Multiple sclerosis (MS): changing insights and treatment protocols
MS is a heterogeneous disease and selecting persons with similar patterns of MS is crucial for recommending treatments. For the past 25 years, patients with MS have been grouped according to their clinical course (relapsing forms of multiple sclerosis, primary progressive multiple sclerosis, secondary progressive MS). Important new insights into the MS mandate a change in this paradigm. To truly deliver “personalized” care for persons with MS, it is essential to measure parameters that inform us about the underlying disease severity. For example, progressive disability is not necessarily a late feature of the illness. There are changes in the central nervous system showing tissue degeneration characteristic of progressive disease at the very onset of the illness. Besides,the diseasevaries from person to person and relates to differing patterns of tissue destruction, the ability to heal (remyelination), cognitive dysfunction, and motor disability. Finally, non-neurological comorbidities must be considered whiledesigning treatment protocol. These include an individual’s age, sex, habits (e.g., smoking, alcohol intake), and comorbid health issues (e.g., diabetes, heart disease, obesity, high blood pressure).
Summary:
- MS is a heterogeneous disease, no one person’s MS is the same as another person’s MS.
- Multiple Sclerosis as a disease is a continuum. The earlier slotting of MS based on the patterns of disease, such as whether this was the first neurologic event (“clinically isolated syndrome”), whether the patient had relapses (“relapsing-remitting form of multiple sclerosis”), whether the course was progressive from the start (“primary progressive multiple sclerosis”) or had degenerated into a progressive pattern (“secondary progressive MS”). Get the best multiple sclerosis treatment in Dubai for any such issues.
- With new insights,we canselect patients with MS based on the underlying biology of their disease, to start individualizing disease-modifying therapies.
- Most important insights come from central nervous system MRIs of the brain and spinal cord. Using exceptionally strong, high-field MRIs we can see the loss of brain volume (atrophy) being present even at the initial stages of the disease, particularly in areas like the thalamus, without any correlation with areas of acute inflammation.
- MRI also helps in the identification of slowly progressive, destructive lesionscalled “paramagnetic ring lesions,”which are areas of low-grade inflammation.
- With stronger MRIsit has also become possible to measure the formation of new myelin in the central nervous systems of persons with MS.
- Optical coherence tomography (OCT) has emerged as a technique to monitor the course of MS. OCT is a technique for measuring the thickness of nerve layers in the retina. The optic nerve is an extension of the brain and in persons with MS the retinal nerve layers are often thinned, even without a history ofoptic neuritis.Measuring how well the optic nerve conducts electrical impulses by a test called Visual Evoked Potentials ( VEP) is another valuable tool to monitor the course of the disease not only in the patients with a history of vision issues but also in the ones who never had optic neuritis. We put together our 100% and try to provide the top most multiple sclerosis treatment in Dubai
- Now there is a blood test that correlates with central nervous system injury. Neurofilament Light Chains (NfL) in the blood and/or spinal fluid.
