New findings could change the way multiple sclerosis is treated. A Canadian study is investigating a possibly groundbreaking technique, built on a controversial new theory of the mechanics of the condition, to minimize the damage multiple sclerosis causes. Meanwhile, a discovery in Boston could help doctors better determine the best course of treatment for a particular patient.
Multiple sclerosis is an autoimmune disease that affects 400,000 Americans. The immune system attacks as an intruder the fatty substance, called myelin, that wraps around nerves. This myelin sheath helps the nerves operate more efficiently, speeding up impulses as they travel the neural pathways.
When the myelin isn’t there, it causes symptoms that come and go. These are generally functional deficiencies that arise as nerve impulses traveling through the unprotected nerve fibers are slowed down and interfered with as they pass. This results in several temporary but recurring problems including muscle weakness, fatigue, lack of coordination, and unsteadiness in walking.
There is currently no cure for multiple sclerosis, but it can be controlled with medications. Corticosteroids help bring down the inflammation that occurs during episodes. Although MS generally get progressively worse, medications called beta interferons slow this progression. In addition, there is a range of medications that modify the immune response in various ways to protect the myelin sheath, though these can have harmful side effects in some cases and must be administered with care.
One of these, in fact, increases the risk of a particular type of fatal brain infection, and therefore is only used as a last resort. Now a new test may allow doctors determine which patients are likely to require such drastic measures. Genetic examination reveals two categories of MS patients with significantly different rates of relapse. The hope is that the patients for whom the more drastic treatments are needed can be identified and their conditions effectively managed, while those for whom the safer treatment is sufficient can be given that.
Moreover, if a Canadian doctor is correct, some cases of MS may not need ongoing treatment at all. The theory holds that widening the veins in the neck—similar to an angioplasty in the chest—will help eliminate symptoms of MS by eliminating blockages that lead to brain lesions. The procedure has had some success, but has also resulted in fatalities in several instances, and long-term effectiveness is still unknown.