In general, women are affected at almost twice the rate of men; however, among patients who develop the symptoms of MS at a later age, the gender ratio is more balanced.
Waxman To understand what is happening when a person has MS, it is first necessary to know a little about how the healthy immune system works. The immune system -- a complex network of specialized cells and organs -- defends the body against attacks by "foreign" invaders such as bacteria, viruses, fungi, and parasites. It does this by seeking out and destroying the interlopers as they enter the body.
Substances capable of triggering an immune response are called antigens. In order to have room for enough cells to match the millions of possible foreign invaders, the immune system stores just a few cells for each specific antigen.
When an antigen appears, those few specifically matched cells are stimulated to multiply into a full-scale army. Later, to prevent this army from overexpanding, powerful mechanisms to suppress the immune response come into play. T-cells, so named because they are processed in the thymus, appear to play a particularly important role in MS. In order to recognize and respond to each specific antigen, each T cell's surface carries special receptor molecules for particular antigens.
Antibodies typically interact with circulating antigens, such as bacteria, but are unable to penetrate living cells. Chief among the regulatory T cells are those known as helper or inducer cells. Killer T cells, on the other hand, directly attack diseased or damaged body cells by binding to them and bombarding them with lethal chemicals called cytokines.
Kaser Since T cells can attack cells directly, they must be able to discriminate between "self" cells those of the body and "nonself" cells foreign invaders. To enable the immune system to distinguish the self, each body cell carries identifying molecules on its surface. T cells likely to react against the self are usually eliminated before leaving the thymus; the remaining T cells recognize the molecular markers and coexist peaceably with body tissues in a state of self-tolerance.
Components of myelin such as myelin basic protein have been the focus of much research because, when injected into laboratory animals, they can precipitate experimental allergic encephalomyelitis EAE , a chronic relapsing brain and spinal cord disease that resembles MS. The injected myelin probably stimulates the immune system to produce anti-myelin T cells that attack the animal's own myelin. It is possible that, in MS, components of the immune system get through the barrier and cause nervous system damage.
It is possible that the immune response to viral infections may themselves precipitate an MS attack. In the past few years, scientists have developed a set of tools that gives them the ability to pinpoint the genetic factors that make a person susceptible to MS. This work led to major advances in understanding diseases such as Duchenne muscular dystrophy and cystic fibrosis.
Scientists now believe that a person is susceptible to multiple sclerosis only if he or she inherits an unlucky combination of several genes. Instead, scientists suspect that MS develops because of the influence of several genes acting together. The researchers are looking for patterns of genetic material that are consistently inherited by people with MS.
These recognizable patterns are called "DNA markers. This process of moving closer to the gene until it is identified has to be repeated for each of the marker regions from the multiplex families.
Melvin By , as many as 20 locations that may contain genes contributing to MS were identified, but no single gene was shown to have a major influence on susceptibility to MS. Melvin Research will likely find that other, as yet unidentified, genes contribute to MS.
After the location of each susceptibility gene is identified, the role that the gene plays in the immune system and neuralgic aspects of people with MS will have to be determined.
Because the immune system is so involved in MS, many scientists think at least some of the susceptibility genes are related to the immune system. Further indications that more than one gene is involved in MS susceptibility comes from studies of families in which more than one member has MS.
Several research teams found that people with MS inherit certain regions on individual genes more frequently than people without MS. Of particular interest is the human leukocyte antigen HLA or major histocompatibility complex region on chromosome 6.
HLAs are genetically determined proteins that influence the immune system. Investigations in northern Europe and America have detected three HLAs that are more prevalent in people with MS than in the general population. Studies of American MS patients have shown that people with MS also tend to exhibit these HLAs in combination--that is, they have more than one of the three HLAs--more frequently than the rest of the population.
Furthermore, there is evidence that different combinations of the HLAs may correspond to variations in disease severity and progression.
Kaser Studies of families with multiple cases of MS and research comparing genetic regions of humans to those of mice with EAE suggest that another area related to MS susceptibility may be located on chromosome 5. Other regions on chromosomes 2, 3, 7, 11, 17, 19, and X have also been identified as possibly containing genes involved in the development of MS.
Hauser These studies strengthen the theory that MS is the result of a number of factors rather than a single gene or other agent. Development of MS is likely to be influenced by the interactions of a number of genes, each of which individually has only a modest effect. Additional studies are needed to specifically pinpoint which genes are involved, determine their function, and learn how each gene's interactions with other genes and with the environment make an individual susceptible to MS.
Such research could also uncover the basic cause of the disease and help predict the course of the disease in an individual. This would make it easier for physicians to tailor therapies and provide information to help people make life decisions. Another possible benefit may be the early diagnosis of people in families where one or more member already has MS. Many physicians believe that the earlier MS is diagnosed and treatment begun, the better the outcome will be.
Symptoms of MS may be mild or severe, of long duration or short, and may appear in various combinations, depending on the area of the nervous system affected. Complete or partial remission of symptoms, especially in the early stages of the disease, occurs in approximately 70 percent of MS patients. Fifty-five percent of MS patients will have an attack of optic neuritis at some time or other and it will be the first symptom of MS in approximately 15 percent.
This has led to general recognition of optic neuritis as an early sign of MS, especially if tests also reveal abnormalities in the patient's spinal fluid. National Multiple Sclerosis Society Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance at some time during the course of the disease.
These symptoms may be severe enough to impair walking or even standing. Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or "pins and needles" sensations; uncommonly, some may also experience pain.
Loss of sensation sometimes occurs. Occasionally, people with MS have hearing loss. Brunnscheiler ; National Multiple Sclerosis Society Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked.
Patients themselves may be unaware of their cognitive loss; it is often a family member or friend who first notices a deficit. Such impairments are usually mild, rarely disabling, and intellectual and language abilities are generally spared. Scientists do not yet know whether altered cognition in MS reflects problems with information acquisition, retrieval, or a combination of both. Types of memory problems may differ depending on the individual's disease course relapsing-remitting, primary-progressive, etc.
Brunnscheiler In addition, about 10 percent of patients suffer from more severe psychotic disorders such as manic-depression and paranoia.
National Multiple Sclerosis Society As the disease progresses, sexual dysfunction may become a problem. Bowel and bladder control may also be lost. Health Central In about 60 percent of MS patients, heat, whether generated by temperatures outside the body or by exercise may cause temporary worsening of many MS symptoms. In these cases, eradicating the heat eliminates the problem. Counseling may help MS patients, their families, and friends find ways to cope with the many problems the disease can cause.
Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks.
Until recently, the principal medications physicians used to treat MS were steroids possessing anti-inflammatory properties; these include adrenocorticotropic hormone better known as ACTH , prednisone, prednisolone, methylprednisolone, betamethasone, and dexamethasone. Studies suggest that intravenous methylprednisolone may be superior to the more traditional intravenous ACTH for patients experiencing acute relapses; no strong evidence exists to support the use of these drugs to treat progressive forms of MS.
Also, there is some indication that steroids may be more appropriate for people with movement, rather than sensory, symptoms. Mayo Clinic While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients. Two forms of beta interferon Avonex and Betaseron have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS. In addition, MRI scans suggest that beta interferon can decrease myelin destruction.
Alpha interferon is also being studied as a possible treatment for MS. Goals of therapy are threefold: In conclusion, MS is a disease that is well known but poorly understood by the medical and nursing community as well as the general public.
It has no known cure and the genes that are accountable for it have yet been pin pointed. The United States is capable of finding a cure for this disease; over the years, medical researchers have found cures for many diseases that were thought incurable.
Not only time and money are needed to find a cure for this disease, but faith and heart are needed to realize the importance Glossary antibodies -- proteins made by the immune system that bind to structures antigens they recognize as foreign to the body.
The body usually responds to antigens by producing antibodies. Physicians use a variety of tests--electrophoresis, isoelectric focusing, capillary isotachophoresis, and radioimmunoassay--to study cerebrospinal fluid for abnormalities often associated with MS. Cytokines are an important factor in the production of inflammation and show promise as treatments for MS. Demyelination ultimately results in nervous system scars, called plaques, which interrupt communications between the nerves and the rest of the body.
Also known as major histocompatibility complex. Since there is a decrease in muscle mass and strength the ability, gait also becomes altered. In , Baum and Rothschild found that , people were reportedly diagnosed with multiple sclerosis. Women were stated to be three times more likely than men to get MS Whitney, Over time it seems the prevalence of this disease has not increased sharply within the general population of Americans, although the likelihood of a female being diagnosed with the disease is increasing.
This may be due to environmental or genetic risk factors. Purpose Locomotion is the most basic and yet most essential part of a human transportation.
The purpose of this paper is to focus on how Multiple Sclerosis effects gait pattern. This was used to rule out obesity. Eight muscles were identified for either the swing phase or stance phase. Swing muscles were anterior tibialis, hamstrings, quadriceps and hip flexors; Stance muscles included the gastronomies, quadriceps, adductors, gluteus medius and gluteus maximums.
Goldfarb, et al found that patients with Amyotrophic MS spend less time in the swing phase and more time in stance phase.
Therefore, walking velocity decreased in patients Amyotrophic MS. They also found there was no correlation between velocity of walking and the following: Another study on MS looked at the effects of an aquatic exercise program on gait parameters.
All subjects participated in a 10 week aquatic exercise program consisting of aqua-calisthenics and freestyle swimming. Results indicated patients with MS showed decrease in stride length, slower free speed walking rates and higher walking cadence than those patients without MS. They also found that patients with MS have less vertical lift when walking..
Thus, according to there research aquatic fitness programs have no major effect on improving or impairing studied gait parameters. A study by Rodgers et al also looked at gait characteristic before and after a six month aerobic training program. They also found that patients with MS have an increase tightness of the hip flexors. However, because of the nature of the disease they were only able concluded that because neurological decline from MS occurred within the 6 month time frame for several subjects, it was difficult to differentiate the effects of intervention by exercise, form changes in status resulting from progressive of the disease Rodgers, et al Twenty eight subjects were used, 14 with MS and 14 without MS 14 control subject matched for age, gender and height.
In this study subjects were measured on their standing balance with feet apart, feet together, stride stance, double support stance, single support stance and self generated perturbations. Results illustrated that there were no differences between MS and the MS control group on the ability to maintain standing balance with feet apart, feet together or in stride stance. Alonso and colleagues reported incidence rates of 7. An overall incidence rate of MS of 3. The downward trend in incidence that we found is in contrast to studies in Denmark, where the female incidence of MS has almost doubled since the s while male incidence has remained constant.
Moreover, separate surveys carried out and analysed at different times may be subject to methodological differences. It is not clear why our study has detected a decreasing incidence while others have suggested increasing incidence. Changes in awareness of MS and the challenges of diagnosing MS may account for changes incidence over time. However, we could identify no specific reason why the methodology or data source we used should have had an impact on our finding of decreasing incidence of MS over the period of the study.
In the current study, the mean female-to-male ratio for MS was 2. For example, a recent analysis of trends in the sex ratio in MS for individuals born between and found a marked increase in Northern Europe not including the UK from 2.
This may be partly accounted for by changing health-related behaviours of men in recent years, perhaps having more contact with medical services than was the case historically. We are not able to identify any particular reason why the study methodology or data source could have confounded our findings regarding sex-ratio.
A recent study using HES data for the period — showed regional variations in hospital admission rates for MS in England. Early studies on MS suggested a trend with latitude with increasing prevalence in more temperate climates in Northern and Southern hemispheres.
Regional variation in MS epidemiology may be due to genetic or environmental factors and interactions between them. This is supported by studies on the effect of month of birth on subsequent risk of MS in Northern and Southern hemispheres. Further studies are needed to investigate the causative factors of MS, particularly the role of Vitamin D, genetic susceptibility factors and infective agents.
This study provides a comprehensive picture of the prevalence and incidence of MS throughout the UK over two decades. It shows that more than people in the UK were newly diagnosed with MS in and that patients with MS are living longer, leading to a rising population living with the disease.
This has important implications for resource provision in the UK. All authors were involved in drafting and reviewing the manuscript. Statistical analysis was carried out by SVM. The guarantor for the study is ISM. This grant supported study meetings but MSNTC had no input into the design of the study, collection, analysis or interpretation of the data or in the decision to submit the paper for publication.
All authors have completed the Unified Competing Interests form at http: The other authors have no non-financial interests that may be relevant to the submitted work. Provenance and peer review: Not commissioned; externally peer reviewed.
National Center for Biotechnology Information , U. Journal of Neurology, Neurosurgery, and Psychiatry. J Neurol Neurosurg Psychiatry. Published online Sep Received Mar 22; Accepted Aug For permission to use where not already granted under a licence please go to http: This article has been cited by other articles in PMC. Abstract Objectives To estimate the incidence and prevalence of multiple sclerosis MS by age and describe secular trends and geographic variations within the UK over the year period between and and hence to provide updated information on the impact of MS throughout the UK.
Design A descriptive study. Background Individuals with multiple sclerosis MS can experience high levels of disability and impaired quality of life for prolonged periods.
Hypothesis This was a descriptive study. Study population The study population included all patients with acceptable data who contributed follow-up time to the database after Statistical analysis The analysis plan is shown in figure 1. Open in a separate window. Mortality rates were analysed using logistic regression models.
Office for National Statistics We applied these adjusted age-specific and gender-specific incidence and prevalence rates to population statistics obtained from the Office for National Statistics ONS for the UK population to estimate the absolute numbers of new and prevalent cases of MS in the UK population in Secular trends The prevalence of MS increased by about 2.
Strengths and weaknesses of the study A major strength of this study is that it covers a representative sample of GPs spread geographically throughout the UK, and a patient population with age and sex distributions similar to those of the general UK population.
Relation to other studies The prevalence rates we found are slightly higher than the rates reported by Thomas et al in , also using the GPRD: Conclusions This study provides a comprehensive picture of the prevalence and incidence of MS throughout the UK over two decades. Supplementary Material Web figures: Click here to view. Multiple sclerosis in the UK Service use, costs, quality of life and disability. Eur J Health Econ.
Paper Masters Custom Research Papers on Multiple Sclerosis Paper Masters writes custom research papers on Multiple Sclerosis and delve into a sample of a paper ordered for an analysis of the degenerative disorder.
Introduction Multiple Sclerosis is a demyelization disorder of the central nervous system and the spinal cord; which leads to patches of plaques in the regions of the brain and spinal cord.
Incidence and prevalence of multiple sclerosis in women and men by age (General Practice Research Database –). (A) Incidence (per 10 5 patient years). (B) Prevalence (per 10 5 patients). People with multiple sclerosis (MS) undergo changes to their identity and this might have an effect on mood. The subjective experience of this identity change is currently not well understood. Past research highlights that social groups, established prior to diagnosis, might protect against the .
The free Health research paper (Multiple Sclerosis A+ Research Paper essay) presented on this page should not be viewed as a sample of our on-line writing service. If you need fresh and competent research / writing on Health, use the professional writing service offered by our company. Multiple Sclerosis. It is the least severe, has little progression, and takes up twenty percent of all cases. The second type is Benign Relapsing-Remitting Multiple Sclerosis. It carries symptoms that fluctuate in severity, mild disability, and it makes up thirty percent of the total. The third type is Chronic Relapsing Multiple Sclerosis.