More than 30,000 people in Australia live with multiple sclerosis, which is the most common nerve condition in young adults.
There are a lot more people with the disease now than there were ten years ago.
This is mostly because of earlier diagnosis and higher life expectancy.
However, as medicines have improved, many people's symptoms have become less
severe.
What does multiple sclerosis mean?
An ongoing nerve disease called multiple sclerosis (MS) impacts the brain and
spinal cord, which are part of the central nervous system.
Myelin is the protective lining of nerve fibers that lets electrical signals
move quickly and efficiently from the brain to the rest of the body. MS happens
when the immune system attacks it by mistake.
This damages and inflames the body, making it hard for the brain and body to
talk to each other. This can cause a lot of different symptoms, like tiredness,
weakness, stiffness, and motor dysfunction, like shaky movements, muscle
twitches, and trouble speaking.
MS is most common in people between the ages of 20 and 40, and three times as
many women as men have it.
There is no known single cause, and the disease varies in severity and growth
from person to person. However, genetic susceptibility, environmental and
lifestyle factors, and illnesses (like the Epstein bar virus that causes
glandular fever) have all been linked to its development.
Professor Arun Krishnan from the School of Clinical Medicine and the
Neuromuscular Disease and Multiple Sclerosis Research Group at UNSW Sydney
said, "It's a disease that can leave people with a lot of physical
problems."
"But that doesn't happen as often as it used to." Many people with MS
would be in wheelchairs if you ran an MS center thirty or forty years ago.
"Right now I don't have anyone in a wheelchair," Prof. Krishnan, who
runs the Multiple Sclerosis Clinic at Prince of Wales Hospital, said.
MS is becoming more common.
More than 33,300 people in Australia have MS, which is about 131 out of every
100,000 people. These numbers were last taken in 2021.
According to the most recent report from MS Australia, which came out last
year, that number is up 30% since 2017, which shows a big rise in MS cases. A
group called the Menzies Institute for Medical Research put it together.
A different study that looked at data from 81 countries found that the number
of MS cases has been going up around the world. Most people agreed that the
rise was caused by earlier diagnosis, better discovery, and longer life.
Prof. Krishnan agreed that the main reason for the rise was earlier and better
spotting. He also said that MRI scans, which are one of the main ways to
diagnose MS, were easier to get now than they were decades ago. There is a
chance that risk factors also played a role.
He said that the real rise in MS cases may be much less than 30% when better
diagnosis and longer life are taken into account.
The different kinds of multiple sclerosis
The signs of multiple sclerosis can come on and off or get worse over time.
Relapsing remitting This is the most common form of the disease and the one
that most people are first told they have. It has clear attacks of symptoms
followed by healing times during which symptoms may go away completely or
partially.
After that, some people get secondary progressive MS, which means that their
symptoms get worse over time even though they don't have any clear attacks.
Then there is main progressive MS, which only affects some people who have the
disease. Patients in this group have brain signs that get worse over time from
the start, and the disease moves much more quickly.
How to treat multiple sclerosis
MS still doesn't have a fix, but there are more than a dozen disease-modifying
medicines that can help handle symptoms and slow the disease's growth.
A huge amount around the world. Which means, say,
you were able to text with your left hand there on Friday but not on Monday.
That is a slip-up. You will be taken to the hospital and given steroids. After that,
we will check to see what preventative drugs you are on or may need to be on.
However, Prof. Krishnan said that there are still not many disease-modifying
treatments available for people with worsening MS.
More progress is also needed to better track how well treatments are working
and to better tailor the care that each patient gets.
The fact that people get worse is a good sign that a drug isn't working. But
you can't be sure if it's helping or if the person has just been lucky and
hasn't relapsed in two years.
How the eye could help us understand MS
Prof. Krishnan and Associate Professor Maria Markoulli from the School of
Optometry and Vision Science are working on studies to find a better way to
check for inflammation in MS patients' eyes so that treatment can be better
tracked and targeted.
They are working with Ph.D. students to find out how the eye and tear film can
be used as biomarkers for MS to see how well treatment is working and how the
disease is spreading.
According to the experts, the eye is the only place in the body where you can
see inflammatory cells directly and without hurting the tissue. It also gives a
good picture of neurodegeneration, which is not seen on a normal MRI scan.
People with MS might not need MRIs or more invasive treatments like biopsies in
the future if this method works as well as planned. It could be part of their
regular checkups.
The collecting part of the project is almost over, and it is hoped that the
main data will be made public in the next year.
What MS has to deal with next Also, he said, more needs to be done to
treat conditions like pain and tiredness that make it hard to do things. The
treatments that are already in place don't do a good job of this.
MS medicines have come a long way, but more money is needed for important study
to keep making them better and maybe even find a fix one day.
"These days, the difference in life span between people with MS and people
without MS is getting very small," Prof. Krishnan said, adding that he
hoped there would be no difference in the next few decades as study continued.
