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What Parts Of The Brain Are Affected By Multiple Sclerosis

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Multiple Sclerosis: Its In Your Head

Whiteboard: Multiple Sclerosis

Multiple sclerosis is a disease of the central nervous system that causes damage to your brain, spinal cord, and optic nerves. Its characterized by lesions, or areas of tissue damage that occur when your immune system behaves abnormally and attacks these areas.

While many symptoms of MS throughout the body can be caused by lesions in either the brain or the spinal cord, cognitive symptoms of MS those related to your memory, language, and problem solving are believed to be caused only by lesions in the brain.

Brain lesions are a hallmark of MS, but theyre not the only way MS can affect your brain function. MS can also contribute to brain atrophy, or shrinkage, over time a process that occurs in all people as they age, but typically happens much more quickly in people with MS. Brain atrophy, in particular, can contribute to cognitive symptoms of MS.

Pathogenesis Of Acute Demyelination And Axonal Injury

In the initial stages of MS, many different components of the adaptive and the innate immunity induce demyelination and neuronal loss . The activation of auto-reactive CD4+T lymphocytes in the peripheral immune system is necessary for their migration across the bloodbrain-barrier and into the CNS. After myelin destruction, T cells are in situ reactivated by antigens within myelin debris and their clonal expansion results in multifocal demyelinating plaques . Peripheral B lymphocytes are involved in the antigen presentation and initial stimulation of CD4 T cells. Also, they are an essential source of pro- and anti-inflammatory cytokines promoting every autoimmunity response driving MS. In addition, the presence of chemokines and survival factors in the CSF of patients with MS, promotes the formation of meningeal follicle like structures, in progressive phases but also in early RRMS . T cells and B cells may, therefore, play an equally important role in the immunopathology of MS .

Axonal destruction is quite extensive in all active WM lesions and the extend of axonal loss is related to the number of immune cells within the plaques . Activated immune cells and microglia/macrophages release a number of pro-inflammatory cytokines , proteolyticenzymes and free radicals that can directly damage axons . Additionally, axons may die secondarily, due to the loss of pre- and post-synaptic signals in regions far from the lesion site .

What Organs Are Affected By Multiple Sclerosis

Multiple sclerosis is an incurable disease of the central nervous system that can affect the brain, spinal cord and optic nerves. Common symptoms include fatigue, bladder and bowel problems, sexual problems, pain, cognitive and mood changes such as depression, muscular and visual changes.

In this way, what body systems are affected by multiple sclerosis?

Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord .

Also, does MS affect one or both sides of body? A lack of feeling or a pins-and-needles sensation can be the first sign of the nerve damage from MS. It usually happens in the face, arms, or legs, and on one side of the body. It also tends to go away on its own.

Thereof, what parts of the brain are affected by multiple sclerosis?

MS attacks tissues in the brain and spinal cord, known as the central nervous system . This system includes the complex network of nerve cells responsible for sending, receiving, and interpreting information from all parts of the body.

Can MS affect kidneys?

The rate of kidney deterioration as a result of bladder dysfunction due to multiple sclerosis is low, affecting only 3 percent of the patients, a single tertiary center study shows.

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Are There Any Effective Treatment Methods

Once again, thereâs no cure for MS, but there are treatment options used to treat symptoms. These treatments fall into the following categories: disease-modifying, relapse management, and symptom management therapies, as well as physical therapy and alternative medicine.

Perhaps some of the most promising medications are those which reduce relapse and slow the progression of MS. Known as immunomodulatory therapies, this treatment option targets inflammation for individuals with either relapsing-remitting or secondary progressive MS.

To reduce relapse, steroid medications are often offered to decrease the severity of relapses. For individuals with MS, relapse simply means that theyâre experiencing an attack caused by inflammation in a set area within the CNS. This treatment method is typically only used short-term, as steroids can yield their own set of symptoms. Other medications will also be offered to reduce symptoms such as pain and fatigue.

For those who suffer from mobility issues, physical therapy can help strengthen and improve everyday activities. Others are also interested in more natural approaches, utilizing homeopathic medicine, massage, herbs, and meditation. Remember, everyone is unique which is why you should stick to the treatment plan in which you have created with your personal health care provider.

How is Multiple Sclerosis Linked to Dementia?

References

Rutgers Professors Advanced Analysis Could Let Therapy Start Earlier And Lead Ms Research In New Directions

Multiple sclerosis is an autoimmune disease that affects ...

The search for the cause of multiple sclerosis, a debilitating disease that affects up to a half million people in the United States, has confounded researchers and medical professionals for generations. But Steven Schutzer, a physician and scientist at Rutgers New Jersey Medical School, has found an important clue that may explain why progress has been slow. It appears that most research on the origins of MS has focused on the wrong part of the brain.

Look more to the gray matter, the new findings published in the journal PLOS ONE suggest, and less to the white. That change of approach could give physicians effective tools to treat MS far earlier than ever before.

Until recently, most MS research has focused on the brains white matter, which contains the nerve fibers. And for good reason: Symptoms of the disease, which include muscle weakness and vision loss, occur when there is deterioration of a fatty substance called myelin, which coats nerves contained in the white matter and acts as insulation for them.

When myelin in the brain is degraded, apparently by the bodys own immune system, and the nerve fiber is exposed, transmission of nerve impulses can be slowed or interrupted. So when patients symptoms flare up, the white matter is where the action in the brain appears to be.

Important clinical and research potential

This research was funded by the National Institutes of Health.

Interested media are invited to contact Rob Forman at

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Rehabilitation And Physical Therapy

Rehabilitation can help improve or maintain a persons ability to perform effectively at home and work.

Programs generally include:

Physical therapy: This aims to provide the skills to maintain and restore maximum movement and functional ability.

Occupational therapy: The therapeutic use of work, self-care, and play may help maintain mental and physical function.

Speech and swallowing therapy: A speech and language therapist will carry out specialized training for those who need it.

Cognitive rehabilitation: This helps people manage specific problems in thinking and perception.

Vocational rehabilitation: This helps a person whose life has changed with MS make career plans, learn job skills, and get and keep a job.

Ological Observations And Interpretational Issues

When interpreting changes of FC in the MS brain, some statistical issues arise yielding caveats when interpreting general differences between MS and HC. As such, it is not yet clear whether the FC changes observed in MS are passive or active . Moreover, whether such neural plasticity is adaptive or maladaptive is a topic of much discussion. When such issues are taken into account, however, we believe that FC can be investigated at an individual level and significantly improve the accuracy of MS differential diagnoses and prognoses.

Methodological Observations

Highly discriminative regions: real effect or statistical artifact?

Firstly, we have seen that in MS FC of several brain regions, particularly deep gray matter regions, seems to be affected more often than other regions. When studying healthy brains, these regions are considered hubs, i.e., highly-connected regions through which large parts of the brain’s overall communication is mediated .

Formation of larger networks or breakdown of modularity?

Interpretational Issues

What does increased or decreased FC mean?
Are FC changes active or passive in MS?

Beyond such methodological issues, an additional question that remains open is that of the underlying mechanisms which actually drive FC changes in MS. Specifically, one could classify such mechanisms as either passive or active .

Can FC/neuroplasticity be maladaptive in MS?

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How Can I Prevent A Multiple Sclerosis Flare

Disease-modifying therapies are the most effective way to reduce the number of flare-ups you experience. Leading a healthy lifestyle is also important. The choices you make can help slow disease progression. Good care can also lessen your symptoms and improve your quality of life.

Lifestyle changes that can improve your condition include:

  • Eating a healthy diet: There is no magic MS diet. Experts recommend a balanced diet that includes lots of fruit and vegetables, whole grains, healthy fats and lean protein. You should also limit your intake of added sugars, unhealthy fats and processed foods.
  • Getting regular exercise: Multiple sclerosis can cause muscle weakness, loss of balance and difficulty walking. Aerobic exercise, flexibility and strength training are essential to help keep muscles strong and maintain physical function.
  • Managing stress: Stress can take a physical and emotional toll. It can also interfere with sleep, which can worsen MS-related fatigue. Its important to find ways to manage stress such as yoga, meditation, exercise, and working with a mental health provider.
  • Not smoking and limiting alcohol intake: Smoking and alcohol are linked to worsening MS symptoms and could speed the disease’s progression. Quitting smoking will support your health.

Considerations In Special Populations

How the Blood Brain Barrier Affects Multiple Sclerosis Treatment

Pregnancy and MS

Pregnancy does not seem to have a detrimental effect on the overall disease course of MS. In general, DMTs are not recommended during pregnancy, so efficient family planning with the help of the obstetrician can help minimize the amount of time the patient is off DMT. Pregnancy during MS is associated with a decreased incidence of relapses, but there is a rebound in relapse frequency in the postpartum period. Relapses during pregnancy can be treated with short courses of high-dose corticosteroids if needed, though it is preferable to not treat mild relapses since adverse effects to glucocorticoids can be seen. A mid-pregnancy visit with the treating neurologist is recommended for postpartum planning. It is also generally recommended that patients who were previously treated with DMT prior to pregnancy resume treatment immediately postpartum unless they plan to breastfeed. If breastfeeding is pursued, cranial MRI 2 months after delivery for disease surveillance is appropriate. If there is evidence of active disease, the benefits of breastfeeding should be balanced with the need to resume DMT.

Vaccines and MS

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Tests To Diagnose Ms Include:

  • Neurological examination this involves testing the cranial nerves to detect possible areas of damage from MS lesions, looking at your reflexes, your muscle strength, the feel of sensations and your vision. You may also have your walking speed and style assessed as part of this physical examination.
  • Blood tests mainly to rule out other causes of your symptoms.
  • Magnetic resonance imaging to look for scarring in your brain and spinal cord.
  • Lumbar puncture to test your cerebrospinal fluid . CFS examination can support MRI findings and help rule out other diseases.
  • Neurophysiology tests to measure the electrical activity of the brain to detect possible lesions which may not be seen on an MRI. Tests such as evoked potentials follow impulses as they pass through nerves and can be assessed on your eyes, your ears or your peripheral nerves.

If lesions or scarring are found on the brain or spine MRI, to confirm a diagnosis of MS a neurologist will look for evidence that the scarring happened at different points in time and in different parts of your central nervous system . This forms the basis of international guidelines to help neurologists diagnose MS accurately, called the McDonald criteria.

To achieve the best possible outcomes for people with MS, it is recommended that delays in diagnosing MS be minimised and that goals for treatment and ongoing management of MS be set early in the course of the disease.

What Happens To The Nervous System

  • Patches of inflammation may occur in the myelin that surroundsaxons in the brain and other parts of the nervous system. This inflammation can damage the myelin.
  • Myelin around axons may deteriorate and be lost. This is called”demyelination.”
  • Axons may be damaged and destroyed.
  • When myelin is damaged, the transmission of electrical signals along axons is impaired. It is possible that the body can repair damaged myelin after inflammation is reduced. This process is called “remyelination.”

    Normal Neuron

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    Complementary Therapies And Ms

    Medications and physical therapies can be complemented by other therapies. Be cautious when investigating a complementary therapy and be sceptical of miracle cure claims. Always ask your MS healthcare team for advice before starting any complementary treatment, as some complementary treatments may have negative interactions with medications you may be taking.

    Definition And Disease Course

    Brain In Multiple Sclerosis Photograph by Cnri/science ...

    There are several different forms of MS. Since these classifications were based upon clinical characteristics, they are empiric and do not reflect specific biologic pathophysiology. Nonetheless, they provide an organized framework for diagnosis and long-term management. Approximately 85% of patients present with a relapsing-remitting MS disease course at onset, where symptoms appear for several days to weeks, after which they usually resolve spontaneously. After tissue damage accumulates over many years and reaches a critical threshold, about two-thirds of the patients transition to secondary progressive MS , where pre-existing neurologic deficits gradually worsen over time. Relapses can be seen during the early stages of SPMS, but are uncommon as the disease further progresses. About 10% to 15% of patients have gradually worsening manifestations from the onset without clinical relapses, known as primary progressive MS . Patients with PPMS tend to be older, have fewer abnormalities on brain MRI, and generally respond less effectively to standard MS therapies.

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    Quantification For Topographical Probability Maps In Hemispheric Sections: Sample 1

    Demyelination and leukoaraiosis

    Each demyelinated lesion in the brain of individual patients was manually drawn in the patients own brain section map. Lesions were identified by focal areas of myelin loss or sharply demarcated shadow plaques. All lesions identified in individual patients were then superimposed onto a virtual brain section of the same area . The probability of a lesion to occur in a specific brain area is provided by a colour code . Areas of leukoaraiosis in controls were identified in sections stained with Luxol Fast blue. In a normal brain of young individuals only diffuse differences in myelin density are seen between different white matter areas in comparison with the corpus callosum. Areas of leukoaraiosis were defined as those with at least 30% reduction of myelin density in comparison to the myelin density in the corpus callosum, measured by densitometry .

    SMI31-positive neurons

    Meningeal inflammation

    Understanding The Brain Spinal Cord And Nerves

    Many thousands of nerve fibres transmit tiny electrical messages between different parts of your brain and spinal cord. Each nerve fibre in the brain and spinal cord is surrounded by a protective sheath made from a substance called myelin. The myelin sheath acts like the insulation around an electrical wire. It is needed for the electrical impulses to travel correctly along your nerve fibres.

    Nerves are made up from many nerve fibres. Nerves come out of your brain and spinal cord and take messages to and from your muscles, skin, body organs and tissues.

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    Relieving Symptoms During A Flare

    Other drugs are useful when a person experiences a worsening of symptoms during a flare. They will not need these drugs all the time.

    These medications include corticosteroids, which reduce inflammation and suppress the immune system. They can treat an acute flare-up of symptoms in certain types of MS. Examples include Solu-Medrol and Deltasone . Steroids can have adverse effects if a person uses them too often, and they are not likely to provide any long-term benefit.

    Other medications and approaches can treat specific symptoms. Those symptoms include:

    Behavioral changes: If a person has vision problems, a doctor may recommend they rest their eyes from time to time or limit screen time. A person with MS may need to learn to rest when fatigue sets in and to pace themselves so they can complete activities.

    Problems with mobility and balance: Physical therapy and walking devices, such as a cane, may help. The drug dalfampridine may also prove useful.

    Tremor: A person may use assistive devices or attach weights to their limbs to reduce shaking. Medications may also help with tremors.

    Fatigue: Getting enough rest and avoiding heat can help. Physical and occupational therapy can help teach people more comfortable ways to do things. Assistive devices, such as a mobility scooter, can help conserve energy. Medication or counseling may help boost energy by improving sleep.

    Bladder and bowel problems: Some medications and dietary changes can help resolve these issues.

    What Is The Prognosis For People With Multiple Sclerosis

    How does MS affect my brain?

    In some cases, multiple sclerosis does lead to disability and loss of some physical or mental function. But thanks to advances in treatment, most people with MS will continue to lead full, active and productive lives. Taking steps to manage your health and lifestyle can help improve your long-term outcome.

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    Brain Atrophy: Why Volume Loss Is A Concern

    All people tend to lose brain volume as they age a process known as atrophy. But in people who have MS, this process typically happens much faster.

    Its normal to lose 0.1 to 0.5 percent of brain volume each year as you age. However, in people with MS, this range is typically 0.5 to 1.35 percent, according to an article published in September 2016 in the journal Multiple Sclerosis and Related Disorders. This greater atrophy may begin even before an MS diagnosis.

    When nerve fibers die off in significant numbers due to an MS lesion, myelin is lost from the areas of the brain outside that lesion. Thats because nerve fibers can be very long, extending from one area of the brain to another. A lesion may affect only a small portion of a nerve fiber at first, but when the nerve fiber dies, myelin is lost from the entire length of that fiber beyond the lesion.

    There are two main types of tissue in the brain: gray matter and white matter. Gray matter consists of the main bodies of nerve cells, while white matter consists of the nerve fibers that extend from these bodies. White matter gets its color from the myelin that surrounds nerve fibers. So when myelin is lost in areas outside lesions, it tends to cause atrophy of white matter.

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