The Neuropsychiatry of Multiple Sclerosis – What Should Psychiatrists Know?
Multiple sclerosis (MS) is an autoimmune disorder that is characterized by muscle weakness and numbness as well as problems with vision and bladder control. It is caused by the immune system attacking the nerve-insulating myelin sheath, which disrupts the communication between brain and peripheral parts of the body.
Oligodendrocytes are the cells that form the myelin sheath around nerve axons in the central nervous system (CNS). These cells are critical in the development of the brain as well as the correct functioning of the nerve cells. The myelin sheath they produce acts as insulation that protects long nerve projections as well as allowing the conduction of a nerve signal.
In MS, there is a loss of myelin in defined areas (lesion sites) in the brain and spinal cord. The disease is characterized by a large array of invading immune cells that attack and degrade the myelin sheath, the myelin producing oligodendrocytes and the nerve itself. These lesion sites develop with time and initially result in clinically benign symptoms but can progress in to profound disabilities.
Most treatments for MS are immunosuppressive drugs that manage the symptoms without reversing neurological damage. Although they have shown efficacy, there is still a high demand for effective and safe treatments that focus on mitigating autoimmunity, stimulating regeneration and restoring lost functionality.
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