What is Multiple sclerosis? MS Overview

What is Multiple Sclerosis?

If you are reading this article, you probably wonder ‘what is multiple sclerosis’? Multiple sclerosis (MS) is a brain and spinal cord disabling condition. In MS, the central nervous system is disabled due to damage of the protective sheath on behalf of the immune system. This sheath, also referred to as myelin covers the fibers of the nerves and when attacked restricts communication between the brain and the body. Additionally, this disease causes the nerves to deteriorate or become damaged permanently. The multiple sclerosis treatment is determined by a doctor with expertise in diagnosing nervous system diseases.

What is Multiple Sclerosis?

What is Multiple Sclerosis?

The course of multiple sclerosis is quite unpredictable. Only a small number of people diagnosed with MS have a mild course with little disability. Also, MS patients rarely have a steadily worsening condition. Most cases have short period of MS symptoms followed by long periods of somewhat relative relief. The result may be partial or full recovery.

When one is given a multiple sclerosis diagnosis, there is no way to determine or predict how the treatment will go and will it lead to full or partial recovery. Additionally, there is no way to understand why some people develop this condition and others don’t. Perhaps this is the main reason behind the fact that there is no cure. As the disease progresses, a result of cortical atrophy begins to exists. This is a term used to describe the shrinking of the brain.

Researchers have discovered that MS can also damage the nerve cell bodies that lie in the brain’s gray matter. Additionally, it can also damage the axons, the spinal cord and the optic nerve. The optic nerve is the one that transmits visual information to the brain from the eyes.

Plaques

The term multiple sclerosis refers to the areas of scar tissue in the brain. These are called sclerosis, lesions or plaques and are visible in the white matter of patients. Sclerosis can be small or large in size, reaching the maximum size of a golf ball.

Plaques appear as a result of inflammation in the brain. When the immune system cells attack the myelin sheath, it leads to development of plaques. Additionally, this process damages axons too.

When the person is healthy, the immune system cells patrol for unhealthy cells or infectious agents such as viruses. When they recognize such agent or cells, they start producing substances that are aimed towards stopping the infectious agent. After the discovery of unhealthy cells, these ‘surveillance’ cells kill or clean out the dying area. What follows is a process of producing substances that will repair and heal the remaining cells.

When a person suffers from multiple sclerosis, these surveillance cells act differently than in the brain of healthy people. They are still active, but start to attack the healthy myelin. The reason behind this is still unknown. This is why this disease is placed in the list of autoimmune disorders, right next to lupus and rheumatoid arthritis. All these are cases where the immune system attacks some healthy tissue by mistake. Whatever the reason is the healthy tissue results in being destroyed or highly damaged.

The symptoms of multiple sclerosis will depend of the severity of the immune system reaction, the location of the plaques and the extent of the plaques. These lesions primarily appear in the spinal cord, cerebellum, brain stem, optic nerves and the white matter located around the brain ventricles.

Multiple Sclerosis

Multiple Sclerosis

People with Multiple sclerosis

  • Age

Multiple sclerosis most commonly develops in young adults. The most often affected group is people aged 20 to 40 years old. However, this is not a limit since the MS can also affect older people and even children.

  • Number of people

The exact number of people with MS is yet not discovered. Experts give an approximate number of 250,000 to 350,000 people in the US. According to this estimate, approximately 200 new cases are being diagnosed weekly.

  • Men or women

As is the case with all autoimmune disorders, women are more likely to get diagnosed with MS than men. The odds are twice as high for women when it comes to multiple sclerosis.

  • MS and geography

When it comes to geography, the people at highest risk of this disorder are those of Northern European descent. Native Americans and Asian Americans are known to have low rates of multiple sclerosis.

Genetic Susceptibility to MS

MS can be inherited. There are many studies of families that have indicated that people who have relatives diagnosed with MS are at higher risk of developing this disease than those who do not. About 15% of the people being diagnosed with this disease are estimated to have inherited this from a relative with the disease. However, the risk chances are still too low, to the extent that even identical twins have 1 in 3 chance of both sharing the same disease.

Therefore, genes are not really the key cause of this disease. There are many other causes that come in play.

The Course of MS

  • Relapsing-remitting MS

Every individual has a different MS course, but for the majority of people this starts with a first attack and follows with a full or partial recovery. After the first attack, it is not clearly defined when the second one will occur. It can be weeks, months and even years. Of course, this will be again followed by a period of symptoms relief (also referred to as relapsing-remitting MS).

  • Primary-progressive MS

Another type is primary-progressive multiple sclerosis. This is characterized with a physical decline that is gradual and with lack of noticeable remissions. This, however, can still have temporary relief from symptoms. It has a later onset and most commonly occurs in people after the age of 40. The gender factor here is not more inclined to women. Men and women have equal chances of developing this type of MS.

  • Secondary-progressive MS

This type of MS starts with a relapsing-remitting course to later move to a primary-progressive course. People with severe relapsing-remitting MS symptoms can develop secondary progressive, especially if they are not treated properly or in time.

  • Marburg Variant of MS

Also referred to malignant MS, this variant is quite rare and unusual. When one suffers from malignant MS, this may cause a relentless decline and a swift that can result in death or significant disability.

  • Balo’s Concentric Sclerosis

This type causes concentric rings on demyelination. Luckily, these can be seen on an MRI, but this still is a rapidly progressing disease. However, it is also rare and unusual MS variation.

Exacerbation of MS

Exacerbation is an attack of MS, commonly referred to as a relapse or a flare-up. This condition unravels sudden worsening of the symptoms of MS or appearance of new symptoms. The MS attacks are considered to be associated with newly damaged brain areas and are characteristic of relapsing-remitting stage of MS. The attacks are usually followed by periods of partial or full recovery, without any apparent symptom worsening.

An exacerbation can be mild or severe. In cases of severe symptoms, this can significantly interfere with the daily activities of the patients. The attacks can last from several days to several weeks, but sometimes there are cases where they last for months.

When the symptoms subside, the patient is considered to be in remission. This can be misleading because the lesions of MS still appear during this so called ‘remission period’. Even though patients do not experience symptoms in this period, this may only be a result of the inflammation not being severe or is present in such areas in the brain that do not produce symptoms that are obvious.

It is actually not that uncommon that a patient does not perceive an MS symptom. Research has suggested that only 1 out of 10 lesions are perceived in general. This is why MRI is used to establish the diagnosis and decide on the treatment. Even if a person feels better, MRI should be used to determine whether the treatment is really effective or not.

Research on MS

The cause of this disease has not been indentified just yet, but there is great progress in other MS research areas such as in treatment development. This treatment is particularly aimed towards preventing exacerbations of the disorder.

Many researchers work on discovering new avenues for therapeutics, including protective drugs for the myelin cells, or drugs that can help myelin cells recover after an attack.

Additionally, there are various newly developed treatments that are successful in preventing the formation of new lesions in small studies. All treatments are constantly tested in clinical trials.

Other studies have shown that by destroying the immune system with the help of chemotherapy, one can go through a replacement with immune system stem cells and improve MS treatment. These cells are obtained from the patient’s blood and are known to halt the development of new lesions. The purpose is to reset the immune system so that it is no longer confused and it stops attacking the patient’s brain. This strategy is also being tested in numerous clinical trials.

Other studies work on whether stem cells transplanting should be derived from bone marrow and how helpful can this really be in MS cases.

Several studies have shown that destroying the immune system with chemotherapy and then replacing it with immune system stem cells obtained from the patient’s own blood can halt development of new MS lesions. This treatment appears to re-set the immune system so that it no longer attacks the brain. This strategy is being tested in clinical trials. Other studies are investigating whether transplanting stem cells derived from bone marrow, called mesenchymal stem cells, may be helpful in MS.

Researchers are constantly trying to find ways to prevent the progression of this disease. They are investigating the symptoms that do not respond to the treatments approved by FDA and trying to determine whether this is caused by problems with the neuronal cells producing parts.

The fact here is, people work on finding a cure or proper treatment for this disease daily. Even though the cause of multiple sclerosis cannot truly be discovered, treatment may be just around the corner. The researches’ results are improving daily and clinical trials are performed in order to determine a way of helping people suffering from multiple sclerosis.