Episode transcript
Voiceover:
Welcome to The Raw Nerve, the official podcast of MS Australia, a conversation space for all things multiple sclerosis.
Join us for news and views on the latest research, treatments and advocacy efforts, as well as candid and informative interviews with our community, those living with MS, and their families and carers, together with leading clinicians, researchers and advocates.
Dr Fiona McKay:
Hello and welcome to The Raw Nerve. I’m your host, Dr Fiona McKay.
Today on The Raw Nerve, we’re talking about innovative new research in multiple sclerosis, or MS. Thanks to very generous giving by our community, this new research has been funded under MS Australia’s 2026 Mid-Year Research Grants, announced in late July.
Every year, MS Australia holds two grant rounds to select the top research projects to fund. Our Mid-Year MS Research Grants Round is specifically focussed on investment in the people and the ideas that have the strongest potential to shape the future of MS research and of MS treatment.
We provide incubator funding to allow researchers to explore research avenues that are a bit ‘out of the box’, or aspirational “blue sky” ideas, with a view to completely new ways to treat or manage MS.
We also invest in projects from talented researchers who are just starting their research careers, so that we’re building capacity and innovation into the next generation of MS researchers.
The three new projects announced in July for our 2026 Mid-Year Grant Round address our community’s top priorities for MS research, including:
- Causes and prevention
- Better treatments; and
- Cures via repair and regeneration of cells
These projects, spanning the role of Epstein-Barr virus in MS, myelin in “mini brains”, and harnessing AI for more sensitive monitoring of MS are the topic of our discussion today.
Today, we’ll be speaking with two MS researchers about two of these cutting-edge projects:
- Dr Tal Koren, from the Brain and Mind Centre at The University of Sydney; and
- Dr Samantha Barton, from the Florey Institute of Neuroscience and Mental Health at the University of Melbourne.
You’ll also hear about research underway by our third grant recipient, Dr Carla Proietti, from the Institute for Molecular Bioscience at The University of Queensland.
And I’ll give you a quick rundown on what’s happening at MS Australia’s National Symposium on MS Medications in Melbourne, later this year and that is open to the public.
I’d now like to welcome into the studio Dr Tal Koren from the Brain and Mind Centre at The University of Sydney.
Welcome to you Tal.
Dr Tal Koren:
Thank you very much, Fiona. Thank you for having me.
Dr Fiona McKay:
Thanks Tal. Your new project is called “Biomarkers of Disease Progression in the Spinal Cord in MS.”
Can you tell us what is this project aiming to improve or better understand?
Dr Tal Koren:
Sure.
So, most of the research we have in multiple sclerosis has historically focussed on the brain: it’s larger by volume; it’s much easier to image. But very little has been done on appreciating how multiple sclerosis affects the spinal cord.
That makes sense. The spinal cord is a much smaller organ to image. It’s quite narrow, it’s surrounded by bone, and your heart and your lung move a lot…it’s pretty hard to image and study. However, it quite profoundly impacts disability in patients living with multiple sclerosis.
People who’ve got ten or fifteen lesions in the brain may be able to get away with just having a bit of fatigue or brain fog. But if you have one large lesion in your spinal cord you may not be able to walk.
The spinal cord, even though it’s quite small, it’s essentially integrated in our ability to coordinate movements, to sense our surroundings together with our bladder and our bowel function.
So, this particular study is trying to better understand how multiple sclerosis affects the spinal cord in terms of both the disease burden and in terms of lesions and how the lesions change over time. But also, other markers of the disease within the spinal cord and how they interact with disability.
And we try and utilise new MRI technologies, together with artificial intelligence, to try and answer some of those questions.
Dr Fiona McKay:
That’s very impactful research Tal.
You are a consultant neurologist. Can you tell us a bit about how the experiences of people with MS led you to developing this project?
Dr Tal Koren:
So, I think that, despite the fact we have quite good therapies for the majority of patients with multiple sclerosis these days, there remains a small portion of patients who do not respond to where we want to. Or some patients with progressive disease.
And I did notice that the majority of these patients are the ones that I’ll see every six or twelve months and they will have regular imaging. And every time I see them, they will tell me that they’ll feel like their ability to walk has deteriorated, they can’t walk as far, they get more fatigued, but these scans themselves when we see and review them, they report as normal; with no new lesions and no changes.
Usually, those patients are the ones that have got significant burden in the spinal cord.
And it results in a lot of frustration from the patients, that their scans don’t reflect what they’re actually experiencing. And a lot of uncertainty about whether or not we are treating the disease in the best way and what is it that we are lacking in our scans to appreciate the disability.
Dr Fiona McKay:
So, how are you going about this research and addressing this? Can you unpack the process of how you’re doing that?
Dr Tal Koren:
We’re trying to answer some of those questions with a few different steps.
So, what we’ve started doing is we’ve got a retrospective study of patients who have had multiple scans of the spinal cord in the past and we are specifically looking at both the number of lesions they had and how that integrates with disability but also how these lesions actually change over time.
And a lot of work has been done into the concept of chronic active lesions in the brain, but not a lot of that has been done in the spinal cord.
The next part of the study is that we’re specifically looking – it’s a prospective study into a new MRI technology that we’ve developed called 3D STIR. Which is a new volumetric spinal cord scan.
Now the idea is that this particular scan allows us to have a much finer resolution of the spinal cord and look at spinal cord lesions in three planes or three dimensions. With using that, we’ll be able to first of all pick up much smaller lesions that regular scans may not be able to pick up and better measure how the lesions themselves change over time.
We’ll also be focussing on something called spinal cord atrophy.
So, we know that patients with multiple sclerosis – the actual volume of the spinal cord shrinks with time, but we don’t fully understand how that correlates with disability. So, we’re trying to use those new scans to identify that as well.
Dr Fiona McKay:
Fantastic.
Can you tell us Tal, you’re using AI in your project. Can you tell us a little about how that’s going to be used and what are your thoughts on the use of AI in medicine more generally?
Dr Tal Koren:
Yes, sure. So, artificial intelligence…AI incorporates lots of different technologies but is one of the most exciting technological developments in modern medicine these days.
We’re specifically looking at deep learning models.
So, what we’ve trying to achieve is using all the data that we’ll generate, we’re going to be training deep learning tools to identify what lesions in the spinal cord look like.
So that wherever a patient gets a scan, whether it’s in Sydney, Darwin, Shepparton or Mount Isa, if there’s not an MS-specific radiologist available, they’ll be able to identify the spinal cord lesions and see how they actually change over time automatically. Together with how the spinal cord volume changes.
And we…hopefully this will significantly assist both neurologists and radiologists and the patients.
Now of course, AI is not only used in the context of diagnosis.
What’s really exciting as well is there is a concept called “Doctor Copilots”, whereby while I’m a specialist in neurology and multiple sclerosis, I’m not a sub-specialist in other areas of medicine. And the idea is to try and integrate other technologies to try and provide doctors with information from other fields at their fingertips.
So that if I see patients with multiple sclerosis who have got other medical conditions, I’ll know how my therapies are going to affect the other conditions and the other therapies as well.
So, I think AI is going to be used quite a lot in different ways within medicine in the future.
Dr Fiona McKay:
Yes, it has incredible potential, doesn’t it?
So, back to your project, if this research is successful, what do you see it changing in the future?
Dr Tal Koren:
So, I guess the aim of this project is to provide qualitative, precise information about how the disease affects the spinal cord for both neurologists, radiologists and for the patients.
The aim is that using the information and we’d be able to give better prognostic information to patients about how their disease is affecting them, how it’s likely going to evolve in the future, which may have significant impact on choice of treatments.
Now the long-term goal of course is to be able to use these disease imaging metrics and actually integrate them into clinical trials. As the majority of studies…of clinical trials really focus on how medications affect the brain.
But the hope is that if you can actually better measure how the disease affects the spinal cord, we’d be able to actually study that as well which has not been done effectively in the past.
Dr Fiona McKay:
So, it’s giving you a much more sensitive barometer of what’s going on in the patient, particularly if they’ve got these spinal cord lesions.
Dr Tal Koren:
Exactly.
And we don’t actually know where the majority of our medications affect spinal cord lesions in the cord. This has not been studied accurately.
Dr Fiona McKay:
That’s an incredible advance.
Could you tell us Tal, what inspired you to get involved in MS research, and what do you enjoy most about your work?
Dr Tal Koren:
I completed my neuroimmunology fellowship at the Brain and Mind Centre and Royal Prince Alfred Hospital.
Multiple sclerosis is the most common neurological condition to affect the central nervous system, and I think the field has transformed quite a lot in the last ten to fifteen years.
I used to say that neurology is where cancer medicine and oncology was fifteen years ago. In terms that we had a lot of information of how disease affected patients but don’t have the treatments for that.
And I think that that future is now.
We have really good, effective therapies for patients.
And what’s really, I guess inspiring and exciting for me, is when I see patients with newly diagnosed multiple sclerosis, particularly patients who’ve got other family members or friends diagnosed with MS maybe twenty or thirty years ago. I’m able to tell them that actually with the new lines of therapies that we have now, their future prognosis landscape is going to be very different, and we expect them to have a relatively disease and disability-free life in the future with our therapies.
Dr Fiona McKay:
It’s such an exciting outlook, isn’t it really?
And what do you think motivates and drives you forward every day, in the context of your research?
Dr Tal Koren:
Despite what I just said as well, we still have around 10 to 15 per cent of patients who either have progressive disease or for some reason are not responding to medications the way we’d hoped. There is still an unmet need to provide adequate therapies for those patients.
I think this is still a significant challenge and I think a lot of the research we focus on is trying to meet those particular unmet challenges. And I hope that this particular project will provide some information about what some of the drivers for the disease progression in those patients are that don’t respond. And may be able to affect the way we design our clinical trials in the future and actually create better therapies for those patients in the future.
Dr Fiona McKay:
Thank you so much Tal for joining us on The Raw Nerve Podcast. And we’ll be back right after this short break.
Voiceover:
You’re listening to The Raw Nerve, the official podcast of MS Australia, a conversation space for all things multiple sclerosis.
Subscribe to our podcast today at msaustralia.org.au/podcast.
And now, back to the show.
Dr Fiona McKay:
Welcome back to The Raw Nerve.
Today we’ve been talking about innovative MS research that’s just been funded under MS Australia’s 2026 Mid-Year Grant Round announced in late July.
We’ve just heard from researcher Dr Tal Koren from the Brain and Mind Centre at The University of Sydney about his exciting project.
And shortly, we’ll hear from Dr Samantha Barton from the Florey Institute of Neuroscience and Mental Health at the University of Melbourne about her project.
Our third grant recipient, Dr Carla Proietti, from the Institute for Molecular Bioscience at The University of Queensland couldn’t join us today, but I wanted to share a little insight into her project.
Dr Proietti has been awarded an MS Australia Incubator Grant for her research project called: “How Genes and Epstein-Barr virus Interact in multiple sclerosis.”
Now there are two key factors very strongly linked to the development of MS.
The first of these is infection with Epstein-Barr virus, or EBV. This is a very common virus that infects over 90 per cent of adults globally. But the latest research suggests it’s probably necessary for the development of MS.
Now the second factor strongly linked to MS development is our genetics. And the strongest genetic susceptibility comes from particular inherited immune genes called HLA class II genes. However, it’s still unclear how these factors work together to contribute to the development of MS.
So, Dr Proietti and her team have found a specific pattern of antibodies against EBV that’s much higher in people living with MS than in people without MS or those with other autoimmune diseases.
This pattern’s also found in cerebrospinal fluid, the fluid that surrounds the brain and the spinal cord. And this suggests that the immune response to EBV may be active in the brain in MS.
So, Dr Proietti’s project will investigate whether these HLA risk genes influence which EBV proteins a person makes antibodies against. They’ll examine whether this leads to harmful immune responses in the brain and the spinal cord in MS.
To do this, the team has developed special chips that contain every single protein made by EBV.
They take blood and cerebrospinal fluid samples from people with MS and see which EBV proteins the person is making antibodies to, either in the blood or in the brain.
This research will help determine how genetic risk factors and EBV interact in MS.
It will provide us with a clearer understanding of disease mechanisms and in the longer term, these findings could support the development of improved tools for MS diagnosis and significantly for people living with MS, disease monitoring.
So, we’ll add a link to our show notes where you can read more about Dr Proietti’s project, about her work and about what drives her.
Voiceover:
You’re listening to The Raw Nerve, the official podcast of MS Australia, a conversation space for all things multiple sclerosis.
Subscribe to our podcast today at msaustralia.org.au/podcast.
Now, back to the show.
Dr Fiona McKay:
I’d like to welcome into the studio today’s second guest, Dr Samantha Barton from the Florey Institute of Neuroscience and Mental Health at The University of Melbourne.
Welcome, to you Samantha.
Dr Samantha Barton:
Thank you for having me.
Dr Fiona McKay:
So, Sam, your new research project is called “Defining Genes That Drive Myelin Formation.”
Can you tell us a bit more about this work. What is it aiming to improve or to better understand?
Dr Samantha Barton:
Yes, sure.
So, I guess I’ll take it right back to the beginning and I’ll just talk about the wonders of the human brain.
Because actually our human bodies are incredible in the way that they protect the brain. It’s encased in a skull and the spinal column.
Whilst this makes us…you know the brain is very well protected, it also them means that we can’t really understand what’s going on when something goes wrong.
And this has led to us using a lot of animal models to understand development and also disease
But in the context of diseases like MS, we don’t really know what’s happening at a cellular level.
Why are the cells talking to each other in such a way that’s leading to that myelin degenerating and then that kind of chronic accumulation of damage?
And so, our research has come in where we have been able to generate these sort of human ‘mini brains’. And I really do mean mini. They’re the size of a grain of rice.
But they’re made with human cells, and these human cells mimic our brain cells, so we effectively have these little ‘mini brains’ in a dish and we can start asking questions about human myelination: how does this myelin form, and what happens when it’s damaged? And by understanding these processes, we hope to try to then be able to fix these processes and identify pathways where we can intervene.
Dr Fiona McKay:
It’s just incredible. So, how are you actually going about the research? Can you unpack the actual process for us?
Dr Samantha Barton:
Yes. And I know you’re asking about the ‘mini brains’ and that’s completely fine because they sound crazy. But it’s a really cool technique and actually, the guy that came up with this system, these stem cells won the Nobel Prize about twenty years ago. So, it’s really revolutionised the field of medicine, but particularly neurology.
And so, what happens is – when our cells in our body decide what they want to be, a lung cell or a kidney cell, they kind of have decided and they can’t go backwards.
But this guy that won the Nobel Prize, he took some skin cells and kind of worked his science wizardry and was able to make that cell back into a stem cell.
And a stem cell is a cell that can become any cell of the human body.
So, what that means is that when a person like you or I donate these skin cells, we can them turn them into stem cells and make any cell of the human body including brain cells.
And the true magic is that those brain cells are genetically identical to us.
So, if I was to donate my skin cells, I could make a mini brain in a dish that would genetically mirror what is inside my brain.
Dr Fiona McKay:
It’s just a phenomenal model isn’t it for really studying these diseases?
Why do you think Sam that this research you’re undertaking really matters for people living with MS?
Dr Samantha Barton:
So, in the field of MS there are a lot of drugs available to help people but at the moment, all these drugs just target the immune system.
So, they kind of dampen down that immune response and they stop those peripheral immune cells from going into the brain.
But there are no drugs available that actually repair any of the damage that’s created.
And so, with a person with MS, unfortunately it continues to be progressive and that’s why it’s termed a neurodegenerative disease as well as an autoimmune disease.
And so, we think that in order to identify a drug that can repair the myelin damage, we really need to understand why is that myelin damaged in the first place and how can we fix that process.
So, we’re taking a sort of taking a basic biological approach of asking questions: how does myelin form, how can we make myelin form, how can we fix myelin?
And so, by understanding that at a really basic fundamental biology level, we hope to then be able to translate that through to people with MS and actually identify kind of therapeutic candidates that may be able to repair that myelin in these people.
Dr Fiona McKay:
Incredible. So, if this research is successful, what could it change in the future?
Dr Samantha Barton:
The dream would be to identify something we can target with a drug.
So, identify a protein or a pathway involved that prompts human myelination and so then can we kind of create a drug that targets that protein or that pathway? So, when a person with MS if they take that drug, then it kind of promotes that repair, promotes new myelin formation and hopefully slows or even prevents that neurodegeneration from occurring.
That’s the ultimate dream.
Dr Fiona McKay:
Yes, incredible. So, changing tack a little bit now, Sam could you tell us what inspired you to become involved in MS research, and what is it that you enjoy most about your work?
Dr Samantha Barton:
When I first started studying science at university, I was fascinated by the human brain. It’s complexity and sophistication and despite its brilliance, only one small thing needs to change, and you have these devastating consequences, that don’t just affect your brain, but they affect your whole body.
So, I became pretty obsessed with understanding the human brain and that’s led to where I am today. So, using stem cells to model brain cells and understand how they kind of talk to one another.
I only started working on MS recently, over the past few years. And it’s partly because the science I do lends itself to asking these questions that pertain to MS.
But I think it is more than that.
MS can affect anyone at any age, but it has a higher incidence in women, it has a higher incidence around the age that I am.
And so, that also means that I see a lot more people around me being diagnosed. I see it a lot more and I’m more familiar with it and I think it just became clear to me that if I have the capacity to be able to answer some of these questions, then why wouldn’t I.
I guess what I enjoy doing most is seeing my staff or my students – their faces light up when they find something new.
And I think that’s a really cool place to be. The things that we’re finding in the lab is knowledge that no one knows yet. We are finding the things that go into textbooks that people will read.
And so, I think there’s something really exciting about finding new information that no one knows yet.
Dr Fiona McKay:
It’s that joy of discovery, isn’t it.
So, what would you say motivates and drives you forward every day in the context of your MS research?
Dr Samantha Barton:
I suppose being able to marry…I’m a basic biologist. I just am fascinated by cells and how they talk to one another.
If my fascination with the brain can actually translate to helping people with neurological diseases like MS, well that would be incredible.
That’s absolutely why I do what I do.
Dr Fiona McKay:
Thank you so much Sam for joining us today on The Raw Nerve Podcast.
Dr Samantha Barton:
Thank you so much for having me.
Voiceover:
You’re listening to The Raw Nerve, the official podcast of MS Australia, a conversation space for all things multiple sclerosis.
Subscribe to our podcast today at msaustralia.org.au/podcast.
Now, back to the show.
Dr Fiona McKay:
Finally, on today’s podcast I’ll give you a quick rundown on our National Symposium on MS Medications, happening later this year.
2026 marks 30 years since disease-modifying therapies, or DMTs, first became available for people living with MS in Australia.
MS Australia’s National Symposium on MS Medications takes place in Melbourne in November 2026 and is open to the MS community and other interested people.
This full-day research symposium is held in partnership with the Florey Institute of Neuroscience and Mental Health, and it will reflect on three decades of progress in the development of MS medications, their impact on care and quality of life, what’s been achieved, what remains unmet and what comes next.
Bringing together clinicians, researchers, people living with MS and industry, our symposium’s going to look back on 30 years of treatment advances and look ahead to future therapies.
Also, to remaining knowledge gaps and access considerations.
Across the day, the symposium will focus on five things.
Firstly, 30 years of MS medications in Australia. What have these therapies delivered, and what does this mean for people living with MS and for the health system?
Secondly, how has MS treatment evolved, and how changes in effectiveness, safety and expectations have shaped care.
Thirdly, how are MS treatment decisions made today. How do we balance benefits, risks and lived experience across the life stages.
Four., Why does disease progression remain a challenge, and where current and future research is focused to solve this.
And finally, what’s next in MS medications, discussing emerging therapies and what’s needed to translate innovation into real-world benefit in this space.
We’re pleased to host this landmark symposium in Melbourne at the Florey Institute of Neuroscience and Mental Health.
We look forward to welcoming researchers, clinicians, people impacted by MS and industry to this important national discussion. The program will include Professor Anna Williams from the Institute of Regeneration and Repair at the University of Edinburgh, Professor Helmut Butzkueven from Monash University, people living with MS from our Lived Experience Expert Panel, and many more.
Attendance is free.
To register, please go to the link in our show notes.
We really hope to see you there.
Dr Fiona McKay:
So, today on The Raw Nerve, we’ve been talking about new and innovative MS research funded under MS Australia’s 2026 Mid-Year Grant Round.
MS Australia plays a vital role in funding research and coordinating the MS research in Australia.
Our stewardship of MS research in this country is so vital. Investment in research remains critical to improving outcomes for people living with MS.
And every breakthrough begins with researchers asking questions no one has answered before.
MS Australia is committed to supporting Australia’s leading researchers as they tackle some of the biggest unanswered questions in MS.
Our investigator-led grant program is often described as the gold standard in terms of the checks and balances and the way the program is run and managed.
The way that grant recipients such as Samantha, Tal and Carla are selected and chosen in a rigorous process is incredibly competitive.
And we can see the quality of the grant recipients that have been successful in this round.
So, we congratulate our three researchers on their new research projects. We’ll be watching progress with great interest.
Thank you very much to our listeners for joining us on The Raw Nerve today.
Until next time, thank you.
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Thanks for listening to The Raw Nerve, the official podcast of MS Australia.
To hear more, subscribe to our podcast today at: msaustralia.org.au/podcast
