Meaningful progress in multiple sclerosis research often begins with a single question. But those questions may not always fit the requirements of large federal or medical industry grants.
Research that holds the potential to change lives can often run into funding roadblocks, when it’s difficult for doctors and scientists to get major funders on board with initial projects, new ideas, and small studies. But these ideas can lay the foundation for deepening our understanding, and sometimes these small research projects grow into the kinds of large-scale efforts that change the way MS is treated around the world.
These early-stage ideas still need support to move from concept to reality. Internal grants from the Rocky Mountain MS Center (RMMSC) provide that support to the RMMSC at University of Colorado (CU) research team, funding projects that ask practical, patient-centered questions and build the foundation for larger studies.
Why Grassroots Research Funding Matters
Major sources of funding for research — like the federal government and pharmaceutical industry — typically prioritize large-scale trials or projects with commercial potential. While those efforts are critically important, they often leave out smaller studies that explore emerging ideas or address gaps in everyday patient care.
The kind of grassroots funding provided through the RMMSC helps to fill that space by directing resources to launch pilot projects, gather initial data, and demonstrate feasibility — critical steps that make future funding, and access to those larger funding sources, possible.
This approach also shortens the distance between a promising idea and real-world impacts on patient care. It ensures that questions about things like pregnancy in MS, treatment changes as you age, behavioral health concerns, and other everyday patient issues are studied right now, not just years from now.
The MS Center’s Approach to Research
Research at the MS Center can be looked at as the culmination of three guiding principles:
- Start early. Detecting MS sooner and understanding risk before damage occurs can change the course of the disease. Studies focus on biomarkers, imaging, and other signals that help clinicians act earlier.
- Personalize decisions. MS care is not one-size-fits-all. People face choices every day — whether to start or stop a medication, how to plan for pregnancy, or how to manage fatigue and mood. Research aims to provide evidence that supports informed, individualized decisions.
- Learn from every visit. With patient consent, routine care becomes an opportunity for discovery. The Biorepository and linked clinical data allow researchers to ask new questions without starting from scratch, accelerating progress and making the most of every sample and survey.
The Questions That Drive This Work
How can MS be diagnosed earlier and with greater confidence?
When is it safe to pause or stop a disease-modifying therapy—and for whom?
How do pregnancy, postpartum, and pregnancy loss affect MS activity?
What does comprehensive care look like for children and adolescents living with MS?
Which tools — blood tests, imaging, digital measures — will help track what matters most, sooner?
Each project funded through RMMSC internal grants addresses one of these questions. Together, they reflect a commitment to research that improves lives today while shaping the future of MS care.
Current Projects Funded by RMMSC Internal Grants
Biorepository: The Engine That Powers Faster, Smarter MS Research
Primary Investigator: Enrique Alvarez, MD, PhD
The Biorepository is a cornerstone of MS research at CU Anschutz. With patient consent, paired cerebrospinal fluid (CSF) and blood samples are collected and stored, often linked to clinical information and MRI findings. Longitudinal blood samples from individuals starting new disease-modifying therapies add another layer of insight. This combination—samples plus real-world context—enables researchers to test ideas quickly and compare results across studies.
Biomarkers such as neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) can reflect nerve injury and inflammation. Access to high-quality samples allows scientists to investigate whether these markers change with specific therapies, track subtle disease activity, or predict who might need closer follow-up. Internal funding supports the infrastructure behind this work: freezer capacity, sample processing, regulatory compliance, and staff time. It also enables expansion so future projects have the resources they need from day one.
Evaluation of Clinical and Radiologic Relapses Around Pregnancy Loss in Women with MS
Primary Investigator: Elle Wade, MD
Pregnancy often reduces MS inflammatory activity, while relapse risk can rise postpartum. What happens after pregnancy loss — and does pre-conception DMT use influence that risk? Evidence is limited, which means MS doctors aren’t always equipped to offer a clear path forward for their patients.
This study reviews charts for women with MS who experienced pregnancy loss between 2010 and 2024. Investigators are comparing relapse rates and MRI changes before and after pregnancy loss, and tracking details such as age, MS history, type of loss, and pre-conception treatment.
Findings could guide clinicians in planning imaging, follow-up visits, and treatment adjustments. For patients, this means clearer, evidence-based recommendations during a challenging time.
PRE-DISC MRI: Predicting Relapse Events after DMT Discontinuation with MRI
Primary Investigator: Andrew Wolf, MD
Stopping or pausing a disease-modifying therapy is a real decision point for many people with MS. Some patients who’ve been stable for many years can do so safely, while others may experience renewed inflammation or new disease activity. Clinicians monitor MRIs closely after discontinuation, but currently there’s no reliable way to use imaging to predict who is most likely to relapse.
PRE-DISC explores whether MRI changes after stopping a DMT can serve as an early warning. The study compares outcomes for individuals with and without post-discontinuation MRI activity, and examines how imaging findings relate to later clinical events.
If certain MRI patterns are shown to consistently signal higher near-term risk, clinicians will be able to adjust care plans sooner and provide clearer guidance for patients considering treatment changes.
“MRI lesions often develop without symptoms,” says Wolf, “and with this study we aim to better understand what risk exists for worsening MS symptoms longer-term for those patients who have changes on their MRI after stopping DMT. This question would be difficult to answer in a clinical trial so using ‘real-world’ data from our clinic patients is critical.”
Risk Factors and Longitudinal Outcomes for Demyelinating Diseases Associated with TNF-a Inhibitor Use
Primary Investigator: Andrew Wolf, MD
TNF-a inhibitors are widely used to treat autoimmune conditions such as rheumatoid arthritis and inflammatory bowel disease. Rarely, individuals on these medications experience demyelinating events — symptoms or MRI findings that can resemble MS. This project seeks to clarify how often these events occur, who’s at higher risk, and what long-term outcomes look like.
Seed funding supports a multi-site research consortium to standardize case identification, capture consistent clinical details, and follow outcomes over time. The RMMSC at CU serves as the coordinating center, working with partners through the Autoimmune Neurology Research Consortium.
Results will help clinicians make safer decisions when neurological symptoms appear, improving care for people managing multiple autoimmune conditions.
“We see patients every week who have either developed MS after using a TNF-a inhibitor or who have another autoimmune condition, such as rheumatoid arthritis or inflammatory bowel disease, along with MS for which these drugs are often used,” said Wolf. “We have a very limited understanding of how these medications may increase risk for MS or if they may be used safely in some circumstances. This study hopes to take an initial step at better understanding the problem and plans to incorporate findings from several other MS centers.”
Understanding the Behavioral Health Needs of Youth with Multiple Sclerosis
Primary Investigator: Jennifer Lindwall, PhD
Co-Investigators: Teri Schreiner, MD, MPH; Ryan Kammeyer, MD; Christa Hutaff-Lee, PhD.
MS in childhood and adolescence brings challenges that extend beyond physical symptoms. Anxiety, depression, fatigue, and school functioning can all shift after diagnosis. Families need care that takes these concerns into account, as part of their routine MS management.
This project expands an existing database to track behavioral health outcomes over time. During annual visits, patients complete validated tools for depression, anxiety, quality of life, and fatigue. The team also documents recommendations and whether families were able to access services.
A structured, year-over-year view will help MS care teams anticipate needs, adjust care plans, and connect families to timely support. It also builds evidence to guide future interventions for pediatric MS.
“Consistently assessing the behavioral health needs of youth with MS is critical for providing comprehensive health care, connecting youth to important resources, and promoting overall well-being,” said Lindwall.
Evaluation of Biomarkers in Pregnant Healthy Controls and Patients with Multiple Sclerosis
Primary Investigators: Anna Shah, MD; Enrique Alvarez, MD, PhD
Pregnancy often lowers relapse risk, but the first months after delivery can bring increased inflammatory activity. Predicting who is most at risk remains a challenge. This pilot study examines whether blood biomarkers — specifically NfL and GFAP — can help forecast postpartum relapse.
Researchers will follow several pregnancies in people with and without MS, collecting blood samples at four points during pregnancy and twice postpartum. If changes in these markers align with relapse risk, clinicians could plan imaging and treatment with greater precision.
Internal funding supports assays, participant recruitment, and regulatory work — critical steps for a smooth study launch and high-quality data collection.
“The data behind family planning in multiple sclerosis has really come quite far over the last decade but there is still more work to be done,” said Shah. “This study hopes to utilize newer biomarker parameters to see if we can allow our patients to family plan even more safely! The goal is to eventually make sure all of our patients can pursue whatever their family planning goals are, regardless of a diagnosis of MS.”
Bringing It All Together
Each of these projects began with a doctor asking a simple question: What information would help make the next decision with confidence?
Grassroots funding sources like the RMMSC’s internal grants make it possible to answer those questions sooner. They support the foundational work — data collection, regulatory steps, and pilot analyses — that turns ideas into evidence, and evidence into better MS care.
These projects reflect the MS Center’s commitment to research that matters most to patients and families. They also build the foundation for larger studies that will shape the future of MS care.
How to Support This Work
Early-stage research depends on community support — patients who participate in studies, families who share samples and stories, and donors who make these earliest stages of research possible. To learn more about participating in research or supporting future efforts, visit MSCenter.org/research.
