 Hi, my name is Vivienne Lee and I'm a doctor at the Royal Melbourne Hospital Mortals-Clerosa Centre. I'm also undertaking my PhD in MS at the University of Melbourne. MS is a neurological disease that results from damage to the fatty insulating covering around nerve cells in the brain and spinal cord called myelin. It occurs when the body's own immune system, which normally fights infections, mistakenly recognises the myelin as something foreign and starts to attack it, leading to inflammation and cell damage. The function of nerve fibres that normally transmit messages becomes slowed and disrupted, producing neurological symptoms. MS is the most common cause of disability from an acquired neurological disease in young adults and affects over 25,000 Australians. MS usually begins with a relaxing remitting phase with flare-ups of symptoms known as relapses, followed by complete or partial recovery. Relapses can lead to varied symptoms such as vision disturbance, weakness or paralysis, numbness, balance and coordination problems and bladder and bowel issues. Apart from relapsed related symptoms, many people with MS also experience other challenges such as fatigue, cognitive symptoms, pain and heat sensitivity. Over time, a significant proportion of patients develop secondary progressive MS where there is steady worsening of symptoms and increasing disability without recovery. A smaller number of patients have primary progressive MS where they experience gradual decline from the beginning. The underlying cause of MS is not entirely known that results from a combination of genetic and environmental factors including low vitamin D levels, viral infection and smoking. MS is usually diagnosed based on a combination of clinical symptoms, MRI scan findings and sometimes other tests. Once diagnosed, there are now many treatments available for people with the relapsing form of MS. These include self-injected medications, oral tablets and infusions. These disease-modifying therapies work on the immune system and reduce the frequency and severity of relapses and changes on MRI scans. However, so far, there has been more limited progress in finding effective therapies for progressive MS to slow down the rate of accumulating disability or to repair the damaged myelin. There are also other medications to manage MS-related symptoms as well as non-medication treatments such as physiotherapy. Now, there is a lot of ongoing research on many different aspects of MS from the biological processes underlying the disease to improve methods of diagnosis and monitoring and new treatments particularly for progressive MS and to manage the symptoms of MS. The effects of COVID-19 on people with MS who are on immunosuppressive medications has also been an active area of research. Here are a couple of examples of recent research in MS. On the topic of risk factors for MS, one recent study has provided more evidence on the link between X-Tin bar virus or EBV, which is a common virus that causes glandular fever and subsequent development of MS. This study was conducted using serially collected blood samples from several million members of the US military over a period of 20 years. As EBV infection is very common, a very large-scale study like this was required to track new EBV infections and MS diagnoses. They found that of those initially not infected with EBV, 97% of those that developed MS became EBV positive compared to only 57% in those who did not develop MS. The study concluded that the risk of developing MS increased 32 times after EBV infection. However, most people infected with EBV do not go on to develop MS, which means that there are other risk factors involved in the process. In the era of COVID-19, several recent studies have found that people on certain immunosuppressive disease-modifying therapies used to treat MS produced lower levels of protective antibodies after receiving the COVID-19 vaccination compared to people who are not immunosuppressed or taking other types of MS therapies. However, apart from antibodies, there are other parts of the immune system that may be able to respond to the vaccine and help to fight the virus. More research in this is ongoing, but currently a third and fourth dose of the COVID-19 vaccine is recommended for people with MS taking certain disease-modifying therapies to optimize their immune response. So whether it is discoveries in the laboratory, clinical trials of new drugs or studies in real-world healthcare settings, researchers producing new insights into the disease to improve the care of people with MS.