Berislav Ruška

Research is the essential bridge between daily clinical practice and the future of medicine. Although balancing clinical practice and research can be challenging, it is the only way to ensure that we continue to improve outcomes for the people we treat.

Berislav Ruška, MD, PhD, is a neurology resident at the Sveti Duh University Hospital in Zagreb, Croatia. 

Dr. Ruška graduated from the University of Zagreb School of Medicine in 2018 and enrolled in the doctoral program Biomedicine and Health in 2019. After working as a  physician at the Emergency Medical Service of Zagreb County, he began his neurology residency in 2021. He has been actively involved in neurological research since his medical studies and is the author or co-author of approximately fifteen scientific papers published in international peer-reviewed journals. He regularly participates in national and international scientific congresses.

His research focuses on understanding disease mechanisms in multiple sclerosis (MS), with a particular emphasis on autonomic nervous system dysfunction and its clinical relevance. Understanding the evolution of autonomic abnormalities in people with MS represents an important step toward unraveling the complex pathophysiological processes that drive disease progression.

Advancing long-term understanding of autonomic dysfunction in multiple sclerosis

This prospective single-center cohort study investigated changes and predictors of autonomic dysfunction in people with multiple sclerosis over a six-year period from disease onset. Conducted at the Referral Center for Autonomic Nervous System Disorders at the University Hospital Center Zagreb, the study enrolled 121 newly diagnosed people with MS who underwent autonomic assessments. Autonomic symptoms were evaluated using the COMPASS-31 questionnaire at the beginning and the end of follow up, while objective autonomic function was assessed using the Composite Autonomic Scoring Scale (CASS) at baseline and every two years thereafter.

The results demonstrated that although overall COMPASS-31 and CASS scores did not change significantly over time, there was a progressive decline in cardiovagal and sudomotor function at four and six years of follow-up. Importantly, the proportion of patients with symptomatic dysautonomia nearly doubled over the six-year period. Experiencing relapses during follow-up significantly increased the likelihood of developing autonomic dysfunction, while early transition to high-efficacy disease-modifying therapy was associated with a reduced risk of long-term autonomic impairment.

These findings provide original and clinically relevant insights into the progression of autonomic dysfunction in MS. The study highlights the importance of comprehensive patient assessment that includes autonomic testing and strongly supports the early initiation of high-efficacy therapies as a strategy to preserve neurological function and improve long-term quality of life for people living with MS.

Bridging clinical practice and future therapies

For Dr. Ruška, a fascination with the complexity of the human body has guided his path toward medicine since childhood. Research represents a vital bridge between daily clinical practice and the future of neurological care. Despite the challenges of balancing research with clinical responsibilities, he views scientific work as essential for advancing patient outcomes and improving therapeutic strategies.

Outside of work, he focuses on recharging and maintaining close connections with family and friends. Being selected as a finalist for the International Medis Awards is, in his view, a recognition of collective effort and teamwork and a strong motivation to continue striving for better outcomes for people affected by multiple sclerosis.