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Lizzy East Couch and her husband, Patrick (left), share a laugh with UAMS neurologist R. Lee Archer, M.D., before the start of the symposium. Image by Tim Taylor

UAMS Brings Together Patients, Caregivers and Providers for First MS Symposium

March 26, 2025 | The University of Arkansas for Medical Sciences (UAMS) hosted its first Multiple Sclerosis Symposium on March 15, bringing together patients, caregivers and health care professionals to discuss the oft-debilitating neurological disease.

For co-organizer Ashley Pike, Ph.D., a postdoctoral fellow in the UAMS Helen L. Porter and James T. Dyke Brain Imaging Research Center, the event was personal; in 2008, she was diagnosed with multiple sclerosis, often called MS.

A native Nebraskan who moved to Arkansas to attend graduate school, Pike said she discovered many people who are living with MS don’t know what resources are available to assist them, which is why she and Chrystal Fullen, Psy.D., a neuropsychologist in the UAMS Psychiatric Research Institute, worked with the Department of Neurology to put on the symposium.

“Arkansas is what’s called an MS desert, because we don’t have a lot of access to care,” Pike said as she welcomed 125 participants, including 55 people who attended virtually. “We don’t have a lot of MS specialists. We don’t have a lot of neurologists compared to other states. But that’s OK because we have the most passionate MS experts and neurologists and specialists who are here today for you.”

MS is a chronic autoimmune disease that affects the brain and spinal cord. During MS, the immune system gets confused and attacks the myelin sheath, which protects the nerves. This damage, commonly referred to as lesions, interrupts the transmission of nerve signals, causing a variety of issues.

According to the National Multiple Sclerosis Society, 2.9 million people worldwide live with MS, including nearly 1 million in the United States.

Yoga instructor Sarah Thomas, who was diagnosed with MS in 2010, led the attendees in breathing and some gentle chair yoga poses. She encouraged the participants to find a way to keep moving and to hold onto a positive outlook.

“You have a purpose. Every day you open your eyes, and you see a new day — you have a purpose. Don’t let multiple sclerosis take that from you.”

Following Thomas, Lizzy East Couch shared the story of her diagnosis and life with MS. She was 25 years old when she first felt a tingling sensation down her spine. A few months later, the pinkie and ring fingers on both of her hands went numb. Weeks later, her feet went numb — and within 24 hours, she was numb up to her chest.

Couch, along with her parents Bob and Cynthia East, started looking for answers. They met with a local neurologist who suspected Couch had MS but couldn’t diagnose it because the tests were inconclusive. After steroid infusions, the numbness went away, and the family thought everything was OK.

“Then on the same day, one year later, I called my mom and said, ‘My feet are numb again,’” Couch said.

This time, Couch sought treatment at UAMS with R. Lee Archer, M.D., who diagnosed her with MS and started her on Copaxone, a daily injection that she took for the next 13 years.

“I hated this shot, but I managed it well, and I overcame the pain and the dread of them,” she said. “On this medication, I had no new lesions or symptoms.”

During this time, she married Patrick Couch, and they had two children — Elizabeth and Harvey. She stopped taking Copaxone during her pregnancies because MS symptoms typically subside during pregnancy.

After the birth of her second child, Couch asked Archer if she could stop taking the shots. He agreed to try it, so she stopped for a year. However, during that time, a new lesion formed on her brain.

“I learned at this doctor’s visit that I had something called shot fatigue. I was panicking at the thought of restarting the shots and taking them for the rest of my life,” she said.

Instead of restarting the Copaxone, Couch said, Archer prescribed naltrexone, a federally approved drug for the treatment of alcohol and opioid-use disorder. Although not approved for treating MS and other autoimmune diseases, the medication is sometimes prescribed in low doses for these diseases.

Couch has been taking naltrexone for the past year. In addition, she has been running, working out and eating better, which has “helped immensely on all fronts, particularly with brain fog,” a term used to describe such cognitive symptoms as mental sluggishness, memory issues and difficulty concentrating.

Danny Hill, Pharm.D., a pharmacist in the UAMS Health Neurology Clinic, discussed the improvements made over the past 15 to 20 years in MS medications. He encouraged patients to take an active role in their treatment.

“The more active you are and the more engaged in your treatment, I feel like the better your medication management and your MS journey will go,” he said.

He said there are disease modifying therapies (DMTs), which work to prevent or slow progression of MS, available in a variety of dosage forms including pills, injections or IV infusions.

“It is very important that we find a treatment that will work for you, that you can tolerate, and that fits your schedule,” he said. “If you are on board with your treatment, then you’re going to be more compliant with it and be more successful with it.”

He noted there are a variety of other medications that can be taken to alleviate the wide range of symptoms caused by MS, such as fatigue, pain, spasticity, changes in sensation and mobility impairment.

“Each patient must be evaluated individually because no two cases of MS are exactly the same. There’s no cookie cutter approach to treating MS,” he added.

Social worker Cobie Bernard, LCSW, works with MS patients in the Central Arkansas Veterans Healthcare System and said a big part of her job is supporting patients and helping mitigate barriers. She also helps the veterans get any equipment, such as canes, walkers or wheelchairs, they need for their worst days.

“Ultimately, I want to help you engage your meaning. We’re focusing now more on what matters to you versus what’s the matter. And I love that,” she said.

Stephen Docherty, Psy.D., a neuropsychology fellow in the Psychiatric Research Institute, discussed the cognitive and emotional wellness changes that patients typically experience or notice when they’re diagnosed with MS.

“Symptoms of MS are broadly broken into things that can be seen clearly by everyone, such as fatigue or pain and discomfort,” he said. “And then there are things that other people can’t see, like changes in your emotions, feelings of sadness, depression, anxiety or changes in your thinking abilities.”

Docherty said many MS patients experience changes in their processing speed, or how quickly they can think. “If you’re thinking slower, it’s going to be harder for you to access the knowledge and skills you have as effectively. You can still do it. You can still remember it. It’s just going to take you longer.”

This slower processing speed also affects how quickly one can learn things, Docherty said, adding that “processing speed is one of the most impactful changes people can see in MS.”

Executive function, or the ability to organize and plan, also can be adversely affected by MS because it takes longer to complete a task or “because it might be a little more difficult to manipulate or organize your thoughts.”

Docherty said many patients with MS notice they can no longer concentrate for long periods. They may also experience changes in their visual spatial abilities.

He noted there are adaptations that can be made to help alleviate some of these changes.

He encouraged patients to give themselves more time to complete a task and to minimize distractions so the brain can focus. “If we’re focusing on one thing at a time, our brain has to do less management of its resources, so it’s going to be more efficient.”

Docherty noted that lists can help patients who struggle with executive function, adding that “notes and lists are like a set of instructions for ourselves.”

He encouraged patients to seek support from mental health professionals, from their personal support networks and from each other.

The symposium wrapped up with an expert panel featuring UAMS neurologists R. Lee Archer, M.D., and Carolyn Mehaffey, M.D.; UAMS interventional pain specialist Aparna Jindal, M.D.; UAMS neuropsychologist Jennifer Kleiner, Ph.D.; UAMS physical therapist Amanda Williams, DPT; and neurologist Kathryn Chenault, M.D., of The Neurology Clinic & MS Clinic of Arkansas in North Little Rock.

After the event, Pike said she was very pleased with how things went and noted that organizers hope to hold an MS symposium every March during Multiple Sclerosis Awareness Month.

“We want this to be a valuable resource for MS patients and their caregivers,” she said. “When you’re battling a chronic illness, it is so important to have a strong support system to lift you up.”