Multiple sclerosis explained: How MS affects the brain and body

Multiple sclerosis (MS) is unpredictable and currently incurable. But strides are being made in treatment, and it’s now possible to live with the disease without being defined by it.

What is MS?

MS is an autoimmune disease in which the immune system attacks the central nervous system, including nerves in the brain, spinal cord, and eyes. It affects nearly one million people in the U.S.

When an MS attack happens, it triggers inflammation in the body and leads to a condition called demyelination. That’s when the protective coating around nerves gets damaged. Without that coating, it’s difficult for signals to travel smoothly between the brain, spinal cord and the rest of the body.

Precisely what causes the body to turn on itself remains a mystery, and a cure has not been discovered. However, early treatments and disease-modifying therapies are improving ways to manage the disease. New research suggests early interventions are an essential defense against future MS attacks.

How is MS diagnosed?

No single test can definitively diagnose multiple sclerosis, but a doctor can find evidence of it and rule out other conditions using various tests, including:

• blood tests
• lumbar punctures
• magnetic resonance imaging (MRI)
• neurological exams
• vision exams

How MS can progress and damage the body

When MS damages the protective covering around nerves, known as the myelin sheath, it causes lesions and scarring (sclerosis). The affected areas of the central nervous system influence the type and severity of the disease.

Symptoms can come and go, as seen in relapsing-remitting MS. Symptoms can also appear, remain and worsen over time, which is called primary progressive MS.

Most people with MS initially experience relapsing-remitting episodes. For some in this group, the condition eventually worsens to the point where they are diagnosed with secondary progressive MS.

Women are diagnosed with MS three times more often than men, but men have a higher likelihood of developing progressive forms of the disease.

Key stages of MS progression

In addition to beginning as one form and advancing to another, the disease can also produce primary and secondary symptoms.

• Primary symptoms result from damage to the nerves and their protective coating.
• Secondary symptoms are complications from the primary symptoms.

For example, damage to sensory nerves and numbness can be primary symptoms. Chronic nerve pain resulting from the damage can be a secondary symptom.

If a primary symptom can be managed, secondary issues can often be avoided. When that’s not possible, medication and therapies can help address secondary symptoms.

The immune system’s role in MS

In MS, something triggers the immune system to attack the central nervous system. This self-attack on the body causes inflammation, which is responsible for many symptoms. Medications that target parts of the immune response in MS have been shown to reduce inflammation and the buildup of new lesions.

Vitamin D’s role in MS

MS is more common in areas with less sunlight, suggesting a possible link between vitamin D deficiency and the risk of the disease. Early research suggested that low vitamin D levels may increase the risk of developing MS. However, more recent studies show mixed results.

Although the exact effect of vitamin D on people with multiple sclerosis isn’t completely understood, the vitamin itself is vital for skeletal and immune health. Therefore, it’s important for everyone, including people with MS, to get at least the daily recommended amount of vitamin D.

Primary physical and mental effects of MS

Each person’s experience with multiple sclerosis varies, but common symptoms can impact both physical and mental health. If you notice any MS-related symptoms, even if they come and go, you should see your primary care doctor. They might refer you to a neurologist for a more detailed assessment. If MS is diagnosed, you can work with your care team to customize a treatment plan that targets your symptoms and helps prevent relapses and disease progression. Today, it is possible to live with MS and not be defined by it.

If MS is diagnosed, you can work with your care team to customize a treatment plan that targets your symptoms and helps prevent relapses and disease progression. Today, it is possible to live with MS and not be defined by it.

Early and common symptoms

Symptoms vary from person to person, but persistent numbness, tingling or weakness should be evaluated by a healthcare professional — especially if it's on one side of the body or from the waist down. Other common symptoms include:

• vision problems, in one or both eyes
• pain and stiffness
• weakness and fatigue
• muscle spasms
• paralysis

Body systems affected by MS

Multiple sclerosis primarily affects the central nervous system, including the brain, spinal cord and optic nerves. This nerve damage can lead to problems in other parts of the body.

• Muscular system: MS nerve damage disrupts the transmission of nerve signals to muscles, leading to muscle weakness and dysfunction.
• Skeletal system: MS raises the risk of osteoporosis mainly because of decreased mobility and long-term steroid use. Weak bones, along with balance problems, also increase the chance of fractures.
• Circulatory system: MS is linked to increased risk of cardiovascular disease, possibly due to chronic inflammation and reduced physical activity.
• Reproductive system: For people with MS, sexual dysfunction is common due to nerve damage, fatigue and mood changes. However, fertility is not significantly affected. Women with MS can conceive and breastfeed.
• Excretory systems: MS-related nerve damage can cause bladder dysfunction, such as urgency, retention and incontinence. Bowel issues can also arise in people with MS.

Unpredictability and variability of MS

MS is unpredictable, so the biggest challenge for many people living with the disease is the uncertainty about their future and how the disease will affect their ability to live independently.

One person might only have a couple of symptoms. Another may experience more issues, and their severity could change over time. This unpredictability can make it hard to plan for social events, vacations and long-term commitments.

Revolutionary advancements in treatment

MS treatments have improved steadily since the first disease-modifying therapy was introduced in 1993. Today, there are more than a dozen options — most for relapsing-remitting MS.

Many current treatments mainly aim to prevent relapses. New research focuses on reversing disease progression and restoring function, especially for progressive forms of MS.

Clinical trials

Allina Health offers opportunities to participate in clinical trials through our neuroscience research team. By participating, your condition may be better managed, and the data collected could help others like you — and possibly bring researchers closer to a cure for MS.

Medical treatments for MS

Standard medical treatments fall into three main categories:

• Disease-modifying therapies: These include injections, infusions or oral medications that alter the immune system to slow disease progression, as well as treatments like physiotherapy and occupational therapy that improve strength, mobility and daily living.
• Corticosteroids: These medications are administered intravenously or orally to quickly suppress the immune system and reduce inflammation during an MS flare-up.
• Symptomatic treatments: These approaches target specific problems to enhance daily functioning and quality of life. Examples include walking difficulties, fatigue and bladder dysfunction.

Other treatments for MS include:

• Integrative medicine: These interventions come from disciplines and traditions that have historically been outside of traditional Western medicine but are now gaining recognition through scientific research and clinical trials. Vitamins and minerals, as well as acupuncture and massage, are part of this integrative and functional medicine category.
• Emotional support: Emotional support for people with MS includes professional counseling and therapy, peer support through local and online groups, and self-care practices like mindfulness.
• Rehabilitation: Rehabilitation therapies can help people with MS improve their ability to function at work, at home and in the community. Services include support for enhancing overall conditioning, reducing fatigue, and addressing speech and swallowing issues.

Lifestyle changes for managing MS

Healthy living can help someone with MS feel their best and build the strength to deal with symptoms more effectively. Here are some key focus areas:

• If you smoke, quit.
• Keep moving with regular exercise.
• Eat well with a balanced, healthy diet.
• Prioritize good sleep.
• Find ways to manage stress.

Distinctive clinical care

Due to MS's unpredictability, having a trusted doctor and care team to support your decision-making can be very helpful. Allina Health provides expert specialty treatment for MS at Allina Health Neuroscience, Spine, and Pain Institute in Minneapolis. The institute’s holistic care for MS includes:

• coordinated medical treatment
• specialty pharmacy services, including oral medications and intravenous (IV) infusions
• rehabilitation services
• mental health support
• lifestyle modification guidance