Multiple sclerosis is a progressive disease for which no cure has yet been found. Researchers are working to identify new and better strategies to stop that progression.
People with primary-progressive MS (read more about courses of MS) experience a slow but nearly continuous worsening of their disease from the onset, with no distinct relapses or remissions. A more common type of progressive MS is secondary-progressive MS, which starts as relapsing-remitting MS and then transitions into a progressive course, with or without occasional relapses.
Some of the burning questions that are being addressed through research include:
- What factors influence the transition from a largely relapsing-remitting course with distinct immune attacks to a largely progressive (steadily worsening) course (secondary-progressive MS)?
- Can the disease-modifying therapies prevent, delay, or slow long-term MS progression?
- What causes primary-progressive MS, and is it the same (currently unknown) thing that causes more common forms of MS?
- What new therapies will help people with progressive MS?
- What causes degeneration of nerve fibers—thought to be the cause of long-term disability experienced by many with MS—and how can that be stopped or reversed?
Since its inception, the National MS Society has been actively involved in supporting studies related to progressive MS, from funding laboratory studies of the molecular processes that may contribute to disease progression, to clinical research about how to track MS progression and treat it. Furthermore, the more than 440 research projects we’re currently funding explore virtually every aspect of MS, as well as more basic research into nervous system development and repair and the workings of the immune system. Most of these projects do not focus on any particular form of MS, but aim to build understanding of what causes all forms of MS and how to correct the problem.
Read more about living with progressive MS, including primary-progressive disease.
People with primary-progressive MS experience a slow but nearly continuous worsening of their disease from the onset, with no distinct relapses or remissions. This is a relatively rare course of progressive MS, but it is a focus of several grantees, such as these two:
- Nitin J. Karandikar, MD, PhD (University of Texas Southwestern Medical Center) is characterizing specific immune responses mounted by subtypes of immune cells in people with relapsing-remitting MS versus people with primary-progressive MS. Currently, there is no approved drug for the immunologic treatment of PP MS, and questions remain as to whether PP MS is a different disease or one aspect of the same spectrum. Dr. Karandikar is focusing on how CD4 and CD8 T cells change in activity and function over time and how they behave when an individual is taking a disease-modifying therapy. This should provide insight into the immune dynamics at work especially in PP MS, which could lead to a therapy to stop it.
- Rohit Bakshi, MD (Brigham and Women’s Hospital) is using novel imaging techniques to examine and compare different parts of the brain in primary-progressive and other types of MS. Dr. Bakshi is analyzing grey matter volume to determine correlations with progression of physical or cognitive dysfunction in people with primary-progressive and other types of MS, and comparing findings with those from people without MS. This study may yield new strategies for predicting and monitoring MS progression.
Here are some projects, large and small, focusing on understanding and stopping the progression of MS:
- Nervous System Repair and Protection Initiative What if we could actually reverse the damage that MS causes, restoring function to those who have been living with the disease for years? Four teams in the U.S. and Europe are using $15.6 million to lay the groundwork for clinical trials by 2010. This targeted initiative has direct relevance to those with progressive MS. Read about other research aiming to repair MS tissue damage .
- Jorge R. Oksenberg, PhD (University of California at San Francisco) leading a Collaborative MS Research Center team that is seeking molecules that may be used as "markers" to predict MS progression.
- The Sonya Slifka Longitudinal MS Study, tracking over 4,500 individuals with MS in 50 states over an extended period of time, is asking, among other questions, what factors determine the long-term course of MS, MS progression and disability.
- Progression to permanent disability is not necessarily associated with MS relapses. We might be able to try shorter courses of MS therapies (rather than life-long treatment), if we knew which time-periods were the most critical in preventing relapses to maximize the possible impact on long-term disability. Helen Tremlett, PhD, and colleagues (University of British Columbia) are examining the relapse rates in over 2500 people who have not taken disease-modifying drugs and have been followed for up to 23 years. They are investigating the effect of MS relapses occurring at different stages of the disease on disability progression. This study can provide much-needed information on the progression of MS, and on how to tailor treatments for individuals with this disease.
- Barbara S. Giesser, M.D. (University of California at Los Angeles) is testing a new way to improve walking ability in people with progressive MS. This new rehabilitation approach uses a robotic device that moves the legs while the person is suspended over a treadmill. To compare the effectiveness of the robotic technique, a total of 40 persons with progressive forms of MS are undergoing 36 training sessions over 12 weeks. Additionally, some participants will have functional MRI performed to see whether training has helped reorganize activity in the brain involved with coordinating walking. This study could be an important step toward improving everyday function and quality of life for people with progressive MS.
Read more about MS rehabilitation research.