Intro multiple sclerosis and neuroimmunology

Question 1

What can be said about the regenerative capability of the central nervous system?

Answer 1

The central nervous system has a poor regenerative capability => almost all neuron population can’t be renewed

Question 2

What are some general facts about multiple sclerosis?

Answer 2

• Presumed autoimmune disease
• Onset age 20-40 years
• Woman 3x more
• More common at higher latitudes (northern hemisphere)

Question 3

What are the symptoms of multiple sclerosis?

Answer 3

Can give a whole range of different symptoms

• Focal symptoms: motor paresis (legs or arms)
• General symptoms: fatigue (symptom n°1), emotional (depression) and cognitive

Question 4

What diagnostic can be found in the cerebrospinal fluid for patients with multiple sclerosis?

Answer 4

• Clonal expansion of IgG
• Unknown specificity of these IgGs
  => Important diagnostic tool but tells little about the disease

Question 5

What can a MRI scan show for patients with multiple sclerosis?

Answer 5

Shows white lesions on the image (most lesions are in the deep white matter: near the ventricles, also happens in cortical layers)
MRI is an important diagnostic tool!

Question 6

What can be the causes of multiple sclerosis?

Answer 6

1. Environmental factors: lack of vitamin D, obesity, infections, etc.
2. Epigenetics
3. Genes
   => Complex gene-environment interactions

Question 7

How does the efficiency of the treatment evolve with the progression of multiple sclerosis?

Answer 7

Treatment of multiple sclerosis is effective at the beginning of symptoms, after a couple of years it becomes less effective

Question 8

What can be said on the variety of treatments for multiple sclerosis and what does that imply for the patient?

Answer 8

• Different treatments affect different stages of the disease progression and at different locations/targets
• Since treatments can vary a lot: it is important to assess benefit-risk ration with patient’s condition (no one-size-fit-all medication)