As a chronic disease, therapies used to treat MS focus on altering the disease course by reducing disease activity and slowing down the accumulation of disability.
Symptomatic treatment options are also important in helping individuals fulfil their personal, social, and occupational roles and improve quality of life, for as long as possible.
Inflammation is more pronounced in the acute stages of MS but can continue into the chronic stages. Peripheral immune cells found to infiltrate MS lesions include macrophages, T cells, B cells, and plasma cells. At later stages of the disease, these cells, along with activated CNS-resident microglia and astrocytes, promote atrophy of grey and white matter.
*Reestablishing or rearranging neural connections.
†Cell type that creates myelin in the CNS.
*Specialised end of an axon that determines and guides the direction of growth.
*In a 1-year longitudinal study, patients with early RRMS meeting criteria for no evidence of disease activity (NEDA-3; n = 56) and those with evidence of disease activity (n = 36) showed increases in local cortical connections. This change was not observed in healthy controls (n = 101) over the same period.
Altered functional connectivity has been associated with changes in MS symptoms. Cognitive and motor performance as well as other neurologic dysfunctions (e.g. fatigue, visual problems, depression, and sleep disturbance) are often associated with alterations in functional connectivity or change in network coherence.
Once diagnosed, there are several different types of MS including relapsing remitting MS (RRMS), secondary progressive MS (SPMS), or primary progressive MS (PPMS).
Relapses are episodes of neurologic deficits that can coincide with inflammation and demyelination which are typically discernible by MRI as white matter lesions. Relapse intensity can vary from mild to severe with complete or incomplete neurological recovery, and the symptoms they cause can vary from patient to patient.
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