23 - Multiple Sclerosis

Summary

Multiple sclerosis (MS) is classified as an organspecific autoimmune disease. The experimental autoimmune encephalomyelitis (EAE) models appear to be most useful and significant for studies of immune pathogenesis. The goals of disease-modifying therapy in MS, reducing relapse frequency or reducing disability progression, may or may not improve quality of life in the short term. Neuropsychological testing is most appropriate for a study that specifically targets neurocognitive deficits in MS. Measures using MRI, such as the number of contrast enhancing lesions and T2 hyperintensity volumes, are routinely used in MS clinical trials. Generally, MRI measures have the advantage of being more objective and more sensitive than clinical measures. Ethical concerns surrounding placebo-controlled trials in relapsing-remitting stage of MS (RRMS) involve the availability of effective disease modifying drugs that reduced the severity of MS. All approved therapies for MS at present have been directed at the RRMS and have targeted inflammation.