New Resource: Mental Health Guide for Autistic College Students

Florida State University Autism Research
Florida State University Autism Research

Vanessa Bal, associate professor at the Graduate School of Applied and Professional Psychology and the Karmazin and Lillard Endowed Chair in Adult Autism and Evan Kleiman, assistant professor of psychology at Rutgers, are available to discuss a newly created resource guide for how autistic college students can address mental health questions and issues. To read and share with your audiences, click here: https://rb.gy/of3kah

The authors include suggestions and recommendations to address questions or situations such as:

  • What can I do to promote my well-being?
  • What can I do if I am overwhelmed?
  • When should I seek help?
  • Why should I seek mental health services?
  • What can mental health services provide for me?
  • What types of services exist?
  • How do I access services?
  • What problems or barriers might I encounter?
  • What should I say when contacting a service?
  • What can parents do to help?

Vanessa Bal, who also serves as director of the Psychological Services Clinic at the Rutgers Center for Adult Autism Services, studies ASD from a lifespan perspective.

Evan Kleiman’s work focuses on understanding the everyday occurrence of factors of interest to clinical psychological scientists. He has a specific focus on the everyday lives of people at risk for suicide.

The guide was created as part of an Organization for Autism Research (OAR)-funded project.

A Clearer Picture of Multiple Sclerosis

Cedars-Sinai Physician-Scientists Are Pioneering Imaging Techniques and Investigating New Biomarkers to Improve MS Diagnosis and Treatment

Newswise: A Clearer Picture of Multiple Sclerosis

Credit: Image by Cedars-Sinai.

Using advanced techniques for imaging the brain and eyes, along with new biomarkers, researchers in the Department of Neurology at Cedars-Sinai are working to present a clearer picture of multiple sclerosis (MS). Their work could lead to improved diagnosis and treatment of the disease, in which the body’s immune system attacks the brain, spinal cord and optic nerves.

“Multiple sclerosis is a disease that can look very different in different people, and the path to diagnosis is equally varied,” said MS specialist Marwa Kaisey, MD, assistant professor of Neurology at Cedars-Sinai. “Diagnosis is complex because many other diseases mimic MS, and while we have a set of diagnostic criteria, there’s no single test that is definitive.”

Misdiagnosis Is Common

The immune system in patients with MS attacks the insulating layer that protects nerves. The disruption or loss of these layers results in lesions, which show up as white spots on MRI brain scans—the main tool for diagnosing the condition.

MS lesions disrupt communication within the brain and between the brain and other parts of the body, resulting in vision problems and eye pain, double vision, muscle weakness, trouble with coordination, fatigue, dizziness, and hearing and speech problems. But MS is not the only condition that can cause white spots to appear on an MRI.

“Almost 1 in 5 new patients coming into our clinic with an existing diagnosis of MS turned out not to actually have MS, according to a study that we published in 2019,” Kaisey said. “When we talk to other MS specialists about this, they’re not surprised. They also see this trend of misdiagnosis.”

Kaisey said migraines are the most common cause of non-MS white spots on MRIs. “However, in our past study, among 43 people who were misdiagnosed with MS, we found as many as 27 different conditions actually causing the white spots on their imaging,” Kaisey said.

Patients who are misdiagnosed with MS are needlessly prescribed costly immune-modifying treatments that can increase risk for infection, cause organ damage and decrease the effectiveness of vaccines.

“If you have MS, the medications are worth the side effects because they are saving your life and protecting your brain,” Kaisey said. “But it’s a big deal to be on these medications if you don’t need to be.”

New Brain Signs

A newly identified biological sign called “central vein sign” could help physicians determine whether white spots on a patient’s MRI are caused by MS or by something else, ultimately reducing misdiagnosis.

MS lesions tend to form around tiny veins through which immune cells enter and attack brain tissue, so most lesions caused by MS have a vein in the middle. “We’ve known this for more than 100 years, but until recently we didn’t have a way to see it on an MRI,” Kaisey said.

New MRI techniques pioneered by Pascal Sati, PhD, director of the Neuroimaging Program in the Department of Neurology and associate professor of Neurology at Cedars-Sinai, make central vein sign visible.

“Current MRI images don’t give us the whole picture, which is why we developed MRI sequences that improve image quality so that we can see very small veins, called veinules, in the brain,” said Sati. “We superimpose that over a conventional MRI image of the lesions so that it is clear which brain lesions have a central vein and are likely caused by MS.”

Ongoing studies at Cedars-Sinai and 10 other MS centers in North America are using Sati’s technique to image 400 patients at risk of developing MS—the final step in scientifically validating central vein sign as a way to diagnose MS.

Importantly, the imaging technique Sati developed can be used with widely available MRI scanners and performed quickly enough to fit the workflow of the typical radiology center. He is also developing a machine learning algorithm to make evaluation of the imaging results easier for physicians.

“Once the image is taken, our deep learning algorithm can analyze it very quickly and tell the clinician how many lesions show the central vein sign,” Sati said. “The number of lesions with the central vein sign can indicate whether or not the patient has MS.”

The central vein sign could also help doctors determine how well a patient is responding to treatment by confirming that any new lesions that develop are caused by MS and not something else.

“With the central vein sign, we can clearly see which lesions are related to MS,” Sati said. “This information is empowering doctors to make decisions about whether to continue a patient’s current therapy, switch to a different MS therapy, or treat them for a completely new, or different, condition.”

Another Window Into MS

Imaging of the retina—the layer of tissue at the back of the eye—and the optic nerve can also help improve MS diagnosis. Neurologist Omar Al-Louzi, MD, director of the Visual Outcomes Laboratory at Cedars-Sinai, is at the forefront of this technology.

“Around 25% of MS patients experience vision loss or blurring as their first symptom, and as many as 80% experience vision problems at some point in the course of their disease,” said Nancy Sicotte, MD, chair of the Department of Neurology, director of the Multiple Sclerosis and Neuroimmunology Program and Women’s Guild Distinguished Chair in Neurology. “Dr. Al-Louzi’s research seeks to use the eye as a window to produce better outcomes for patients.”

Using a technology called optical coherence tomography (OCT), which functions like an MRI for the retina and optic nerve, Al-Louzi can detect MS lesions that an MRI can miss.

“The optic nerves are very small and difficult to image,” Al-Louzi said. “Detecting lesions there can help us clinch an MS diagnosis, especially in patients who are relatively early on in their disease course.”

Optical coherence tomography captures 3D images of patients’ retinal layers, including the ganglion cell layer, which sends visual information to the brain.

“Shrinking of the ganglion cell layer often mirrors overall brain degeneration, and occurs in 70% to 80% of MS patients,” Al-Louzi said. “This is why ganglion imaging could also help us improve diagnosis.”

Retinal imaging could also help indicate how well a patient is responding to treatment.

Al-Louzi is continuing to study the role of OCT, along with a related technique called optical coherence tomography angiography (OCTA), as a way to understand how MS affects the blood vessels in the retina.

“Our lab is collaborating with Dr. Kaisey to compare the vascular fingerprint of MS in the retina to that of other brain conditions involving blood vessels, such as migraine or small vessel disease, to see whether retinal vessels can help us distinguish between these different conditions,” Al-Louzi said.

While ocular nerve and retinal imaging is important to evaluate in MS patients, it is not yet widely available in practice. Al-Louzi hopes his research will help change the standard of diagnostic care.

“I think failing to use these imaging techniques is a missed opportunity,” said Al-Louzi. “Our hope is that these tests will become widespread and shorten the time between symptom onset and getting the right diagnosis.”

Seeing patients wrongly diagnosed with MS, and MS patients who have gone undiagnosed, drives these physicians to keep working toward better solutions.

“I didn’t really intend to go into this line of research, but being in clinic every day and seeing these problems firsthand, I just had to do something about them,” Kaisey said. “Almost 1 million people in the U.S. alone live with MS. Fortunately, these imaging techniques could offer an invaluable solution.”  

Mayo Clinic researchers use AI, biomarkers to personalize rheumatoid arthritis treatment

Treatment options for rheumatoid arthritis have often relied on trial and error. Now Mayo Clinic researchers are exploring the use of artificial intelligence (AI) and pharmacogenomics to predict how patients will respond to treatments, and to personalize care. Findings were published in Arthritis Care & Research.

The study focused on predicting the response to methotrexate, one of the most common rheumatoid arthritis medications.  Applying patient data that included genomic, clinical and demographic information, researchers used AI to determine an initial response to methotrexate in patients with early-stage rheumatoid arthritis. Data used in the study came from a collaboration between Mayo Clinic and the Pharmacogenetics of Methotrexate in Rheumatoid Arthritis (PAMERA) consortium, that led to early genome-wide association studies.

This work evolved from the union of AI and pharmacogenomics co-led by Liewei Wang; M.D., Ph.D.Arjun Athreya, Ph.D. and Richard Weinshilboum, M.D. “This approach began by developing tools to predict drug treatment outcomes in major depressive disorder, but we are delighted to see that it can potentially be applied widely, in this case to the drug therapy of rheumatoid arthritis,” says pharmacogenomics leaders Drs. Wang and Weinshilboum.

“In my everyday practice, patients frequently ask, ‘What medication will be most effective for me’ or ‘What is the chance this medication will help?’ This is a study that seeks to address these questions,” says Elena Myasoedova, M.D., Ph.D., a Mayo Clinic rheumatologist and lead author. By predicting a response to methotrexate, researchers identified which patients are most likely to benefit from this medication in the first three months of treatment.

Other study authors are Paul Tak M.D, Ph.D., University of Amsterdam; Ronald Van Vollenhoven, M.D., Ph.D., University of Amsterdam; Leonid Padyukov, M.D., Ph.D., Karolinska Institutet; Paul Emery, M.D., University of Leeds; Ann Morgan, M.B., Ch.B., Ph.D., University of Leeds; Tim Bogartz, M.D., Vanderbilt Medical Center; Arjun Athreya, Ph.D., Mayo Clinic; Erin Carlson, Mayo Clinic; Cynthia Crowson, Ph.D., Mayo Clinic; John Davis III, M.D., Mayo Clinic; Kenneth Warrington, M.D., Mayo Clinic; Krishna Kalari, Ph.D., Mayo Clinic; Robert Walchak, Mayo Clinic; Richard Weinshilboum, M.D., Mayo Clinic; Liewei Wang; M.D., Ph.D., Mayo Clinic; and Eric Matteson, M.D., Mayo Clinic.

More research is needed to understand how these findings can be used in practice. The study, which is part of a series looking at the roles of AI and pharmacogenomics in treating rheumatoid arthritis, was performed in collaboration with Mayo Clinic’s Center for Individualized Medicine.

“Predicting a response to rheumatoid arthritis medication can be challenging, but this approach is very promising and is an exciting development in treating the disease,” Dr. Myasoedova says.

Study Finds Rate of Multiple Sclerosis Similarly High in Black and White People


The rate of multiple sclerosis (MS) cases varies greatly by race and ethnicity. A new study suggests that the prevalence of MS in Black and white people is similarly high, while much lower in Hispanic and Asian people. The research is published in the April 27, 2022, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“MS has long been believed to be a disease of white people, but the prevalence of MS in Black people has been understudied and therefore underrecognized,” said study author Annette Langer-Gould, MD, PhD, of Kaiser Permanente Southern California in Los Angeles and a member of the American Academy of Neurology. “The findings of our study and other recent studies indicate that MS has affected Black and white adults at similar rates for decades.”

Langer-Gould said, “The belief that MS is rare in Black people has been based on a history of problematic evidence, including a 1950s study of veterans that found white men more likely than Black men to receive services through the Veterans Administration for MS. That study did not consider the barriers and disparities Black men faced in receiving services, and that they were less likely to be measured accurately.”

Langer-Gould also notes that even current research uses the terms Hispanic, Asian, Black, and white, which are socially constructed labels that influence social standing and opportunities for advancement in the U.S., not uniform biological or even cultural differences. She said it’s crucial that new research addresses systemic bias in medical research.

This new study looked at more than 2.6 million adults residing in Southern California. Researchers analyzed Kaiser Permanente health records to determine how many people had a confirmed diagnosis of MS in 2010.

Researchers identified 3,863 people with MS. The average age was 52 and 77% were women.

Researchers found that MS prevalence per 100,000 people was similarly high for Black and white people, occurring in 226 per 100,000 Black people and in 238 per 100,000 white people. MS prevalence was lower among Hispanic and Asian people, occurring in 70 per 100,000 Hispanic people and 23 per 100,000 Asian people.

The percentage of women with MS was more pronounced among Black and Asian people. Of Black people with MS, 82% were women and of Asian people, 84% were women. Of white people with MS, 76% were women and of Hispanic people, 75% were women.

“Understanding MS prevalence in all people has important implications when it comes to making sure people are properly screened and treated for this disease,” said Langer-Gould.

“More studies are needed to determine whether MS is also an emerging disease among Hispanic people in the U.S. and whether MS susceptibility and prevalence vary among Hispanic or Asian individuals from different cultures and ancestral backgrounds,” Langer-Gould added. “Larger studies are also needed that look at bigger populations across the U.S.”

Researchers Identify Potential Targets for Treating Autoimmune Diseases

Autoimmune disease awareness
Autoimmune disease awareness


Approximately 23.5 million people in the U.S. have an autoimmune disease, and some studies suggest that number could be rising. New research using a mouse model for multiple sclerosis has uncovered a potential new area to explore for possible treatments for autoimmune disorders. The study is published ahead of print in the American Journal of Physiology-Cell Physiology. It was chosen as an APSselect article for May.

“The research team delved further into the connection between nephronectin and the immune system, identifying its role in a chain of cellular processes that stimulate an immune response. Finding therapeutics that disrupt these mechanisms could uncover novel treatment options for autoimmune diseases.”


Autoimmune diseases occur when the body’s immune system attacks its own healthy tissues, organs or cells. Treatments currently available for autoimmune diseases can come with serious side effects, such as an increased risk of contracting contagious diseases.

In earlier studies, researchers found that several mouse models of different autoimmune diseases had elevated levels of nephronectin. They also found that blocking nephronectin reduced inflammation in a mouse model of arthritis. Nephronectin is a protein known to be critical to kidney development but also appears in other parts of the body.

In the current study, the research team delved further into the connection between nephronectin and the immune system, identifying its role in a chain of cellular processes that stimulate an immune response. Finding therapeutics that disrupt these mechanisms could uncover novel treatment options for autoimmune diseases.

The researchers established that blocking nephronectin “significantly inhibited the development” of experimental autoimmune encephalitis—used as a model for multiple sclerosis—in mice. They then identified a number of proteins that bind to nephronectin. Among these was selenoprotein P, a glycoprotein that is known to stimulate the production of the antioxidant glutathione peroxidase 1.

Through further analysis, the researchers found evidence for a mechanism by which nephronectin influences the immune response. When nephronectin binds to selenoprotein P, it creates a feedback loop that alters the balance of signals to the immune system. This imbalance stimulates white blood cells to be more active than they should be. This activity then exacerbates the severity of EAE.

“Our findings also suggest that the nephronectin–[reactive oxygen species] axis may be a potential therapeutic target for treating autoimmune diseases,” researchers wrote.