Understanding MS Progression
Multiple Sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS) that can lead to various debilitating symptoms like muscle weakness, numbness, fatigue, and difficulty in coordination. It affects more than 2.5 million people worldwide, and the cause of the disease is yet to be discovered. MS is a progressive disease where symptoms worsen over time, and it can be split into three stages:
Preclinical stage
The preclinical stage, also referred to as the initial or asymptomatic stage, occurs before symptoms first appear. During this stage, the immune system attacks the myelin, which is the protective insulation surrounding nerve fibers in the CNS. However, the body has an inherent ability to repair and replace damaged myelin at this stage, and people may not know they have the disease until they develop the first symptoms.
Relapsing-Remitting stage
The relapsing-remitting stage is the most common stage in MS, affecting about 85% of patients. During this stage, a person experiences periodic flares (relapses) of symptoms, followed by periods of complete or partial recovery (remissions). The majority of symptoms during this stage disappear entirely during the remissions phase, although some symptoms may persist, albeit at a milder level than before. This stage can last for several years to decades.
Secondary and Primary Progressive stage
The secondary progressive stage follows the relapsing-remitting stage, where a person experiences gradual but continuing worsening of symptoms even during the remission. The progressiveness of symptoms in this stage can begin over several months or years after the initial presentation. Some people may not experience the relapsing-remitting stage and instead directly progress to the secondary progressive stage.
The primary progressive stage is a less common form of MS, affecting about 10-15% of patients. In this stage, a person experiences a gradual progression of symptoms from the onset without any remission, which typically leads to significant disability within a few years of onset.
Can MS Progression Be Stopped?
MS is a progressive disease, and there is currently no cure for MS. However, there are various treatments for managing the symptoms and slowing down the progression of the disease. Medications are the primary form of treatment; other supportive measures like dietary changes and frequent exercise can improve overall health and help manage some symptoms.
Medical Treatment
Medical treatment has been proven to slow down the progression of MS and reduce the frequency and severity of relapses. Treatment options vary tremendously based on disease stage and individual cases; there is no single treatment that works for every person. Some drugs are used for relapse prevention or reducing inflammation caused by the immune system, while others are used in both early and advanced stages of MS, primarily focusing on blocking or controlling the immune system to reduce the rate of damage to the myelin sheath.
Doctors frequently recommend disease-modifying therapies (DMTs) for the earliest stages of MS to prevent further attacks on the central nervous system; the efficacy of these therapies in people with relapsing-remitting MS is well established. The goal is to slow down the inflammation and reduce the frequency and severity of relapses that develop during the relapsing-remitting stage. The National Multiple Sclerosis Society listed 17 different FDA-approved DMT therapies.
For people with secondary or primary progressive MS, the drugs’ effects are less dramatic, and many people may have little improvement in their symptoms. Medications prescribed aimed at treating symptoms like muscle stiffness, tremors, or depression, and for some individuals, steroids are used in periods of relapse to reduce inflammation to prevent or minimize damage to the nervous system.
Supportive Treatments
Supportive treatments focus on addressing some of the symptoms experienced by people with MS. A healthy lifestyle is a beneficial and necessary step people can take to help manage their MS. Eating a healthy diet can optimize health benefits as people with MS are at greater risk for Vitamin D deficiency, which increases fatigue and other symptoms.
Dietary changes
Vitamin D supplements: Studies have shown that people with MS who have low levels of vitamin D in their blood experience higher levels of fatigue and other symptoms. People can receive vitamin-D from vitamin supplements, sun exposure, and specific foods, like fortified foods or fatty fish.
Foods that are high in Omega-3: Food such as salmon, sardines, and, nuts and olive oil can reduce inflammation in your body, which may be helpful in managing symptoms of MS. These foods should be a regular part of your diet.
Dietary changes should be made in consultation with a doctor or dietitian.
Physical Therapy and Exercise
Physical therapy and exercise are excellent ways to manage symptoms of MS. They can help with balance, mobility, and overall musculoskeletal health. Physical therapy and exercise may also be effective in reducing muscle stiffness, weakness, and spasticity.
Meditation
People with MS often experience depression, anxiety, and stress from coping with the disease. Studies have shown that meditation can be an effective way to decrease depression and anxiety symptoms.
There is no cure for MS, but with effective medical management and lifestyle changes, people with MS can continue to live their lives to the fullest.
Conclusion
MS is a chronic autoimmune disease of the central nervous system that can lead to various debilitating symptoms like muscle weakness, numbness, fatigue, and difficulty in coordination. It affects more than 2.5 million people worldwide, and the cause of the disease is yet to be discovered. MS progression can be divided into three stages: preclinical stage, relapsing-remitting stage, and secondary and primary progressive stage. There is no cure for MS, but timely medical management and lifestyle changes can effectively slow down the progression of the disease.
Frequently Asked Questions (FAQs)
- Q. What is the most common cause of MS?
- A. The exact cause of MS is unknown, but it is widely believed to be brought about by a combination of environmental, geographic, genetic, and immunological factors.
- Q. How is MS diagnosed?
- A. The diagnosis of MS is made based on a combination of patient history, clinical symptoms, neurological examinations, MRI imaging, and laboratory tests to rule out other potential causes of a patient’s symptoms.
- Q. Can MS be completely cured?
- A. No, at present there is no cure for MS; however, timely treatment and support can help to manage symptoms and slow its progression.
- Q. What is the life expectancy of a person with MS?
- A. The majority of people with MS have a normal life expectancy, however some may develop severe complications that may increase the risk of premature death.
- Q. How do disease-modifying therapies (DMTs) impact MS?
- A. DMTs help slow down the inflammation and reduce the frequency and severity of relapses that are most prominent during the relapsing-remitting stage of the MS progression.
References:
- Goldenberg, M. M. (2012). Multiple sclerosis review. P&T: a peer-reviewed journal for formulary management, 37(3), 175.
- Multiple Sclerosis Society. (2019). Treatments. Retrieved August 20, 2021, from https://www.mssociety.org.uk/about-ms/treatments
- Multiple Sclerosis Association of America. (2021). Can MS be cured? Retrieved August 20, 2021, from https://mymsaa.org/ms-information/overview/cure/
- National Multiple Sclerosis Society. (2021). Relapsing-remitting MS (RRMS). Retrieved August 20, 2021, from https://www.nationalmssociety.org/What-is-MS/Types-of-MS/Relapsing-remitting-MS