Multiple sclerosis (MS) is a chronic disease that affects the nervous system. Nerves are coated in a protective covering called myelin. People with MS experience deterioration of the myelin. Nerves may function abnormally when the myelin is damaged. A number of unpredictable symptoms may result, including:
- pain, tingling, or burning sensations throughout the body
- vision problems
- mobility difficulties
- muscle spasms or stiffness
- slurred speech
- impaired memory and cognitive function
Years of dedicated research have led to new treatments for MS. Although there is still no cure for the disease, drug regimens and behavioral therapy allow people with MS to lead healthier, more productive lives.
There is presently no cure for MS. However, many treatment options are available that can help manage the course and symptoms of this chronic disease. Treatment can help:
- slow the progression of MS
- minimize symptoms during exacerbations or flares
- improve physical and mental function
Treatment in the form of support groups or talk therapy can also provide emotional support for people living with the challenges of this chronic illness.
Changing the course of the disease is a primary goal of multiple sclerosis treatment. Drugs that do this are called disease-modifying medications. In 2012, the oral drug teriflunomide (Aubagio) was approved for use in MS patients.
A study published in The New England Journal of Medicine found that people with relapsing MS showed significantly lower disease progression rates and fewer annual relapses when taking teriflunomide once daily than subjects who took a placebo. People given 14 mg of the drug fared better than participants in the 7 mg group. The teriflunomide study was a landmark of sorts, because teriflunomide was only the second oral disease-modifying medication approved for MS treatment.
A third oral disease-modifying drug became available to MS patients in the spring of 2013. Dimethyl fumarate (Tecfidera), formerly known as BG-12, stops the immune system from attacking itself to destroy myelin. The medication, available in capsule form, may also have a protective effect on the body, similar to antioxidants. It is designed for patients who have relapsing-remitting MS, a form of the disease in which you typically go into remission for a period of time before exhibiting an exacerbation of symptoms. People with this type of the disease can benefit from twice-daily doses of the drug.
Multiple sclerosis-induced myelin destruction affects the way nerves send and receive signals, which in turn can affect movement and mobility. Potassium channels are like pores on the surface of nerve fibers. Blocking the channels can improve the nerve conduction of affected nerves.
Dalfampridine (Ampyra), is a potassium channel blocker. Studies reported in The Lancet state that fampridine helps increase walking speed in people with MS. The original study, which tested walking speed for a 25-foot walk, did not show dalfampridine to be beneficial. However, post-study analysis revealed that MS patients showed increased walking speed during a six-minute test when talking 10 mg of the medication daily. In patients who experienced increased walking speed, improved leg strength has also been demonstrated.
MS affects not just your physical body, but cognitive function as well. It can negatively affect memory, concentration, and executive functions, such as organization and planning. Researchers from the Kessler Foundation Research Center found that a modified story memory technique (mSMT) can be an effective rehabilitation for people who experience cognitive effects from MS. This promising treatment method helps patients retain newer memories. It also helps patients recall older information by using a story-based association between imagery and context. Story memory technique might help you remember items on a shopping list, for example. In magnetic resonance imaging (MRI) scans, learning and memory areas of the brain showed more activation after mSMT sessions.
Myelin is irreversibly damaged in people with MS. Preliminary testing suggests a possible new therapy holds promise. A small group of subjects received myelin peptides (protein fragments), or a placebo, through a patch worn on the skin, for a year. According to a report in the July 2013 issue of JAMA Neurology, people who received the infusion of myelin peptides experienced significantly fewer lesions and relapses. The treatment was well tolerated, with no serious adverse events.
The symptoms of MS and the best treatments for the disease vary from person to person. What works for one patient doesn’t necessarily work for another. It’s clear that research and trial and error is the key to finding a cure. The medical community continues to learn more about the disease and how to best treat it.