Multiple Sclerosis (MS) is one of the most devastating neurological diseases as it produces antibodies that attack the brain and spine. Ravaging myelin, a neuron insulator, the attacks from these antibodies lead to scarring and lesions which can cause weakness, pain and walking difficulties among other issues.
However, a new theory focused on MS may be used to help develop new treatments for the disease. Stephen Krieger, a neurologist at Icahn School of Medicine at Mount Sinai in New York City, established this theory with the goal of looking at MS as one disease, rather than a disease with subtypes.
Traditionally, MS is divided into four subtypes: relapsing-remitting disease, primary and secondary progressive MS, and progressive-relapsing MS. The symptoms and lasting effects of each type are progressively worse and more damaging to neurological functions.
According to Scientific American, Krieger's hypothesis is like a swimming pool in need of repair, "Imagine a pool with mountains rising up from the bottom. The mountains represent scars in the central nervous system; the water surface is the threshold at which symptoms appear. Lesions below the water line do not cause symptoms whereas those jutting out of the water do."
In Krieger's theory, the older we get and the further MS progresses, the less the brain is able to compensate for the injured areas, which is akin to water slowly leaking out of the pool exposing more mountains (lesions) and their symptoms make themselves known. He refers to his theory as a topographical model.
If correct, this hypothesis could change the four subtypes to the four stages of MS. Krieger notes that though there are periods of "remission" with MS patients, the old lesions are still present in MRI scans. Though the symptoms seem to disappear, it appears that the brain is able to compensate for the damage more effectively during these periods.
While still a new theory, it is catching the eye of many researchers in the field. The concept that MS is caused by a body's worsening immune activity and its declining brain health may provide new methods of treatment and understanding.
