May 30 is World MS Day. Multiple Sclerosis (MS) is a chronic central nervous system (CNS) disease which affects the brain, spinal cord, and optic nerves. Even in the absence of symptoms, the disease is continuously active (causing brain damage) from early stages of MS.

World MS day is a worldwide stage, for MS patients, to tell their story. Patients from India have the opportunity to share their personal experience in Hindi or English by visiting www.worldmsday.org

MS is relatively rare in India

In recent times, MS prevalence rates in India have been revised from 1 case in every lakh to 3 cases/100,000 people – compare this to US, where MS occurs in 1 per 1000 people. Regionally speaking, higher MS incidence rates of 4.15 and 3.2 were reported from north-west India (≥ 15° N latitude) and south India (≤15° N latitude), respectively. A significantly higher MS prevalence, 26 per 100,000, is recorded in the Parsi community. This anomaly is explained by the fact that Parsis (Zorastrians) are originally from the Iranian province of Pars, which has a high prevalence of MS. These observations match worldwide MS trends of higher prevalence rates in populations that are from temperate or cold climates, Caucasian ancestry, female (2:1), young (20-40 years) and affluent. A typical MS patient is a 20-40 years old female.

In a normal nervous system, nerves (bundles of nerve cells) pass messages amongst themselves at superfast speed. The axon (long arm of a nerve cell) is covered by the myelin sheath (multi-layered bands) with small gaps in between. The nerve impulses, that is, chemical signals jump from gap-to-gap and rapidly spread the messages to surrounding nerve cells. 

MS is neurodegenerative because the damaged myelin sheath and oligodendrocytes (cells that produce myelin) delay communication between nerve cells resulting in inefficient functioning of various body systems.

MS symptoms are variable, unpredictable, and appear in different patterns. Most common patterns are relapsing/remitting (symptoms come and go) and chronic progressive (symptoms continuously worsens).  Depending on which part of the nervous system develops demyelination, the condition affects corresponding body systems. The first MS symptom, in nearly 50% patients, appears as double or blurred vision caused by optic neuritis (demyelination of nerves connected to the eyes). Loss of coordination (30% patients) and speech difficulties also occur frequently. Other common symptoms include numbness, tingling, pins-and-needles sensation, tiredness, dizziness, limb weakness, pain and loss of touch, urinary control, memory and thinking ability.

MRI (magnetic resonance imaging) scans of over 90% of MS patients show the presence of lesions (demyelinated and scarred areas). MRI scans along with the patient’s medical history plus neurological exam confirms MS diagnosis. Spinal taps (check spinal fluid for abnormalities) and EEG (measures brain electrical activity) help rule out other autoimmune conditions or infections (HIV or Lyme disease).

MS treatment options include disease-modifying drugs methylprednisolone, interferons (Avonex, Betaseron), Copaxone and Rebif that provide symptom relief and slowdown the disease progression to prevent relapses. Counselling, physical and occupational therapy help to cope with movement and behavioural symptoms. MS is not fatal but complications arising from a weak immune system, such as pneumonia, lower life expectancy by ten years in MS patients.  

MSSI (http://www.mssocietyindia.org/), found in 9 cities, offers useful advice, reading material, research updates, and community support. MSSI also organizes and conducts health camps, workshops, social events and fundraisers across the country throughout the year.  To end with, here’s a heart-warming picture of a 36 year old MS patient, Jigna Chanpura, who recently completed a 21km Half Marathon at a MSSI event.

“In this regard, the AIIMS is keen to set up of a National MS Registry for maintenance of epidemiological data of MS patients from across the country for evidence based research, treatment, and education,” he added. Since 2011, the department of neurology at AIIMS began collecting data of MS patients undergoing counselling and treatment at the institute to track their demographic profile, medical condition, quality of life, disability stage and post treatment outcome. Relatively rare in the country, multiple sclerosis is an autoimmune disease affecting brain and spinal cord. With the body attacking its own cells and tissues, common symptoms include numbness, weakness in the limbs, sudden loss of balance, blurred vision and paralysis. MS affects youth in the age of 20-40 years.

“A three year national programme ‘reaching out’ pilot project has been initiated since February across cities in Uttar Pradesh to gather more data on MS patients. The final structured project will be implemented in all other states of India in the coming years,” said Bipasha Gupta, national secretary, Multiple Sclerosis Society of India.

Source: IANS

MS is estimated to affect up to 2.5 million people worldwide. The disease tends to strike early in adulthood, with women three times more likely than men to be diagnosed for it, the journal Brain reported. Scientists from the Monash University’s Immunology and Stem Cell Lab (MISCL), Universities of Toronto, Yale and Western Australia, have demonstrated the key role played by the collapsin response mediator protein 2 (CRMP-2) in the development of MS.

Led by reserachers Steven Petratos from MISCL and Claude Bernard, the research team found that a modified version of CRMP-2 is present in active MS lesions, which indicate damage to the nervous system, in a lab model of MS, said a university statement. The modified CRMP-2 interacts with another protein to cause nerve fibre damage that can result in numbness, blindness, difficulties with speech and motor skills, and cognitive impairments in sufferers. When either the modified CRMP-2 or the interaction between the two proteins was blocked, the progression of the disease was halted. Richard Boyd, director MISCL, said the discovery could lead to new treatments for MS, “Blocking the same protein in people with MS could provide a ‘handbrake’ to the progression of the disease.” Petratos said the method used to block the protein was approved for the treatment of other disease conditions by both the US Food and Drug Administration and Australia’s Therapeutic Goods Administration. ”This should mean that clinical trials – once they start – will be fast tracked as the form of administration has already been approved,” Petratos said. 

Source: IANS

Research carried out by the Neuroscience Research Australia have found that people suffering from restless legs syndrome, which causes uncomfortable sensations in the limbs, have reduced function in an area of the brain important for controlling movement. Preliminary results from a new study at Neuroscience Research Australia (NeuRA) suggest that such people have up to 80 % less function in this brain region compared to healthy people. “This is a disorder that is thought to affect one in 20 people, and can severely affect quality of life, but we still don’t know very much about it,” says Kay Double, associate professor of neuroscience. “This study is helping us understand what happens in the brain to cause these symptoms, which will help us find better treatments,” she says, according to a NeuRA statement.

Restless legs syndrome is a disorder that causes uncomfortable sensations in the limbs.

It often flares up at night and disturbs sleep. It tends to run in families.

The NeuRA study is using ultrasound and magnetic resonance imaging (MRI) to look for changes in the structure and function of the brain.

“This is the first time that anyone has looked for these types of changes in people with restless legs syndrome,” says Double. “If we can understand what is happening in the brain, we will be one step closer to helping the thousands with restless legs get a better night’s sleep and lead a better quality of life.”

Source: IANS