platform sessions
were well-attended as were
the poster sessions held on
two consecutive days.
In a packed platform
presentation, Dr. Lublin’s
colleague Dr. Gary Cutter
gave a talk based on the
CombiRx trial described
above, examining the numbers
of patients who had relapses
or developed permanent
changes on their neurological
examination due to MS during
the 3-year trial. Results were
encouraging: all patients in
the trial were treated with
Copaxone, Avonex, or both
medicines, and over 60% did
not have even one relapse.
Furthermore, over 80% of
patients did not develop new
permanent neurologic signs
(lasting more than a year) by
the end of the 3-year study.
Dr. Lublin also presented a
second talk on MS relapses
in the CombiRX trial, and
showed that how relapses
are defined and considered
by clinicians and researchers
have important implications
for clinical trial results and, in
turn, patient care. This study
emphasizes the importance
of precision when considering
possible relapses in MS clinical
trials, just as it is important for
us to consider new symptoms
carefully (and examine our
patients promptly) when
determining if one of our
patients may need treatment
for an MS relapse.
Dr. Aaron Miller presented
a poster on behalf of a
research group at the CGD
Center including research
coordinator Colleen Farrell,
looking at use of glatiramer
acetate (Copaxone) among
women during pregnancy.
As Dr. Miller notes, women
who desire pregnancy while
taking disease-modifying
agents face a dilemma. If they
discontinue medication prior
to attempting to conceive,
they will lose drug protection.
However, continuing
medication may have risks to
the fetus. Because Copaxone
has a Category B rating, we
have at times suggested
that women consider
remaining on Copaxone while
attempting conception and
during pregnancy. Dr. Miller
found that the majority of
44 women in his practice to
whom he offered this option
chose to remain on Copaxone
during conception and
pregnancy, and that outcomes
were similar to pregnancies
14
Please Join Us in
Wishing Stacy Well
It is with mixed emotions that we
announce that our beloved Stacy Ann
Foster—the CGD Ambassador of the
front desk is leaving Mount Sinai, as
of January 9 th , 2013-- to pursue her
nursing career. While we are pleased
MSInteractions • • Winter 2013
for her and ask you to join us in wishing her well,
please be patient with the person who must try to
provide a similar presence. We all wish her well
and hope she will keep in touch with us. Stacy
started with Mount Sinai and the CGD Center in
September 2005. We have appreciated ALL that she
has done to make this Center such a special place.
We know she will do well in her future endeavors.
Addendum:
Stacy wants you to know collectively, that she will
miss everyone and apologizes if she did not have the
opportunity to say goodbye individually.

in the general population. His study
concluded that the results (in this limited
number of patients) suggest that with
sufficient counseling, Copaxone may be
safely continued during pregnancy.
CGD faculty presented two other posters
at ECTRIMS. Dr. Corey McGraw (on behalf
of a team including Dr. Miller, MRI expert
Dr. Matilde Inglese, and Christine Hannigan)
presented the results of a study conducted
entirely at the CGD Center, looking at the
safety of the Herpes Zoster Vaccine in
Patients with Multiple Sclerosis. With a group
of 19 patients over the age of 50 in whom the
Zoster vaccine is FDA-approved, Dr. McGraw
found that there were no MS relapses in the
3 months following the vaccine, and there
were no new MS lesions seen on MRI after
the vaccinations. Dr. McGraw concluded that
the study suggests that this vaccine may be
safely administered to people with MS.
Finally, MS Fellow Dr. Ilana Katz Sand and
Dr. Krieger co-presented on behalf of a
CGD research group including Dr. Miller
and Colleen Farrell the results of a project
titled “Diagnostic Uncertainty During the
Transition to Secondary Progressive Multiple
Sclerosis.” Many patients are interested
in knowing “what type” of MS they have,
including categories like Relapsing Remitting
MS (RRMS) and Secondary Progressive MS
(SPMS). These categories, however, are very
subjective, and clinicians are often reluctant
to answer this question decisively. This study
looked back at the charts of 123 patients
followed at our Center for over 8 years,
and found that there is indeed uncertainty
in how these diagnostic categories should
be applied, and it can take many years
for Secondary Progressive MS to become
evident. Drs. Katz Sand and Krieger were
pleased to be interviewed by French
television talking about the poster (although
they did not attempt to do so in French).
In discussing the poster, Dr. Krieger said he
favors using these terms as adjectives to help
describe a person’s course of MS, rather than
definitive categories.
Taken together, it was a busy Summer and
Fall of 2012 for research at the CGD Center
for MS. With numerous projects both large
and small still underway, 2013 promises to
see further productivity as we seek answers
to questions about multiple sclerosis, and to
improve our understanding for the benefit of
our patients.
TEXAS HOLD’EM
Charity Poker Tournament to
Benefit Multiple Sclerosis
RAISED OVER
$1 MILLION
Please Join Us for
the 2013 MS Walk
The MS walk is on Sunday, April 28, 2013.
We are hoping for spring weather.
Please go online and sign up to join the
MOUNT SINAI CGD Center for MS –
the link is - www.nationalmssociety.org
Save the Date for next year—October 10, 2013
Please walk with us and raise money for
a great cause – our goal is $45,000 to
make us a top-tier team!
Winter 2013 • • MSInteractions
15

The Corinne Goldsmith Dickinson Center for Multiple Sclerosis
After-Hours Seminars 2013
Fourth Wednesday of Each Month (** Except Where Noted)
5:30-7:00 PM, Annenberg 20-01—20 th floor • (1468 Madison – 100th & Madison)
DATE TOPIC SPEAKERS
January 23 rd Update on Current & Future Treatments for MS Dr. Aaron E. Miller
February 27 th How to Understand MS Research Better Dr. Fred D. Lublin
March 28 th** Basic Research: Trying to Cure the Dr. Patrizia Casaccia
(Thursday) Progressive Phase of the Disease
with her research team
April 24 th Understanding Your Diet: Myth vs Reality Dr. Aliza Ben-Zacharia
& Gretchen Mathewson
May 22 nd The Gut-Brain Connection: Dr. Patrizia Casaccia
Disease Manifestation & Response to Treatment with her research team
Free to Attend—Light refreshments provided
Please call 212-241-7958 to reserve a spot
We’re going green, and will not be sending flyers in the mail.
Please save this list for future reference.
Sponsored by Novartis Pharmaceuticals
If you would like to be notified via e-mail,
PLEASE send your e-mail address to:
donna.polisar@mssm.edu
MS Interactions
A quarterly publication of the
Corinne Goldsmith Dickinson
Center for Multiple Sclerosis
5 East 98th Street
New York, NY 10029
Complimentary
Subscriptions
Call 212-241-6854, option 6
If you are not receiving a
copy and want to be on our
mailing list PLEASE give us a
call and let us know – we are
happy to add you to our
mailing list
How to Donate:
Development Office
212-659-8500
Comments & Questions:
Donna Polisar, PhD
CGD Center Administrator
212-241-6854, option 6
www.mountsinai.org/mscenter
Ilana Katz Sand, MD
n Presented a poster at ECTRIMS
n Submitted an abstract for a poster at
AAN as well as applied for fellow award
to attend AAN meeting in March
n Wrote an article for Continuum
Aliza Ben-Zacharia , DrNP
n Co-chaired an international Global
nursing meeting of 400 nurses in
Barcelona, Spain – 11/2012
n Presented a program about the immune
system in MS & emerging therapies in MS
n 5th year chair of the communication/web
site of the IOMSN organization
n Wrote an article about palliative care in MS
n Working on several research projects
CGD NEWS BRIEFS
n Working on several research projects:
• ARMS trial with Dr. Miller
• Applying for an NMSS pilot grant
• Designing an NMO trial with
Dr. Fabian
• Working on a genetics paper with Drs.
Sealfon, Chikina and Gerald
n Wrote an article Good Moves Case
Challenges in Managing Mobility in
Multiple Sclerosis CME Aliza Bitton
Ben-Zacharia, DNP, ANP-BC, MSCN
CME Released: 09/19/2012; Valid
for credit through 09/19/2013
n Developed a program for nurses
evaluating suboptimal response and
promoting outcomes in MS with current
and emerging therapies presented via
multiple teleconference for 350 nurses
Corinne Goldsmith Dickinson Center for Multiple Sclerosis • 5 East 98th Street, First Floor