Multiple Sclerosis: Current Status and Strategies for the Future

Front Cover

Multiple sclerosis is a chronic and often disabling disease of the nervous system, affecting about 1 million people worldwide. Even though it has been known for over a hundred years, no cause or cure has yet been discovered-but now there is hope. New therapies have been shown to slow the disease progress in some patients, and the pace of discoveries about the cellular machinery of the brain and spinal cord has accelerated.

This book presents a comprehensive overview of multiple sclerosis today, as researchers seek to understand its processes, develop therapies that will slow or halt the disease and perhaps repair damage, offer relief for specific symptoms, and improve the abilities of MS patients to function in their daily lives.

The panel reviews existing knowledge and identifies key research questions, focusing on:

  • Research strategies that have the greatest potential to understand the biological mechanisms of recovery and to translate findings into specific strategies for therapy.
  • How people adapt to MS and the research needed to improve the lives of people with MS.
  • Management of disease symptoms (cognitive impairment, depression, spasticity, vision problems, and others).

The committee also discusses ways to build and financially support the MS research enterprise, including a look at challenges inherent in designing clinical trials. This book will be important to MS researchers, research funders, health care advocates for MS research and treatment, and interested patients and their families.

 

Contents

Executive Summary
1
1 Introduction
17
2 Clinical and Biological Features
29
3 Characteristics and Management of Major Symptoms
115
4 Disease Management and Measurement
177
5 Strategies for Future Research on Disease Mechanisms
241
6 Future Strategies for MS Therapies
277
7 Building and Supporting the Research Enterprise
325
Appendix A Committee and Staff Biographies
371
Appendix B List of Expert Consultants
377
Appendix C Workshop Agendas
379
Appendix D Kurtzkes Expanded Disability Status Scale EDSS
385
Appendix E Drugs Used in the Treatment of MS
387
Appendix F US Social Security Administrations Criteria for Qualifying as Disabled from MS
401
Appendix G Treatments That Have Been Claimed to Be of Benefit in MS1
405
Index
413

8 Recommendations
347

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