Figuring out if your multiple sclerosis is changing from the relapsing remitting to the secondary progressive stage can be murky. Signs of progression are discussed like slower walking and worsening memory. The underlying reasons for progression are revealed including nervous system injury, remyelination failure, chronic inflammation and aging. Practical ways to improve progressive symptoms are shared. Successful trials for disease-modifying therapy for secondary progressive multiple sclerosis (SPMS) are highlighted. Tolebrutinib, under expedited review by the FDA, has been shown to slow down progression in SPMS patients by targeting cells in the central nervous system causing chronic inflammation. Introducing our new co-host Jamie Holloman MD from The MS Center for Innovations in Care!  Dr. Holloman completed in neurology residency at Washington University, followed by a 3-year fellowship at the Cleveland Clinic.  He interviews: Christopher Laganke MD, Founder of the Joanne P. LaGanke MS Center, Cullman, Alabama Barry Singer MD, Director of The MS Center for Innovations in Care, Missouri Baptist Medical Center, St. Louis    

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