FROM DIAGNOSIS TO DISCOVERY w/Ashley Pike Ph.D.

When science meets lived experience, something extraordinary happens. Ashley Pike is both subject and scientist—living with multiple sclerosis while actively researching it. Diagnosed in 2008, her path has taken her from the exam room to the research lab, where her curiosity and compassion converge. As a postdoctoral fellow in the UAMS Helen L. Porter and James T. Dyke Brain Imaging Research Center, Ashley explores the brain’s white matter not only through the lens of data but through the heart of personal insight. In this interview, she shares her journey from veterinary technician to neuroscientist, opening up about the mental fatigue of graduate school, the beauty hidden in brain scans, and the need to redefine what a “cure” for MS really means. What unfolds is a conversation rich with intellect, honesty, and a deep belief in the power of personalized progress.

ALLIÉ: Let's just start at the beginning of you and your work with MS. Tell me about your relationship with MS.

ASHLEY: So, I live with MS. I was diagnosed in 2008—17 years ago now. I was working as a veterinary technician at the time. Even before my diagnosis, I was really into medicine. I’d spend time Googling, asking questions like, how can we stop pets from coming in for the same treatments over and over? How do we stop diabetes or kidney disease? I just kept asking questions.

Eventually, I realized I wanted to get to the root of things—I call it being preemptive. That curiosity led me into research. My first research job was in cardiovascular science. I cared for 40 pigs, seven days a week. I loved them—they were like my little children. After that, I worked in breast cancer research. When I got into graduate school for biomedical research, I connected with a professor doing MS research. We had a great conversation, and I thought hard about it. In vet medicine, we didn’t do much neuro work. If something got too complicated, we referred out. I didn’t know much about the brain or spinal cord.

But I live with MS. I thought this could be cool. So, I got into MS research and haven’t looked back. It’s been fulfilling to come into research and take on a role in advocacy and activism, too. That’s where I am now.

ALLIÉ: I think it’s fascinating that you live with MS and you're working on it from both sides. I really appreciate that.

ASHLEY: Before I got into research, many of my coworkers didn’t even know what MS was. I was often shunted aside or treated like I was inferior. It was a tough time. I believed I’d end up in a wheelchair and that I didn’t deserve much because of how others perceived me.

When I started grad school, I had a conversation with my professor where I admitted I didn’t know if I wanted to pursue academia. I wasn’t a traditional student. I’d been working in a clinic for ten years. I wasn’t in my twenties anymore. Academia is a long road, and I didn’t know how MS might affect me—especially before I even knew what mental fatigue was. I limited myself.

But during grad school, I met incredible people who supported me. The narrative shifted from "you’re nothing because you have this disease" to "I commend you for researching a disease you live with." That full 360 was powerful. It brought me to tears. Being seen as an inspiration is still surreal to me, especially considering the trauma I carried.

When I look at MS research, I’m not trying to cure myself. I’m not even trying to understand why I have MS. I focus on helping others living with MS who may not have access to information or may be going through what I did. Knowledge is power. If we can empower people with tools to improve their quality of life while living with MS, then I feel that’s my role.

ALLIÉ: Let’s talk about the visual representation of your research. It’s equal parts brilliant and beautiful. I know it’s the output of your work, but can you share the story behind that visualization?

ASHLEY: You’re seeing the pretty parts of science. Science is mostly boring and emotionless. But here at our teaching hospital, we have an "Art from the Heart" initiative, where you can take your research and express it through art—poetry, sculpture, any medium.

My current research looks at how changes in the brain from MS affect cognition over time. I’m studying how specific white matter tracts predict long-term cognitive behavior. There’s an open-source program we use that recently added a new feature I’d been hoping for. It allowed me to map out different white matter tracts that make up a brain’s connectome and show how the brain compensates for damage.

One of the participants in my cohort—who I’m now close friends with—also has MS and works where I do. She’s also active in advocacy, and we often travel together to D.C. to meet with legislators, which is where I met you. I was inspired to feature her in this visualization. I used her favorite color, purple, with some orange to represent MS awareness. Each strand represents an axon, and the colors show different tracts associated with the cingulum bundle.

Everyone’s brain is unique. The circuits we map form what’s called their connectome. I’m analyzing how the density of these tracts—not their direction—correlates with cognitive function. I’m asking whether it’s the number or the location of lesions that matters more. Traditional research focuses on where the damage is. I’m exploring the idea that compensatory pathways might be what really predict function.

ALLIÉ: It’s fascinating. So, those colors represent different pathways for brain signals?

ASHLEY: Exactly. The atlas we use is from the Human Connectome Project, which mapped 80 major white matter tracts based on scans of thousands of healthy individuals. It allows us to standardize and compare brains. We use regions of interest to estimate where the tracts are, then analyze each person’s unique structure.

Brains vary—head size, positioning in the MRI, etc. So we normalize scans to a template, like the ICBM atlas, which is based on 152 healthy adults. But warping someone’s brain to fit that model can distort things, so we do measurements in the native brain space first to maintain accuracy. It’s complex, and interpretation can vary since we’re turning 3D structures into 2D images.

ALLIÉ: What is the goal of your research? What are you hoping to discover?

ASHLEY: I study information processing speed—how the brain takes in information, understands it, and responds. It’s the most commonly impaired cognitive function in MS. It’s a higher-order cognition involving memory, attention, and more. Deficits in this area often mean deficits in others.

I want to understand how MS-related changes in the brain—beyond what’s visible in clinical imaging—lead to cognitive impairments. There are no effective treatments for cognitive impairment in MS. And more than half of MS patients on disability are there because of cognitive issues, not physical ones. That’s a red flag.

My goal is to develop more individualized clinical approaches. MS isn’t linear; symptoms vary dramatically. A high-functioning patient may still struggle significantly, but if their neurologist compares them to someone worse off, their issues may be dismissed. I want to change that.

We use the term "cure cycle" to describe treatment approaches, even though MS has no cure at this time. The goal is to improve quality of life. If we can do that, we’re doing something right.

ALLIÉ: I love this. As someone living with MS, I really feel the importance of what you’re doing. Let’s talk about that word—"compensatory." It’s fun to say, but it also holds a lot of meaning.

ASHLEY: Yes! Think of it like this: if you break your leg and need crutches, the crutches are compensatory. They’re not your legs, but they help you walk.

Or picture a road map. You’ve got three routes to work: the interstate, the highway, and the backroads. If the interstate is jammed and the backroads are flooded, you take the highway. If all three are blocked, you’re stuck. But if even one alternate route works, you can still get to work.

In MS, lesions block the brain’s "main roads." The brain reroutes signals through secondary pathways. These subservient tracks weren’t designed to take over, but they can fill in temporarily. That rerouting takes effort. So yes, it could explain mental fatigue. You’re using more of the brain to achieve the same function, and that requires more energy. More blood flow. More ATP. That’s something I’d love to study further.

ALLIÉ: That makes so much sense. Maybe that’s where fatigue kicks in—the brain is doing more work to compensate.

ASHLEY: Absolutely. Think of a new extension cord—tight, efficient wiring. Over time, if it gets bent or damaged, it has to use other wires. Less efficient. More energy is needed. That’s the brain on MS.

When I started grad school, I didn’t even know what mental fatigue was. Now I feel it deeply. I come home completely exhausted. And sure, my work in veterinary medicine was hard, but this—this is another level of mental strain. It’s constant problem-solving. There’s no ‘done’. It’s like an eternal book club.

And yes, we know fatigue, depression, and mood can impact cognition. But I think the way the brain compensates could also be a contributing factor. It’s a question worth answering.

ALLIÉ: Definitely. You’re doing brilliant and beautiful work. For me, when I was first diagnosed, my neurologist, Dr. Robert Pace, helped shift my fear into fascination. Maybe it’s a coping mechanism, but being curious about MS helped me face it. Do you feel that way too?

ASHLEY: Honestly, my fascination started before my diagnosis. In vet tech school, I loved learning about white blood cells and the immune system. I geeked out over virology—like how the influenza virus changes to survive. That blew my mind.

I think that fascination helped me separate emotion from science. In the clinic, I was compassionate, of course. But when a dog came in after being hit by a car, I focused on stabilizing vitals, not the trauma. That mindset helped me in research.

With MS, I don’t sit around thinking, "Wow, this is so cool." I see it every day. I focus on how we stop it. Friends often ask, "Are you working on the cure?" And I say, no. I used to feel bad about that, but I’ve made peace with it.

There are brilliant people working on a cure. I focus on improving quality of life now. Because even if a cure comes tomorrow, it won’t give people back what they’ve lost.

Everyone’s path is different. For one person, a ‘cure’ might be returning to work. For another, it’s being seen and supported by their community. Reducing stress, feeling heard—these things matter. Less stress means less disease burden. It’s all connected.

ALLIÉ: Yes, interconnected—that’s the word. All these systems play off each other. I love that you’re redefining the concept of a cure. It’s not one-size-fits-all.

ASHLEY: Exactly. A global cure would be amazing—no one else getting diagnosed. But we still have millions living with MS now. And many are suffering.

Healthcare has changed. Appointments are shorter. Patients with chronic illness need to be heard. Not just for emotional support, but to feel seen. People living with MS aren’t seeking attention—they’re seeking connection.

If one person can feel less alone because of what we share, that’s powerful. We’re not looking for sympathy. We’re looking for a path forward. Together. ∎