Multiple sclerosis (MS) is a chronic disease of the central nervous system. An autoimmune disorder, MS is an unpredictable condition that can be relatively benign, disabling, or even devastating. Some people with MS may be mildly affected, while others may lose their ability to see clearly, write, speak, or walk when communication between the brain and other parts of the body becomes disrupted.
With MS, myelin (a fatty tissue that surrounds and protects the nerve fibers) is lost in multiple areas and that loss forms scar tissue called sclerosis. These areas are also called plaques or lesions. When damaged in this way, the nerves are unable to conduct electrical impulses to and from the brain.
In the U.S., approximately 400,000 people are affected by MS, with symptoms developing, on average, between 20 and 40 years of age – although symptoms can begin as early as age 10 and as late as age 80. There is not enough known about the specific cause of MS to definitively say why a particular person develops the disease. Although researchers believe genetic factors, autoimmune disorders, infectious agent such as viruses, and environmental factors do play a role.
The Multiple Sclerosis Center, located at Brigham and Women’s Hospital, is world renowned for providing the most advanced management and multiple sclerosis treatment options for patients with MS, bolstered by a clinical research program that is leading the way in the latest discoveries. Since its creation in 1999, the Center – led by Howard L. Weiner, MD – has been at the forefront of MS patient care and research, including the landmark CLIMB MS cohort that has provided many insights into genetics, immunology imaging, and treatment of MS.
MS is one of the many diseases and conditions that form the focus of our Neurosciences Center. Our multidisciplinary team of neurologists, neurosurgeons, psychiatrists, and radiologists offers the most innovative and advanced treatments and therapies for MS and all diseases of the nervous system. Our dedication to discoveries and research in these areas has made us the choice for patients from the region and around the world.
To learn more about Multiple Sclerosis, watch this video of Dr. Howard L. Weiner discussing BWH research focused on improving MS treatment and finding a cure.
Multiple Sclerosis symptoms are not the same in all people with the disease. They can be mild or severe and can last a long time or short time. Also, depending on what areas are affected, they can present in many different combinations. The most common symptoms of MS include that a patient may notice first are:
As the disease progresses other symptoms may be noticed, including:
Of all patients with MS, many experience some form of cognitive impairment – sometimes mild and only detectable through testing and other times, apparent. Common cognitive impairments include:
Even with advancements that have been made in MS, there is still no definitive test available to diagnose the disease. Currently, diagnosis is based on clinical attacks –the sudden appearance of symptoms - and magnetic resonance imaging (MRI) evidence of lesions, plaques, and scarring on the nerve fibers. MRI has evolved as a valuable tool used to establish an early diagnosis and monitor disease progression.
At Brigham and Women’s Hospital MS experts develop individualized multiple sclerosis therapy and treatment plans for patients based on:
Because there currently is no cure for MS, current treatments focus on easing symptoms and making life more manageable for patients. Over the past 15 years there has been considerable progress in multiple sclerosis treatments, which may include medication with supportive services such as psychiatry services, therapy services, and nutrition and wellness plans.
Possible medications used to treat MS, include:
In some cases first line therapy with disease modifying treatments may not adequately control disease and second-line options are used as well, including:
There are a variety of other medications that have been shown to have some effect in reducing MS relapses or MRI lesion formation in small studies. These medications are approved for use in other diseases and are occasionally used “off label” in the treatment of MS.
Living with MS does have an impact on mental health and often can lead to depression. At Brigham and Women’s Hospital, MS patients have access to the services they need to cope with the challenges they face.
Specialists within the Department of Psychiatry at Brigham and Women’s Hospital provide a broad range of programs, including specialized services that address the unique needs of patients living with chronic conditions, such as MS.
An integral part of MS is ensuring that each patient receives all the support services they need to help manage the impact the disease has on their overall health and well-being.
Part of the multidisciplinary care provided at Brigham and Women’s Hospital, many patients with MS also benefit from:
Brigham and Women’s Hospital provides a multidisciplinary approach to patient care, collaborating with colleagues in other medical specialties. If your neurologist or neurosurgeon discovers an underlying illness or concern, you will be referred to an appropriate Brigham and Women’s Hospital physician or allied health professional for an expert evaluation.
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