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, and 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. There is still no cure for the disease, but drug regimens and behavioral therapy allow people with MS to lead healthier lives.
Purpose of Treatments
Many treatment options 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.
Changing the course of the disease is a primary goal of MS treatment. Drugs that do this are called disease-modifying medications. One such medication is the oral drug teriflunomide (Aubagio). It was approved for use in people with MS in 2012.
A study published in The New England Journal of Medicine found that people with relapsing MS who took teriflunomide once a day showed significantly lower disease progression rates and fewer relapses than those who took a placebo. People given the higher dose of teriflunomide (14 mg vs. 7 mg) experienced decreased disease progression. Teriflunomide was only the second oral disease-modifying medication approved for MS treatment.
A third oral disease-modifying drug became available to people with MS in the spring of 2013. Dimethyl fumarate (Tecfidera), formerly known as BG-12, stops the immune system from attacking itself and destroying myelin. It may also have a protective effect on the body, similar to the effect antioxidants have. The medication is available in capsule form.
Dimethyl fumarate is designed for people who have relapsing-remitting MS (RRMS). RRMS is a form of the disease in which a person typically goes into remission for a period of time before exhibiting worsening symptoms. People with this type of the disease can benefit from twice-daily doses of the drug.
MS-induced myelin destruction affects the way nerves send and receive signals. This can affect movement and mobility. Potassium channels are like pores on the surface of nerve fibers. Blocking the channels can improve the nerve conduction in affected nerves.
Dalfampridine (Ampyra) is a potassium channel blocker. Studies published in The Lancet found that dalfampridine (formerly called fampridine) increased walking speed in people with MS. The original study tested walking speed for a 25-foot walk. It didn’t show dalfampridine to be beneficial. However, post-study analysis revealed that participants showed increased walking speed during a six-minute test when taking 10 mg of the medication daily. Participants who experienced increased walking speed also demonstrated improved leg strength.
Modified Story Memory Technique
MS affects cognitive function as well as physical functions. It can negatively affect memory, concentration, and executive functions like organization and planning.
Researchers from the Kessler Foundation Research Center found that a modified story memory technique (mSMT) can be effective for people who experience cognitive effects from MS. This promising treatment method helps a person retain new memories. It also helps a person recall older information by using a story-based association between imagery and context. Modified story memory technique might help a person with MS remember items on a shopping list, for example.
Learning and memory areas of the brain showed more activation in MRI scans after mSMT sessions.
What Are Myelin Peptides?
Myelin becomes irreversibly damaged in people with MS. Preliminary testing reported in JAMA Neurology suggests that a possible new therapy holds promise. One small group of subjects received myelin peptides (protein fragments) through a patch worn on their skin over a period of a year. Another small group received a placebo. People who received the application of myelin peptides experienced significantly fewer lesions and relapses than people who received the placebo. The treatment was well tolerated, and there were no serious adverse events.
The Future of MS Treatments
MS symptoms and treatments vary from person to person. What works for one person won’t necessarily work for another. The medical community continues to learn more about the disease and how to best treat it. Research and trial and error are key to finding a cure.