Multiple Sclerosis

MS is an immune-mediated disease, causing multi-focal inflammatory damage and loss of nerve fibre insulation (myelin) in the central nervous system (CNS), with secondary nerve fibre (axon) destruction. In order to reduce the consequences of MS, research effort is forwarded, aiming for developing tools for early diagnosis and treatment.

Development

The cause of MS is still partly unknown; however, the disease develops from a complex interplay between environmental and genetic factors in genetically susceptible individuals. The onset of the disease is usually between 20 and 40 years of age. Most patients (80-90%) experience a relapsing-remitting course (RRMS) while fewer (10-20%) have a continuous progression from the onset, known as primary progressive course (PPMS).

Diagnosis

No single clinical feature or diagnostic test is sufficient for diagnosing MS. Therefore, the diagnosis is based on an individual evaluation of the disease history and clinical neurological examination, supported by magnetic resonance imaging (MRI) of the brain and the spinal cord, as well as cerebrospinal fluid (CFS) analysis.

Activity and treatment

Disease activity is characterized by inflammatory CNS-lesions associated with myelin and axonal damage. Activity evaluated by monthly MRI may be 5-10 times higher than the clinical disease activity that patients or their neurologists recognise. Treatment strategies aim to reduce relapse frequency and prevent disease progression to avoid permanent disability. No curative treatment is available for MS, but corticosteroid treatment to shorten relapses and immunomodulatory therapies are important to modify the disease course. Along with the development of new and more effective treatment strategies in MS, there is also an increasing need for early and precise diagnosis to initiate early treatment. However, a major problem in MS is the lack of disease-specific markers, both for early diagnosis and evaluation of disease activity and treatment response.