- The nervous system is the information network that's necessary
to make all of the body work together.
Muscles don't contract until they get the message to contract,
which comes from the brain going through the spine,
out through the peripheral nerves and then to the muscles.
We have the central nervous system,
which is the brain, the spinal cord and the optic nerves.
And then you have what we call the peripheral nervous system,
and that's attached to the central nervous system,
its smaller nerves as they leave the spine
and go out to the edges of the bodies at the fingertips
and the toes and basically everywhere.
Multiple sclerosis happens to attack just the central nervous system.
So the brain, the spinal cord or the optic nerves.
But obviously, that can
impact pretty much any part of your body.
Multiple sclerosis is an autoimmune disease
where the immune system,
which is supposed to be your body's armed forces,
protecting you from infections and things on the outside.
But in the case of MS, it gets its orders confused
and instead of attacking germs and things like that,
it attacks the brain, the spine and the optic nerves.
So because the central nervous system have connections to the entire body,
the symptoms that are caused by multiple sclerosis are very different
depending on what part of the central nervous system
is being attacked by the immune system at any given time.
Initially, for most people, it presents as a sudden, relatively sudden onset of neurologic symptoms.
That could be loss of vision, it could be trouble walking, it could be numbness
and that's very much a change from what normal should be.
When we look at the person's MRI, we find inflammation.
That's the immune system causing damage.
If left to itself, MS tends to just become what we call progressive,
which just means people slowly get worse over many years
and that is something we want to avoid.
In the early 1990s, there were no treatments for multiple sclerosis.
Zilch, nada, not a thing.
Now we have over 20 different immunotherapies that can control the disease
and while they're not cures, they can effectively put the disease into remission for many, many years
and so the first changes in MS are most likely immunologic changes
and Yale, as a immunologic powerhouse,
is uniquely suited to do this kind of deep inquiry
into these patients immune systems
and tease out what's gone wrong.
The frontier for multiple sclerosis is on both ends.
First, find it earlier, treat it earlier.
Maybe we can prevent it.
But also for the patients who have lived with the disease for many years,
how can we improve their lives, improve their level of function?
And so I think both on both ends of the spectrum, there's room for improvement.