Updated on Mar 26, 2026 | Featured, Research, Your Health
Sarah Levy, PhD
Multiple Sclerosis (MS) patients often worry that the disease will diminish their ability to think and remember, along with their motor skills. Sarah Levy, PhD, Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai, is working to address these concerns, studying the impact of MS on the brain and cognition and uncovering new possibilities for early interventions.
Dr. Levy arrived at Mount Sinai’s Corinne Goldsmith Dickinson Center for Multiple Sclerosis in 2020 with a PhD in clinical psychology and a passion for neuropsychology and neuroscience. She didn’t have extensive experience working with MS patients. But she knew that at the MS Center, she would be able to delve into an area that can be extremely concerning for patients when they receive an MS diagnosis: The potential effects of the condition on thinking and memory.
She was drawn to do a post-doctorate fellowship at Mount Sinai with James Sumowski, PhD, who researches modifiable risk and protective factors linked to cognitive decline.
“My prior research experience largely involved neuroimaging, which plays a central role in MS diagnosis and care,” says Dr. Levy, who is also Associate Director of the MS Cognitive Clinic. “Coming here allowed me to connect that work more directly to questions about cognition and brain–behavior relationships.”
As a result, Dr. Levy stayed on as faculty after her postdoc ended in 2022. Her current research focuses on several crucial areas, including how MS affects cognition; the possible impact of subtle neuroanatomical changes in the brain caused by the disease; and how MS affects cognition as patients age.
MS may affect patients’ thinking, but not in the ways researchers once thought
Besides affecting sensorimotor skills such as balance and coordination, clinicians and researchers have long known that MS can also affect a patient’s thinking and memory. But just as the latest disease-modifying therapies (DMTs) have helped keep severe motor symptoms at bay, these medications may also be changing the outlook for patients when it comes to their cognitive abilities.
Statistics show up to 70 percent of people with MS experience cognitive changes, particularly memory problems and slower information processing. But that outlook has changed with medications that work to quiet the disease’s signature lesions that can appear in the brain’s white matter, according to Dr. Levy.
“These lesions have been associated with cognitive dysfunction, but with our current DMTs, we can stop the formation of new lesions much better than in the past,” Dr. Levy says. “As a result, some cognitive issues, particularly processing speed, are less pronounced than before.”
For example, in a study recently published in the journal Brain, Dr. Sumowski, Dr. Levy and others at the MS Center found that patients with relapsing-remitting MS had normal processing speed, and slowed processing speed is now less of an issue for patients with progressive MS than previously.
That doesn’t mean MS has no effect on cognition. “Since our DMTs help reduce inflammation and protect against cognitive changes, cognition in MS patients now looks different and better,” says Dr. Levy.
She describes the cognitive issues as more subtle, and sometimes easier for patients to work around, but still frustrating. “We’re talking about things like word-finding difficulties, which are the number one cognitive complaint from our patients.”
The other concerns she hears from her MS patients: Losing one’s train of thought in a conversation; forgetting why they came into a room; and the dreaded “brain fog.”
“Many people with MS figure out how to navigate these challenges on their own. But we are working on how we can help with therapies such as cognitive remediation, which addresses these challenges by teaching practical strategies that patients can use every day,” she says.
MS, dementia and aging
Having trouble finding words is also something that happens with normal aging, which can make it difficult to determine whether a patient’s cognitive changes are due to MS or simply getting older. “It can be hard to tell the difference,” says Dr. Levy, who is studying what cognitive aging looks like in MS.
To better understand these distinctions, her current research is expanding to examine how age-related changes in MS compare with changes seen in other conditions, such as Alzheimer’s disease. She is recruiting participants for a study that uses PET scans and blood biomarkers to help make this distinction.
“Those with Alzheimer’s disease have what’s known as a buildup of beta-amyloid proteins in the brain. “In this study, we’ll look for these proteins in patients and combine that with comprehensive neuropsychological testing to see how patients with MS who don’t have these proteins differ from older adults without MS who do.” Early research suggests that people with MS may have lower rates of beta-amyloid in the brain.
“Anecdotally, we don’t often see people with MS with the kind of dense forgetting that occurs with Alzheimer’s disease,” she says. “I have patients with MS in their 70s and 80s who are fully oriented to things like date, time, and where they are—that’s very different from what we see in Alzheimer’s. And while it’s too early to know for sure, it’s an interesting question whether people with MS might have some protection from the disease.”
White matter vs. gray matter in the brain
Another way thinking about MS is changing: For decades, MS was thought of as an inflammatory condition that primarily affected the white matter in the brain. Now, researchers are learning that the gray matter may also be affected.
“In my research, I’m interested in the subtle neuroanatomical changes that may occur in the brain’s gray matter early on in MS, as well as the subtle cognitive changes that might bring,” says Dr. Levy.
Using neuroimaging in collaboration with Erin Beck, MD, PhD, Dr. Levy has found that early on, in some patients, there may be a very subtle loss in the thickness of the gray matter in the brain, known as cortical thickness.
These findings, she stresses, shouldn’t be cause for alarm. “I don’t want to worry patients,” Dr. Levy says. “We are talking about very subtle findings, micro changes, so small they are typically not even mentioned in a radiological report.”
While researchers are still learning about what these changes might mean, and how they might be related to possible cognitive and motor function, the research nevertheless holds promise for improving patients’ quality of life.
“These changes tend to occur very early on in the disease, which means we could have an opportunity to try immediate interventions, such as teaching patients strategies to compensate for possible cognitive changes, or even dietary changes, to help protect the brain,” she says.
Promise in protecting and helping the brain in people with MS
With advances in neuroimaging, clinicians are now able to detect MS at earlier, milder stages, and better understand what the disease looks like early on. That means that, with earlier intervention using DMTs alongside lifestyle modifications in diet, exercise, and sleep, clinicians can better protect patients’ cognitive health.
For MS patients experiencing cognitive symptoms—and even those who are not—Mount Sinai offers a comprehensive neuropsychological assessment clinic to help patients and their doctors get a sense of where they are.
“For every patient who comes through the MS Center, we can provide a baseline neuropsychological exam that looks at memory, attention, language, sensorimotor skills, and executive functioning,” says Dr. Levy. Then we can use this information for comparison over the years, if patients continue with regular testing.
“Just like we use MRIs to track lesions, we can track a patient’s cognitive function over time,” says Dr. Levy.
Mount Sinai neuropsychologists can also look for changes in mood, depression, anxiety, and sleep. “We can relay this information to our neurologists and point patients to interventions that might be helpful,” says Dr. Levy.
Mount Sinai also offers MS patients access to The C. Olsten Wellness Program, directed by Ilana Katz Sand, MD, and staffed with a nurse practitioner, physical therapist, a dietician, and social workers.
But patients are the true experts in what they are experiencing, whether changes in word-finding or walking.
“By listening carefully, we can keep adapting our clinical evaluations to be more sensitive to the issues patients are reporting,” says Dr. Levy. “It’s truly our patients who have allowed us to learn and understand what is happening in the brain, helping us advance the field in a meaningful way—and also shaping the way we care for them.”
If you are interested in participating in Dr. Levy’s forthcoming PET imaging study on cognitive aging and Alzheimer’s disease in MS, you can reach out to her directly at 347-503-5471 or email her at sarah.levy@mssm.edu.
By Paula Derrow
Updated on Mar 18, 2026 | Cancer, Ear Nose Throat, Featured, Head and Neck, Patient Stories, Your Health
Actor Jay Russell, Courtesy of Paper Mill Playhouse
Actors often call on their own experiences when developing a character for the stage. But few have the depth of understanding that 21-year head and neck cancer survivor Jay Russell brings to the role of Caesar Rodney in the musical 1776, playing at Paper Mill Playhouse in Millburn, New Jersey, from Wednesday, April 1, to Saturday, May 2.
The Tony Award-winning show portrays the events leading up to the signing of the Declaration of Independence. Mr. Rodney, a delegate to the Continental Congress, struggled with his own cancer that affected his face throughout this period and eventually died of the disease. In what was arguably his most influential act, he cast a decisive vote for independence.
The actor’s cancer journey began in 2004, when he discovered a lump in his neck. Doctors at what was then called Beth Israel Medical Center took a biopsy, which showed squamous cell carcinoma, a cancer that can arise in the head and neck region. It had started in his right tonsil, then spread to the lymph nodes in his neck. Treatment included surgery, chemotherapy, and radiation. Due to the location of the tumor, Mr. Russell used a feeding tube, which led to a 40-pound weight loss.
“I’m an actor. I take direction well, so I did everything they said to do,” he says. He was back at work about 11 months after the start of treatment. “They took excellent care of me.”
The treatment was successful, and more than two decades later he remains cancer-free. (And in that time, the hospital became Mount Sinai Beth Israel, which closed in 2025.)
“There’s some asymmetry to my face and I sometimes have difficulty swallowing, but my speaking and singing voice came through unscathed,” says Mr. Russell, who has since performed on- and off-Broadway, on national tours and regional theatres, and on film and television.
We know less about Caesar Rodney’s medical story back in the 18th century. There was no effective treatment for his cancer at that time, though reports indicate that a doctor operated on his nose, leaving him disfigured. According to reports, he rarely went out in public without a green scarf covering part of his face.
But he didn’t let his illness stand in his way. Mr. Rodney served as an officer in the Delaware militia, a delegate to the Continental Congress, and governor of Delaware. His history-making moment came when the Continental Congress was voting on whether to declare independence from Britain. At that point, Mr. Rodney was in Dover, Delaware. The other two Delaware delegates were at an impasse in Philadelphia; one delegate was against declaring independence, the other for it. They needed someone to break the tie and get a “yes” vote from Delaware.
Mr. Russell (back row, fourth from right) with the cast of the musical 1776. Photo credited to Rebecca J Michelson.
In the film version of 1776, Mr. Rodney was back home recuperating from his disease; the film portrays him as a frail, elderly man. But the historical record suggests that he was in his late 40s, pragmatic, and back in Dover dealing with the Delaware militia. So, a bit of a different story is told in 1776.
“I imagine our director wanted to cast someone who had strength and resilience,” says Mr. Russell.
In real life and in the show, as soon as he received the message that he was needed urgently, Mr. Rodney jumped on a horse and rode 18 hours through a torrential storm to Philadelphia. He arrived muddy, exhausted, and eager to cast his vote to cut ties with Britain.
Mr. Russell says his personal experience overcoming adversity helps him understand what it was like for the historical figure.
“No matter how strong, resilient, and admirable Rodney was, he was in great pain and discomfort having this untreatable cancer on his face,” he says. “I will certainly use my own memories of the pain, the treatment, and the experience that I had in portraying Rodney.”
That’s not the only lesson Mr. Russell brings to his portrayal of the historical figure.
“Rodney’s diagnosis led him to understand how precious time was and how he had to use every moment,” says Mr. Russell. The politician used that moment to help bring independence to the 13 colonies. The actor brings it to share that important story on stage.
Besides being the 250th anniversary of 1776, Mr. Russell believes the musical’s revival is extremely timely. “This show celebrates the core of what made us a country, and how differing viewpoints can unite and come together for the common good,” he says.
Updated on Mar 19, 2026 | Your Health
Myopia, or nearsightedness, is on the rise among young people.
One reason is that in today’s digital age, screens and devices are a larger part of children’s lives. When children spend extended periods focusing on screens, books, or other nearby objects, their eyes must work harder.
This prolonged close-up activity is thought to trigger signals that promote the eyeball’s elongation. It’s the combined effect of all near-work tasks throughout the day—not just screen time—that contributes to this risk.
Douglas R. Fredrick, MD
In this Q&A, Douglas R. Fredrick, MD, Chief of Pediatric Ophthalmology at Mount Sinai Health System, explains why physicians and researchers are concerned that children are more susceptible to nearsightedness these days and what parents can do about it.
“By educating parents and pediatricians about the importance of limiting screentime and spending time outdoors, we can work together to slow myopia development in children and decrease the risk of irreversible visual loss down the road,” says Dr. Fredrick, who is also Professor of Ophthalmology and Pediatrics at the Icahn School of Medicine at Mount Sinai.
What is myopia?
Myopia, or nearsightedness, is when the eye focuses light in front of the retina instead of directly on it. This makes far away objects look blurry while close objects stay clear. If your child has myopia, their eyeball is slightly longer than normal from front to back, and the only way to focus the light properly is by using glasses or contact lenses.
What is causing an increase in nearsightedness among children?
Contributing factors include extensive time spent on personal devices, too much time spent indoors, genetic factors, and less time in the daylight. Children with one or both nearsighted parents are more likely to become myopic. We don’t yet understand why researchers have found light plays an important role in healthy eye development. However most physicians and parents agree that spending more time outdoors, in natural light, is good for children’s physical and mental well-being.
What symptoms should parents look for?
Children with myopia may exhibit the following symptoms:
What can a parent do about this?
A few ways parents can help lower the risk or slow myopia from getting worse include having your children:
- Keep screens at least 12 inches away from their face
- Follow the 20-20-20 rule: Every 20 minutes, look 20 feet away for 20 seconds
- Spend at least one hour outdoors every day
Should parents limit screen time for their children?
Experts recommend setting screen time limits for children and teenagers to promote healthy development and prevent the negative effects of excessive screen time. Some general guidelines are:
- Up to 18 months: No screen time, except for video chatting with family members
- Age 18 months to 2 years old: Less than an hour of screen time, for educational use
- Ages 2 to 5: Up to an hour of non-educational screen time is acceptable
- Ages 6 to 17: Two hours of recreational screen time a day should be the limit with breaks every 20 minutes
What else can parents do?
Early intervention can yield significant, long-term benefits for your child’s vision and overall ocular health and lays the foundation for long-term myopia control. Your ophthalmologist may recommend the use of spectacles or contact lenses specifically designed to slow the progression of myopia or may even recommend the use of nightly eyedrops shown to also slow progression. Screen time with educational content can be beneficial when balanced well with other activities.
Why are eye exams important?
Regular eye exams are important for children to ensure early detection and treatment of vision issues, including myopia. Children should have their eye health and vision screened by their pediatrician or family doctor at birth, three months, six months, three years, and before kindergarten. This is especially important if there is a family history of myopia. If any concerns are discovered at a screening exam, your child should be referred to a pediatric ophthalmologist for a more thorough examination.
It’s important to diagnose myopia early to ensure kids don’t fall behind in school because they cannot clearly see the board in the front of the classroom. If not detected and treated, children with a higher degree of myopia can develop more serious vision problems later in life such as cataracts, glaucoma, and macular degeneration and retinal detachment.
What occurs during an eye exam?
During your child’s eye exam, clinicians perform several tests to check for myopia. Your ophthalmologist may prescribe eyeglasses to help make vision clearer and keep myopia from worsening. Nearsightedness is usually treated with eyeglasses, contact lenses, or, in adults, laser surgery (where a laser beam of light reshapes the cornea by removing a small amount of eye tissue).
