WEBVTT
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It's October 6th, and we have a lot to talk about, including brand new approaches
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to managing MS-related cognitive changes.
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For so many people living with MS, cognitive symptoms can be among the most
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disruptive challenges they face.
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What makes them especially frustrating is that they're largely invisible to
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family, to colleagues, and often even to clinicians.
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And that invisibility makes finding effective strategies all the more difficult.
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My guest today is Dr. Elizabeth Gromisch, a research neuropsychologist at the
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Mandel Center for Comprehensive Multiple Sclerosis Care and Neuroscience Research
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at Mount Sinai Rehabilitation Hospital in Hartford, Connecticut.
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Her work sits right at the intersection of neuropsychology, practical technology,
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and patient empowerment, focusing on real-world tools that help people actively
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manage and even improve cognitive dysfunction.
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We'll get to my conversation with Dr. Gromischin just a moment,
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but first, a quick reminder.
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We're now just two weeks away from MS Toronto 2026, this year's joint meeting
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of the America's Committee for Treatment and Research in MS and the European
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Committee for Treatment and Research in MS.
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It's the single largest gathering of MS researchers in the world,
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and you can be a part of it.
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This year, MS Toronto 2026 Patient Community Day is happening both in person
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and online on Friday, October 23rd from 3 to 6 p.m. Eastern Time.
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It's an incredible opportunity to hear leading experts break down the latest
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research presented at the conference into clear, accessible language.
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And you'll even have the chance to submit your own questions directly to the researchers.
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Registration is open now at ectrimspatientcommunity.eu and you can find that
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link waiting for you in today's show notes.
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Whether it's struggling to recall a familiar word, juggling a busy schedule
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that starts to feel overwhelming, or remembering to take medications on time,
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cognitive changes can fundamentally alter how someone navigates daily life with MS.
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Joining me in a moment with a preview of emerging digital tools along with practical
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strategies designed to better manage MS-related cognitive issues is Dr. Elizabeth Gromisch.
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Dr. Gromish is a research neuropsychologist at the Mandell Center for
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Comprehensive Multiple Sclerosis Care and Neuroscience Research at Mount Sinai
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Rehabilitation Hospital in Hartford, Connecticut.
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Welcome back to the podcast, Dr. Gromisch.
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Thank you for having me.
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Your work sits at the intersection of neuropsychology, technology,
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and patient empowerment.
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What first drew you to focus on the cognitive and psychological dimensions of multiple sclerosis?
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So I had a longstanding interest in cognition, actually, because my mother had
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a rare form of brain cancer.
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So I saw firsthand how different neurological conditions can take away our ability
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to remember information or pay attention. So that really led me down the road of neuropsychology.
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And I got into the world of MS courtesy of Dr. Fred Foley.
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I ended up joining his research lab by first month of graduate school,
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which was also the first day I decided I'm gonna be doing work on cognition,
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finding better ways that we can do screening.
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And then from there, it really has evolved to including technology from my own
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experience, living with different
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disabilities and realizing how much technology is not made for people,
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when we have fine motor difficulties, when we have cognitive difficulties or vision difficulties.
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We're going to circle back to that issue in just a moment. You know,
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cognitive changes are often among the most feared and disruptive symptoms for
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people living with MS, but they can be invisible to family members,
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employers, and even clinicians.
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How would you describe the day-to-day impact cognitive dysfunction has on illness
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intrusiveness and quality of life?
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It has such a huge impact because we use our, obviously, we use cognition in our everyday life.
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Just having a conversation right now, there's so much we have to keep track
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of. I have to think of what I'm going to say next, remember what you just asked
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me, and also make sure I'm keeping a good pace.
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So anytime there's a breakdown in any of those cognitive functionings,
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that really can disrupt everyday activities. It could be so much harder to remember
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to take your meditation, pay your bills, or get to your appointments.
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And when those start to build up over time, you could feel like your MS really
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is taking over so much of your life and really affect your quality of life.
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So that's why it's really important as clinicians, as researchers,
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we do a better job of detecting cognitive issues and getting people the support they need sooner.
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I always think of you as being a busy person. You have a lot of projects going,
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and I want to touch on a few of them.
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I know, for instance, you've been active in developing and evaluating MS-CogScreen.
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How does this tool differ from traditional assessments, and how does it balance
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clinical rigor with practicality?
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So there's a couple of things that makes it different. So I think the biggest
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one is this was co-designed with our patients.
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So we didn't just develop it and then test it with people and go from there.
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Every step of the development process, I've had my patient advisory board.
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So they gave me feedback on how the tests actually work, the content.
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And then when we got to the technology part, how it looked on the screen.
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Was it easy for them to navigate? Could they see everything correctly?
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Could they interact with it? because there are some touch components.
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Another big part is it is technology. So a lot of times paper and pencil testing
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can be out of reach for clinicians if they don't have access to a neuropsychologist.
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With the tablet, because we built this to be on an iPad, you just need one device
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and you can do everything on that device, score it, administer it.
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And the last thing that makes it different is we have more than just processing
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speed. We actually developed six different subtests and three different versions.
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And we just completed actually our pilot evaluation and found that we can get
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through this entire battery, including about an average of three questionnaires in about 14 minutes.
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And that's comparable to the BICAMS or the Brief International Cognitive Assessment of MS.
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So the reason we did all this testing is we want to see if it would be rigorous.
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Does it measure what it's supposed to? Do they have around the same level of difficulty?
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And then if we have two different evaluators, do they get the same scores every time?
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I'm happy to say I just finished all of the analyses, actually just last month,
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and showed that our numbers are as good or sometimes even better than some of
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the measures that are out there.
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I know this isn't the only digital tool you're involved in where you've chosen
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to include people living with MS as part of the initial design development phase
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of the tool. Why is that important?
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It's important because these are going to be the individuals using these programs,
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whether it's an assessment tool or a treatment app.
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They're the ones who are using it day to day. So if we don't think about what
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their needs are, how it's going to be easier for them to use if the interface
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is something they like looking at, it's easy to see,
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then they're not going to use
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that tool and we're not really going to make something that's meaningful.
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And I have always said that patients with MS, they're the experts in what their
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MS is. They know what MS is like in their daily life. And I learned so much from them.
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I have my expertise as a neuropsychologist, but I don't know what it's like
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to have MS. So that's why it's so important that every stage of development
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includes patient stakeholders.
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And it's not just, oh, how does it look? It's also the content.
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So in all of our development projects, when we've done interventions,
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we ask people, what have you used in the past?
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If we have this technique, how can I make it easier for you to add it to your daily life?
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A moment ago, I heard you talk about some of the advantages of using a digital
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tool like MS-Cog screen versus pencil and paper.
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Are there potential pitfalls that you've identified or may be on the horizon
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when you're transitioning from that traditional pencil and paper neuropsychological
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test to app or tablet-based cognitive assessments?
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Yeah, there's a couple things that we have to keep in mind, first in the development
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process, and then as we get further along for validation studies.
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The first is always, if there's any touch involvement, is there actually a large enough touch target?
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So if someone has spine motor difficulties, can they easily interact with it?
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Or if they have issues with sensation that they don't really feel they're contacting
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the screen, is it going to read their response?
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Is everything big enough? Because that is a huge issue with blurred vision that
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can people actually read this? Or do we need to go in there and change a screen
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for every single person?
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And that starts to come an issue for cognitive screenings because we need everything
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to be standard across the board.
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So if one screen looks bigger for one person than the next, that's going to
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change the validity of the measure.
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Then when we think further down the line of things like speech recognition technology,
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that's a big thing we use. If you do text-to-speech or use things like Siri
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and Alexa, those are all using things called automated speech recognition.
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Now, a big problem is a lot of that technology is developed with voice samples
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from people who do not have any speech impairments.
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And with MS, we can see things like dysarthria.
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So when we're developing these technologies, when we're implementing them in
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the clinic, we really need to make sure that it has been trained on the voices
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that are going to be, you actually said, in day-to-day actual testing.
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So if we don't include people with dysarthria when we're training these programs,
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and then we roll it out at the clinic, then we're not going to get the actual
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valid response we're expecting.
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And then people might get really
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frustrated because the program's not recognizing what they're setting.
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Much of the research in MS Cognition focuses on processing speed and working memory.
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But you've done some substantial work on prospective memory.
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That's remembering to perform an intended action in the future.
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Why is prospective memory so critical for someone managing MS?
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So, prospective memory is that cognitive domain we use every single day.
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So, it's remembering to remember.
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It's remembering to take your medication, pay your bills, make that phone call,
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go to an appointment. it.
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And it's a very complex type of cognition because not only do you have to remember
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what you're supposed to do, you have to keep track of it the same time you're
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doing everything else in your daily life.
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And then remember not only to do the right thing, but do it at the right time.
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So a breakdown at any point in that process can cause a perspective memory failure.
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And what we've seen is when even when people don't reach the level of significant
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cognitive impairment, they can still make these perspective memory errors and
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they recognize they're making that error.
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The biggest one I've always heard when I do this type of testing is,
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I know I'm supposed to do something, but I can't remember what.
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And that causes such a huge amount of frustration.
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Now, one of the problems we have is when it comes to assessing perspective memory,
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those tests are about a half hour long.
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So when you're doing a full neuropsych that's four hours, that doesn't seem
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like, oh, you could add another half hour testing. That's not that bad.
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But our batteries are so full that that extra half hour sometimes is not feasible.
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So how do we actually deal with that? That's where those cognitive screenings come into play again.
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So if there's a way that we can screen if someone has a potential prospective
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memory issue, we then know for the full evaluation that we need to actually
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do this more detailed evaluation.
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You recently led a feasibility study on improving prospective memory through telehealth.
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I'm wondering what strategies or compensations prove to be most effective,
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and are there strategies that some of our listeners can start applying today?
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Absolutely. So the ones that we found, we looked at two different types of strategies.
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The first one was visualization, and that is when you create a mental picture
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in your mind of what you're going to do.
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So when you start, you really try to pull in all your senses and create a mental
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image of what you're going to do. and you think of what would I hear,
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what would I smell, what do I taste, what colors would I see?
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And we build up from there to help you start to use those visual imagery to
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remember what you're supposed to do.
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And then the other technique we add to that is something called implementation
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intentions or adding if-then cues.
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And the reason we do that is we can really divide perspective memory into time-based and event-based.
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So event-based is when you need to do a task surrounded by an event.
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So when the coffee pot goes off, I take my medication.
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Time-based is when it's around a time, such as in 15 minutes,
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I need to do this, or at 11.15, I need to go to my appointment.
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And that time-based one is a lot harder for people with MS.
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So when we do those if-then strategies, that helps make a more salient cue to
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when they're supposed to do something. So that coffee one comes up as an example
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a lot because that's what I train people with.
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So if I see that my coffee is the alarm goes off, then I take my medications.
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And these visual strategies have actually been found to be one of the strongest
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evidence-based cognitive strategies for MS across different types of memory.
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We recently published a systematic review where we detailed every single strategy
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that has been examined in clinical trials and different experimental trials
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to see what's the evidence behind them.
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And those visualization strategies really come across as being some of the strongest evidence.
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So in terms of practicing that at home, there are some different worksheets
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out there, but one of the biggest issues with cognitive rehabilitation,
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especially when it comes to these compensatory strategies,
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it often requires having a clinician to help guide you through it and provide training.
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And that can be a limitation if you don't live near an MS center that offers
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it or have access to somebody who offers it services.
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So that's actually something that we're hoping with our app projects to make
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available to people with MS. We are adopting our self-management program,
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Managing My MS My Way, and we'll be using natural language processing to make that a reality.
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So we will be able to have something in an app where you could practice those
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different strategies and see what works for you.
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You know, I was about to ask you about Managing My MS My Way,
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so this is perfect timing. Tell us more about that program.
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So Managing My MS, My Way is a self-management program. We actually started
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developing it coming up on eight years now, since I just celebrated nine years
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here at the Mandel Center. And I started the very early work on it within the first couple months.
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And the idea is we wanted to take evidence-based self-management strategies
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like cognitive behavioral therapy and energy conservation and put it in the
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palm of your hand so you can access it from your phone whenever you need it.
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And this has, we started with the fatigue, where we have six different modules
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with a lot of interactive worksheets, relaxation tapes developed specifically
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for people with MS, and lots of education.
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So whenever you want to learn new strategies or need some guidance in managing
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your fatigue, you could do it right from your phone or your tablet.
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Eventually, we will also have it available on the computer.
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So it's been a number of years, actually, when we last spoke way back in 2022,
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we had just finished asking our patient stakeholders about what strategies they
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wanted in this app and how we can make it easier to use.
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And over the summer, we finished the beta testing. So we have a fully functional version of the app.
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We asked several of our patient stakeholders to take it home for six weeks,
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try to break it because we're interested in finding any bugs or anything we
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could change to make it easier to use.
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And we found, even though we only asked people, try using it once a week so
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we could see if these different features work,
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we had people using it every day or multiple times a day and then asking,
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when is this going to come available for me to actually use for real life?
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And at this point, we're just making all those adjustments and we'll be doing
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a feasibility study. We're actually changing it to be national so you don't
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have to live in Connecticut to use it, hopefully this fall.
00:17:55.020 --> 00:17:59.690
And our next steps in this line of work is we're trying to make this version
00:17:59.690 --> 00:18:01.550
to address other MS symptoms.
00:18:02.240 --> 00:18:06.550
So our next one that we recently got funding for is to make that cognition version.
00:18:07.010 --> 00:18:10.990
Well, that's exciting. And when the feasibility study goes national,
00:18:11.110 --> 00:18:14.320
if you let me know, I'll let everybody listening to us know,
00:18:14.320 --> 00:18:17.520
and hopefully we can help populate that study for you.
00:18:18.170 --> 00:18:22.710
Fantastic. Yeah, we realize that there are people out there that want to use
00:18:22.710 --> 00:18:26.460
this kind of program, but coming to see me in Hartford might be a little difficult.
00:18:26.930 --> 00:18:32.820
So we have adjusted the study of materials, so you do not need to drive here.
00:18:33.140 --> 00:18:34.930
If you want to, you can always come see me.
00:18:35.320 --> 00:18:41.650
But you'll be able to do everything using RedCap and meeting with us one time on Microsoft Teams.
00:18:42.330 --> 00:18:43.300
That sounds great.
00:18:44.120 --> 00:18:48.530
Your research has shown that self-management behaviors aren't just about knowledge.
00:18:48.840 --> 00:18:53.500
They involve personality, psychosocial health, and physical functioning.
00:18:54.180 --> 00:18:57.810
When you're designing mobile health or mHealth interventions,
00:18:58.240 --> 00:19:02.450
how do you go about tailoring these programs to fit these different patient profiles?
00:19:03.170 --> 00:19:08.340
The big thing we try to do is really make it the program for people to really
00:19:08.340 --> 00:19:09.730
pick and choose what works for them.
00:19:09.910 --> 00:19:14.520
So when we're putting everything together, we're trying to basically cover everything
00:19:14.520 --> 00:19:18.920
under the sun that we can feasibly make available on technology.
00:19:19.510 --> 00:19:25.640
And then we really put it back on the individual. And we say about finding what
00:19:25.640 --> 00:19:28.020
works for you and normalizing.
00:19:28.210 --> 00:19:32.000
If one of these strategies doesn't work for you, you don't like it,
00:19:32.430 --> 00:19:34.270
you don't have to keep using it.
00:19:34.710 --> 00:19:37.340
And that can be a source of frustration for people otherwise,
00:19:37.340 --> 00:19:41.040
when they're told, well, you have to do this strategy, you have to do this activity.
00:19:41.600 --> 00:19:43.720
We really put the power back to the patient.
00:19:44.430 --> 00:19:50.220
When we're designing on the tech aspect, we really are trying to make sure that it is.
00:19:51.730 --> 00:19:57.580
Regardless of who you are, where you are, or what kind of difficulties you have.
00:19:58.350 --> 00:20:03.420
So big things that we did, we took a lot of this very complex information.
00:20:03.950 --> 00:20:07.280
Everything is written in the sixth grade reading level. So you do not have to
00:20:07.280 --> 00:20:12.260
have a lot of experience learning about advanced psychological techniques before you start using it.
00:20:12.880 --> 00:20:16.700
We want things to be as much point and click as possible.
00:20:17.270 --> 00:20:21.780
Having things like speech-to-text available and easy to use,
00:20:22.480 --> 00:20:25.860
and also at baseline, making it a very big font.
00:20:26.300 --> 00:20:34.860
So if you ever look at the normal, I'll find it's a size 12 to 14 font,
00:20:34.860 --> 00:20:36.510
which can be hard for you.
00:20:36.510 --> 00:20:41.810
Our base is size 18, which is the second to largest setting if you were to activate
00:20:41.810 --> 00:20:43.660
that on your phone for every other page.
00:20:44.360 --> 00:20:49.300
Missed appointments and treatment drop-offs are major concerns in chronic illness management.
00:20:49.870 --> 00:20:54.080
What has your research revealed about the root factors behind clinical attendance
00:20:54.080 --> 00:20:58.380
behaviors, and how do you think health systems can better support patients?
00:20:59.160 --> 00:21:02.420
So a big one, going back to what we started talking about, is cognition.
00:21:02.420 --> 00:21:07.180
So that perspective memory is a huge factor, because if people can't remember
00:21:07.180 --> 00:21:10.690
they have an appointment, they're not going to be able to come in.
00:21:11.580 --> 00:21:15.870
So, in order to address that, we need to make sure that we're providing additional
00:21:15.870 --> 00:21:18.610
supports for people who have memory difficulties.
00:21:19.130 --> 00:21:24.210
So, things like offering reminders. We have seen over the years that offering
00:21:24.210 --> 00:21:27.850
telehealth appointments really can make quite a difference for people.
00:21:27.850 --> 00:21:33.870
So, if they can't come into the clinic or maybe they had a last-minute change,
00:21:34.740 --> 00:21:38.360
offering a telehealth appointment can make all the difference for people.
00:21:39.180 --> 00:21:43.760
Things like mood can also affect appointment attendance. So if someone is depressed,
00:21:43.760 --> 00:21:48.980
it's a lot harder to make that activation behavior and then come into the appointment.
00:21:49.510 --> 00:21:55.170
So being aware of the different factors that can affect attendance and really
00:21:55.170 --> 00:21:58.750
having a supportive relationship between patient and provider.
00:21:59.250 --> 00:22:02.710
So if patients feel supported, that's going to make a huge difference and they're
00:22:02.710 --> 00:22:07.240
more likely to interact with their provider than feeling they're being judged
00:22:07.240 --> 00:22:09.590
when they missed an appointment. or they missed a medication.
00:22:10.110 --> 00:22:15.300
So that's also crucial for health systems too, is to be understanding and offer
00:22:15.300 --> 00:22:18.060
support when you can and be flexible if possible.
00:22:18.780 --> 00:22:23.490
I frequently hear that people living well with MS rely on a high level of resilience.
00:22:24.220 --> 00:22:28.930
You co-developed the Multiple Sclerosis Resiliency Scale, which is the first
00:22:28.930 --> 00:22:32.740
multidimensional measure of resilience specific to MS.
00:22:33.480 --> 00:22:38.690
Why develop an MS-specific scale rather than relying on general resilience metrics.
00:22:39.590 --> 00:22:45.320
So a lot of those general resilience metrics were designed for different psychological conditions.
00:22:45.440 --> 00:22:51.770
So it's really based on maybe a one-time event that caused trauma rather than
00:22:51.990 --> 00:22:54.800
how chronic illness can affect us over many years.
00:22:55.460 --> 00:22:58.690
I had started developing that measure actually based on my experience being
00:22:58.690 --> 00:23:03.100
a caretaker to my mother and seeing how living with multiple types of cancer
00:23:03.500 --> 00:23:06.360
really affected how she faced the world.
00:23:06.360 --> 00:23:12.780
And I saw how she bounced back, even when faced with some of the worst news you could possibly get.
00:23:13.440 --> 00:23:17.980
So it started with having conversations with her and realizing this is not really
00:23:17.980 --> 00:23:22.170
reflected in the measures out there for assessing resilience.
00:23:22.710 --> 00:23:26.550
And I saw a lot of those same things popping up with MS as well.
00:23:26.550 --> 00:23:30.720
So that really drove me to try to develop something that captures more of that
00:23:30.720 --> 00:23:36.000
wider experience, as well as the different factors that can influence resilience.
00:23:36.490 --> 00:23:41.290
Trillia is a biopsychosocial model. So there are the psychological aspects.
00:23:41.540 --> 00:23:46.550
There's also physical and there's also social. So we need to consider all those
00:23:46.550 --> 00:23:51.650
different factors and how that may affect how someone responds to all the stressors
00:23:51.650 --> 00:23:52.900
they're at-masking cause.
00:23:53.480 --> 00:23:58.110
So I guess I have a two-part question for you here. How does resilience act
00:23:58.110 --> 00:24:02.670
as a protective buffer against illness intrusiveness and cognitive decline?
00:24:03.180 --> 00:24:08.360
And do you see resilience as a fixed trait, or is it something that can be actively
00:24:08.360 --> 00:24:09.730
built and strengthened?
00:24:10.320 --> 00:24:12.970
It's definitely something that can be built and strengthened.
00:24:12.970 --> 00:24:16.310
So we look at the different aspects of resilience.
00:24:16.310 --> 00:24:21.900
So being able to view the way that you view the world, some of that optimism
00:24:21.900 --> 00:24:26.300
is a big factor, too. So we can address some of these different aspects of resilience
00:24:26.300 --> 00:24:29.610
with different interventions or building support systems.
00:24:30.520 --> 00:24:36.380
And the way that we can view resilience as a buffer is when someone has these
00:24:36.380 --> 00:24:43.420
protective factors, when they are more able to bounce back when they have stressors in their life.
00:24:43.420 --> 00:24:46.460
Doesn't mean they don't get depressed, they don't get anxious,
00:24:46.930 --> 00:24:51.440
but it's similar to different reserve metrics. It's something that kind of,
00:24:52.560 --> 00:24:55.980
lessens the blow when you're dealing with different stressors.
00:24:56.410 --> 00:25:00.060
So that way it doesn't have as much of an impact.
00:25:00.290 --> 00:25:04.300
Or you're being able to have different coping strategies that when you're faced
00:25:04.300 --> 00:25:09.960
with symptom worsening or more difficult doing activities, you're able to mentally,
00:25:09.960 --> 00:25:13.910
you can rationalize what's going on, find, okay, this is what's going on right now.
00:25:14.190 --> 00:25:16.780
And this is how I'm going to address this.
00:25:17.440 --> 00:25:21.860
You know, researchers who base their work on what the evidence shows them never
00:25:21.860 --> 00:25:26.590
enjoy this question, but I'm going to ask you to get your crystal ball out for a moment.
00:25:27.020 --> 00:25:32.680
And as you consider the future of MS care, what emerging digital health or new
00:25:32.680 --> 00:25:37.450
psychological development excites you the most over the next five to 10 years?
00:25:38.140 --> 00:25:41.650
So there's a lot, there's definitely a lot of different things that are coming out there.
00:25:41.840 --> 00:25:48.330
I think digital tools are offering, opening whole new doors for people to access
00:25:48.330 --> 00:25:49.670
psychological treatments.
00:25:50.540 --> 00:25:55.400
I think in the world of MS, access to psychological treatments has been
00:25:55.400 --> 00:26:01.070
a barrier for so many people, whether it's having providers that are knowledgeable
00:26:01.070 --> 00:26:04.160
about MS, having any mental health providers.
00:26:04.570 --> 00:26:08.780
I know there's not a ton of us out there, even less so with neuropsychologists.
00:26:09.070 --> 00:26:14.120
So I always feel bad that I'm 100% research and And I can't see people clinically,
00:26:14.120 --> 00:26:19.830
so my research studies are a backdoor way for people to get some of this information.
00:26:20.570 --> 00:26:25.970
But now that we are having more advanced technology that can be accessible,
00:26:26.110 --> 00:26:31.030
that you can be able to access from your phone when you need it,
00:26:31.030 --> 00:26:34.130
that can connect with wearable devices like smartwatches.
00:26:34.900 --> 00:26:40.980
This is going to make it easier for people to access evidence-based interventions.
00:26:41.610 --> 00:26:46.550
It's going to make it easier for clinicians to provide screenings,
00:26:46.550 --> 00:26:51.550
provide assessments, when previously they couldn't access these kind of tools
00:26:51.550 --> 00:26:54.570
because they didn't have the right clinician in the clinic.
00:26:55.080 --> 00:26:59.310
So then patients are getting care earlier and they're getting help when they need it.
00:27:00.520 --> 00:27:05.250
And I think as we see better improvements with accessibility,
00:27:05.770 --> 00:27:10.960
when I mentioned the automated speech recognition, we've become better at understanding
00:27:10.960 --> 00:27:12.490
we need more training data.
00:27:12.810 --> 00:27:17.190
So there is a great project called the Speech Accessibility Project,
00:27:17.190 --> 00:27:22.360
where they had data from 999 people with speech impairments.
00:27:22.940 --> 00:27:28.900
And the whole idea was to get data from people with dysarthria so that speech
00:27:28.900 --> 00:27:34.530
recognition technology is more accurate to when people have impairments.
00:27:35.130 --> 00:27:39.320
And we're lucky we actually have access to that data, and we're using that for
00:27:39.320 --> 00:27:41.790
training speech recognition for MS-COG screen.
00:27:42.360 --> 00:27:45.920
So that way, it's not going to be a barrier. If someone has a speech impairment,
00:27:45.920 --> 00:27:50.610
they can still get access to these cognitive screening tools.
00:27:51.840 --> 00:27:55.430
And I think as we see more of these technologies becoming on the market,
00:27:55.540 --> 00:27:57.290
and that's also a crucial thing, too.
00:27:57.470 --> 00:28:01.900
We could do all the research we want, but if we don't make this available to
00:28:01.900 --> 00:28:06.990
the general public, then we haven't really made an impact. So I know for my
00:28:06.990 --> 00:28:11.390
own work, we're hoping over the next couple of years to move towards the commercialization stage.
00:28:11.790 --> 00:28:15.680
So you don't have to come in for a research study to access these programs.
00:28:16.220 --> 00:28:18.610
And I think that's going to make a huge difference for people.
00:28:19.250 --> 00:28:23.600
Well, Dr. Elizabeth Gromisch, I want to thank you for all the ways your research
00:28:23.600 --> 00:28:27.200
continues to improve the quality of life for people living with MS.
00:28:27.510 --> 00:28:29.480
And thanks so much for talking with me today.
00:28:30.000 --> 00:28:31.120
Thank you so much.
00:28:32.130 --> 00:28:36.750
That's going to wrap up this episode of Real Talk MS. Real Talk MS is powered
00:28:36.750 --> 00:28:38.540
by the National MS Society.
00:28:38.940 --> 00:28:43.240
And you can share this episode of the podcast by letting your friends or family
00:28:43.240 --> 00:28:51.130
members know that all they have to do is point their web browser at realtalkms.com slash 475.
00:28:51.520 --> 00:28:55.610
You'll find that link in today's show notes, so you can easily copy and paste
00:28:55.610 --> 00:28:57.980
it right into an email or a text.
00:28:58.640 --> 00:29:03.770
I also want to invite you to download the free Real Talk MS app for your iOS
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or Android smartphone or tablet.
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The app will automatically download the latest episode of Real Talk MS.
00:29:11.050 --> 00:29:13.890
You'll be able to download and listen to past episodes.
00:29:14.460 --> 00:29:18.600
You'll be able to save your favorite episodes. And what I'm particularly excited
00:29:18.600 --> 00:29:22.820
about is that I'll be able to share all kinds of bonus content with you.
00:29:23.340 --> 00:29:26.700
And that content will only be available on the app.
00:29:27.120 --> 00:29:31.130
So I hope you'll take a minute to visit the Apple App Store or the Google Play
00:29:31.130 --> 00:29:34.440
Store and download the free Real Talk MS app.
00:29:34.940 --> 00:29:42.370
And you'll find those links in today's show notes or at the Real Talk MS website at realtalkms.com.
00:29:43.240 --> 00:29:47.370
When you're diagnosed with MS early in a high-stakes corporate career,
00:29:47.810 --> 00:29:51.930
the instinct is often to hide it out of fear that your ambitions are over.
00:29:52.820 --> 00:29:58.990
Next week, KPMG U.S. national managing partner Dana Foote joins me to bust the
00:29:58.990 --> 00:30:00.450
myth of the career ceiling.
00:30:01.110 --> 00:30:06.190
Dana shares her journey from hiding IV steroid bags up her sleeves as a young
00:30:06.190 --> 00:30:11.660
auditor to leading a multi-billion dollar audit practice while helping to reshape
00:30:11.660 --> 00:30:14.620
reasonable accommodations from the inside out.
00:30:15.230 --> 00:30:18.910
I hope you're planning to join me next week on Real Talk MS.
00:30:19.500 --> 00:30:22.380
I'm Jon Strum. Thanks for listening.
00:30:23.150 --> 00:30:26.430
Stay safe and make healthy choices.
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