In Search of a Cure for Multiple Sclerosis - dummies

In Search of a Cure for Multiple Sclerosis

By Rosalind Kalb, Barbara Giesser, Kathleen Costello

Doctors and scientists all over the world have been researching the causes of multiple sclerosis (MS) for years. The more that is learned and understood about MS, the more effective treatments become. This means MS patients’ quality of life improves as well. Following are some of the recent questions science has been asking about MS, along with the possible answers.

MS research: What does my future hold?

“What’s going to happen to me?” is one of the first questions people with MS ask their neurologists. Right now, all a neurologist can offer is an educated guess. But exciting lines of research are beginning to identify factors that can help predict a person’s clinical course and response to treatment with much more accuracy.

These factors, which are called biomarkers, include certain genes, proteins found in the blood or spinal fluid, and findings on MRI. With more specific biomarkers, doctors will eventually be able to prescribe more individualized treatment regimens, which should in turn lead to improved treatment outcomes for people with MS.

MS research: How many genes play a role in MS?

The International MS Genetics Consortium, which is a group of scientists who decided to work collaboratively rather than competitively to study the genetics of MS, have determined that no single gene makes a person susceptible to MS. Instead, MS risk is the result of many gene variants throughout the genome working together.

In other words, each gene variant can’t do it alone, but together they put a person at risk for developing MS. To date, scientists have identified more than 50 genes related to the risk of MS, and they anticipate that more will be found. These genes may also help identify new targets for MS treatments.

MS research: Can the nervous system be repaired?

Scientists are looking at many different approaches to repairing the central nervous system (CNS). One strategy aims at inducing the body’s own cells to repair themselves more quickly and effectively. Another strategy involves bringing in outside helpers — replacement cells from other sources that could take the place of damaged nervous system cells.

Research into the potential of cell therapy is proceeding rapidly, using different kinds of adult and non-adult stem cells, including cells from the person’s own body and cells from other sources. It’s still not clear which types of cells, if any, will be of value in treating people with MS. And if more than one type of cell turns out to repair the damage, it’s not clear as yet which will be best.

MS research: Could brain tissue loss alter mood?

More than 50 percent of people with MS experience serious depression at one time or another. While the challenges of this chronic, unpredictable disease can certainly lead to mood changes, other factors contribute as well.

Studies have found that loss of tissue in the hippocampus (paired, horseshoe-shaped structures in the left and right hemispheres of the brain) is also associated with depression in MS, and so is tissue loss in the frontal and temporal areas of the brain. In other words, don’t feel embarrassed or ashamed about depression. It’s a symptom of MS — caused in part by brain changes — which deserves to be treated.

MS research: What might MS in children tell researchers about the cause(s) of MS?

Research shows that a person’s risk of developing MS is somehow determined during his or her childhood, but researchers still don’t know why. The study of children with MS offers a unique opportunity for scientists to learn more about the possible causes of MS. Because the time from birth to diagnosis is much shorter in children with MS than in adults, fewer events or triggers have occurred that might have started the autoimmune disease process.

The Network of Pediatric MS Centers of Excellence is collectively analyzing children’s medical histories, including birth histories, infections, immunizations, exposure to second-hand smoke, and other factors, with the goal of figuring out which of these might be responsible for causing MS.

MS research: Can a brain damaged by MS rewire itself to compensate for the loss?

Research has suggested that one of the major contributors to disability in MS is learned disuse in the brain. In other words, when parts of the brain get used to not being used, the person becomes less able to do things. But scientists know that people’s brains are plastic, which means when damage occurs in one part of the brain, another part of the brain can be trained to take over some of its work.

Recent studies using MRI technology have shown that the brain remains able to change and compensate even in people with advanced MS. This means that no matter how disabled a person is by MS, rehabilitation strategies can help maintain and improve function.