6.9 Million Euros Awarded to Three Progressive MS Symptom Studies
For people living with progressive forms of multiple sclerosis, the hardest daily realities are often not the disease progression itself but the symptoms that accumulate alongside it: persistent pain, fatigue that cuts a walk short, cognitive fog that interferes with conversation, and the particular cruelty of fatigability - the way function declines the longer someone tries to use it. These symptoms lack the disease-modifying treatments that have transformed relapsing MS care, and they are the target of three new studies now receiving EUR 6.9 million from the International Progressive MS Alliance.
The awards, announced under the Alliance's Well-Being Phase II Efficacy programme, represent the second stage of a multi-phase research pipeline that began in 2023. Nine projects received smaller development awards in the first phase; three have now advanced based on scientific merit and their assessed potential for rapid real-world implementation if they prove effective. Results are expected in four to five years.
Pain Management Through Telehealth - University of Washington
Chronic pain affects a large proportion of people with progressive MS, but access to specialist pain management varies enormously by geography and healthcare system. The study led by Dr. Dawn Ehde at the University of Washington School of Medicine addresses this directly by comparing two delivery models for pain self-management interventions: a telehealth-based program that connects patients with a therapist, and an equivalent program designed for independent or coach-supported completion.
The comparison matters clinically. If both approaches produce comparable pain reduction and quality-of-life improvements, the online self-guided version could be deployed far more broadly and cheaply than therapist-delivered care. The study will generate workbooks, global implementation plans, and datasets designed to support adaptation across different healthcare settings - outputs intended to be usable regardless of which delivery mode wins the comparison.
Brain Priming Before Rehabilitation - Canada
The second funded study asks whether preparing the brain before rehabilitation sessions improves the outcomes of that rehabilitation. Led jointly by Dr. Lara Pilutti at the University of Ottawa and Dr. Sarah Donkers at the University of Saskatchewan, the Can-PRIME MS Trial will test three priming approaches - transcranial direct current stimulation (tDCS), aerobic exercise, or a combination of both - applied before task-specific training targeting cognitive function and mobility.
Transcranial direct current stimulation passes a weak electrical current through the skull to modulate neuronal activity, and has shown effects on motor learning and cognitive performance in smaller studies. Aerobic exercise similarly changes the brain's physiological state in ways that may enhance plasticity and receptiveness to learning. Whether either approach, or their combination, translates to meaningful functional improvements for people with progressive MS - and which combination works best - is what the Canadian trial is designed to determine.
Tailored Exercise for Fatigability - Hasselt University, Belgium
The third study, led by Dr. Peter Feys at Hasselt University in Belgium, focuses specifically on fatigability in walking - the progressive decline in gait performance as walking distance increases, distinct from the general fatigue many MS patients experience at rest. The trial will enroll people with moderate-to-severe disability, a group underrepresented in MS exercise research, and test a personalized exercise program that adjusts to each participant's specific walking profile and increases in intensity over time.
The inclusion of moderate-to-severe disability is a meaningful design choice. Much of the evidence base for MS exercise interventions comes from patients with milder disease, limiting how confidently those findings can be applied to people with more advanced limitations. If the tailored program proves effective in this group, it would provide an evidence base for a patient population that currently has few validated options.
Designed With Patients, Not Just For Them
All three studies follow an Alliance requirement that people affected by progressive MS participate in study design, not just as subjects. Each team consulted an advisory board of affected individuals during proposal development, and the Alliance's People Affected by MS Engagement Coordination Team reviewed the proposals as part of the selection process.
This requirement reflects a recognition that studies designed without patient input frequently miss what matters most to the people they aim to help - focusing on outcome measures that are statistically tractable but not clinically meaningful, or designing participation requirements that are feasible for researchers but burdensome for patients. Systematic involvement in design is not a guarantee against these problems, but it provides a structural mechanism for catching them earlier.
What Comes Next
The three studies will run over the next several years, with full results expected in four to five years. The Alliance's Phase II framework explicitly focuses on implementation readiness as well as efficacy - the goal is not just to establish that an intervention works but to generate the evidence and materials needed to adopt it quickly in clinical settings if it does.
Whether that aspiration is realized depends on factors outside the trials themselves, including healthcare system receptiveness, funding availability for implementation, and how strongly the effect sizes prove in diverse patient populations. Phase II trials are informative but not definitive; they are powered to detect effects, not necessarily to characterize them with the precision required for clinical guideline development. If these studies succeed, Phase III confirmation would still be the standard expectation before routine clinical adoption.