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Research shines light on MS causes and management

The sun, genetics, and online management: Associate Professor Ingrid van der Mei is focusing on helping people with MS.

Associate Professor Ingrid van der Mei, leading epidemiologist at the University of Tasmania’s Menzies Institute for Medical Research, is trying to solve the puzzle of Multiple Sclerosis (MS).

MS is a debilitating neurological disease that often presents in young and middle-aged adults. It’s caused by the demyelination of nerve cells. People can develop a large range of symptoms including problems with mobility and muscle function, pain, speech, and vision.

Ingrid’s research focuses on understanding why people get MS and what influences the progression. She targets factors that have the potential to be modified, but also examines how genes interact with those modifiable lifestyle factors. The ultimate aim is to prevent the disease, to slow its progression and improve the quality of life for each person with MS.

Here comes the sun: MS and vitamin D

When Ingrid first started her MS research in 1998, it was known that the rate of MS was seven times higher in Tasmania than in Northern Queensland.

“That led to the idea that sunlight exposure might be involved. That hypothesis turned out to be true,” she said.

Sun exposure was proved to have a vital link to MS.

Ingrid’s research showed that people with MS reported lower levels of sun exposure, particularly during adolescence, and this was backed up by objective measures of sun exposure. This major work was published in 2003 in the British Medical Journal. Further work showed that both low sun exposure and low vitamin D levels were important risk factors of MS.

In another line of research, the team followed people with MS over time, carefully assessing their lifestyle and vitamin D levels. Intriguingly, low vitamin D levels were not only associated with the onset of MS, but also influenced the number of MS relapses. This major discovery was published in 2010 in the Annals of Neurology. At the same time there was a paediatric MS study that backed up these findings, clearing the way for randomised control trials.

“We started to build the evidence with a simple correlation between ambient UV and MS prevalence, and extending to better and more expensive study designs,” she said.

Along the way, the work dramatically changed vitamin D prescription practices.

Bringing MS management online

Ingrid is also running the dynamic Australian MS Longitudinal Study. More than 3,000 people around Australia participate in a number of surveys each year. The data, owned by MS Research Australia, is used for research, service delivery and advocacy, and is available for other Australian MS researchers.

Ingrid will set up an electronic portal where people with MS can be empowered by having important aspects of their health and lifestyle visualised. They can also share their “personal health record” with clinicians to optimise their management.

 Another exciting project is the development of an online self-management program for people with MS – MS WorkSmart.

“Nearly half of the total MS cost is due to sickness absence and early retirement, and it will assist people with MS to maintain their employment and reduce difficulties associated with their employment.

“I want to keep being challenged in my work, through new lines of research and the digital era,” she said.

To be able to do something for the good of all those people with MS is really satisfying.

Do you want to change lives? Start your research degree at the University of Tasmania.