The Science Behind the Glitchy Wiring of Multiple Sclerosis

If you grew up in the '90s, you'll likely remember Selma Blair for her iconic roles in Cruel Intentions, Legally Blonde, and The Sweetest Thing. Her co-star from The Sweetest Thing, Christina Applegate, was America’s rom-com sweetheart. In a cruel twist of fate, both actresses were diagnosed with multiple sclerosis (MS). 

Blair, diagnosed in 2018, has been vocal about her journey with MS. In fact, it was Blair who urged Applegate to get tested for MS in 2021 after a conversation about tingling in her feet during a playdate with their children. This nudge led to Applegate’s diagnosis and ultimately helped her manage the disease and improve her quality of life.

Multiple sclerosis is a condition that affects millions globally, yet it often flies under the radar. Though there is no cure, advancements in treatments allow many to lead fulfilling lives. In India, more cases are being diagnosed as awareness grows.

Multiple sclerosis (MS) is a chronic neurological disorder where the immune system mistakenly attacks the protective covering (myelin) of nerve fibres. This disrupts the communication between the brain and the rest of the body. MS can be unpredictable — while some individuals experience long periods of remission, others may face persistent and worsening symptoms over time.

MS disease activity leads to brain tissue loss, which reduces the brain's ability to function normally over time. MS causes visible lesions and other, less noticeable damage, speeding up brain tissue loss. 

MS symptoms vary from person to person but may include:

• Fatigue
• Numbness or tingling in the limbs
• Weakness or muscle spasms
• Loss of coordination or balance
• Blurred or loss of vision, especially in one eye (often an early sign)

Many of the multiple sclerosis symptoms can come and go or worsen over time, making it a difficult disease to predict or manage on a daily basis. For many MS patients, the lack of visible symptoms can lead to a misunderstanding of the severity of their condition.

People with MS often deal with depression, anxiety, and cognitive issues like memory loss and difficulty concentrating, which significantly affect their daily lives.

The brain uses its "neurological reserve" to compensate for damaged areas by recruiting new areas to take over their tasks. This reserve is crucial for maintaining a healthy brain. MS symptoms are more likely to worsen and progress when this reserve is used up.

MS comes in several forms:

• Relapsing-remitting MS (RRMS) is the most common type, accounting for the majority of cases. It is marked by periods of flare-ups followed by recovery phases.
• Primary Progressive MS (PPMS): In this form, symptoms steadily worsen from the onset without distinct relapses or remissions.
• Secondary Progressive MS (SPMS): This type begins as RRMS but eventually progresses to a continuous form in which symptoms accumulate without remission.

Studies show that 68.4% of patients have RRMS, 16.8% have SPMS, and 14.8% have PPMS.

The exact cause of MS remains unknown, but it is believed to result from a combination of genetic predisposition and environmental factors. 

1. Infections: Studies suggest that individuals with EBV infections may be more likely to develop MS later in life. Other viruses, such as human herpesvirus 6 (HHV-6), have also been investigated as potential triggers.
2. Vitamin D Deficiency: Low levels of vitamin D could lead to a heightened risk of developing MS. MS is more prevalent in areas with less sunlight, which is a key source of vitamin D.
3. Geography: Asia reports a lower incidence of multiple sclerosis than other regions. The condition is more common among individuals of Northern European or Scandinavian ancestry, with Caucasians having a higher risk than those of African descent. It turns out that where you live (and how much sun you get) might play a big part in the development of MS.
4. Smoking: A case-control study with 81 people who have MS and 81 matched controls found that smoking can elevate the chances of developing MS by a whopping 7.6 times! 
5. Obesity: Carrying extra weight might mess with your immune system and trigger inflammation, making you more likely to develop MS.

Other immune system triggers: Individuals with a family history of autoimmune diseases like type 1 diabetes or rheumatoid arthritis may have a higher susceptibility to MS.

Multiple sclerosis is a complex condition best diagnosed and managed by a neurologist specialising in MS and a dedicated care team. “Managing multiple sclerosis involves medications to slow disease progression and manage symptoms, physical therapy to maintain mobility, and lifestyle changes like regular exercise, a balanced diet, and stress management. However, it all starts with an early diagnosis,” says Dr Azad Irani, a neurologist in Mumbai.

With advancements in imaging technology, MS can now be diagnosed much earlier than before, often up to 10 times faster than in the 1980s.

Early diagnosis allows for quicker intervention, helping to start therapy sooner, which can lead to better long-term outcomes for those with relapsing forms of MS.

Multiple sclerosis may be life-changing, but with early diagnosis and the right treatment, it can be managed. Understanding the symptoms, types, and causes is key to taking control. Thanks to new advances in medical research, better outcomes are possible. If you notice any early signs, don’t wait — get checked and take charge of your health.

Early signs of MS can vary greatly, but some common symptoms include unexplained fatigue, numbness or tingling in the limbs, vision problems (such as blurred or double vision), and difficulty with balance and coordination. Some individuals also experience muscle weakness or spasms and cognitive changes, such as difficulty with focus or memory. These symptoms may come and go or worsen over time, making early diagnosis challenging.

Currently, there is no cure for MS. However, advancements in medical research have made it possible to effectively manage the disease. Treatment focuses on slowing disease progression, reducing the frequency and severity of relapses, and improving quality of life. Therapy and lifestyle changes play a critical role in long-term management.

Though there’s no way to prevent MS, understanding the risk factors helps in early diagnosis and treatment.

• Age: MS is commonly diagnosed between the ages of 20 and 40.
• Gender: Women have a higher probability of developing MS than men, with a ratio of approximately 2:1.

MS management focuses on controlling symptoms and slowing disease progression. Therapy, a healthy diet, regular exercise, and managing stress can also help maintain overall health and improve daily functioning. A personalised care plan is helpful.