Multiple sclerosis (MS) is a chronic immune-mediated disorder of the central nervous system (CNS), which consists of the brain and spinal cord. The CNS is responsible for sending messages throughout the body. A fatty tissue called myelin helps the nerves conduct electrical impulses. In MS, the body’s immune system attacks the myelin that surrounds and protects the nerves of the CNS.
Although the exact cause of MS is still unknown, researchers believe that myelin damage is the cause of the faulty response of the immune system. Individuals with multiple sclerosis can experience the following symptoms:
- Weakness or fatigue
- Numbness, tingling, or pain
- Vision problems (blurred, distorted, or involuntary eye movements)
- Poor coordination and concentration
- Speech or swallowing problems
- Loss of bowel or bladder control
- Cognitive problems
- Difficulty walking
Multiple sclerosis can also cause partial or complete paralysis in severe cases. However, not all people with MS experience all of these symptoms, many only have a few of the symptoms.
History of Multiple Sclerosis
Probably the earliest documentation of MS is the case of a 16-year-old Dutch girl named Lidwina from Schiedam, Holland. She developed an acute disease in 1395 and subsequently fell into a frozen canal while skating. Her symptoms were later described as weakness, pain, and blindness in one eye. She eventually died in 1433.
Her symptoms were associated with MS. Mostly, during that time, there was very little knowledge about multiple sclerosis as a disease. The church thought she became ill and suffered for the sins of others, so the church later canonized her in the year 1890. Lidwina is identified as a patron saint of ice skaters and also an unofficial patron saint of MS.
During the early years of the 19th century, physicians heavily relied on superstition and hearsay when it came to taking care of the sick and old.
Ideas about the science of medicine and treatment of diseases were not scientifically tested. However, physicians back then were good observers, so there were MS descriptions written as early as the Middle Ages. When physicians began to scientifically analyze diseases, among the first illnesses described was MS. There were even autopsies done in 1838 that clearly showed what we identify as MS now.
The first record of a patient having MS could be Sir Augustus d'Esté, who was the grandson of King George III of England. Augustus had a personal diary, which revealed a medical history suggesting that he had suffered from MS.
The first “sightings” of the disease were autopsy reports dating back to 1838. The autopsy reports had detailed images of the deceased bodies. The images showed scar tissues or plaques due to inflammation of the brain or spinal cord.
In 1868, Jean-Martin Charcot, a French neurologist and professor, created an association between the scar tissues he saw in the autopsy with the slurred speech, tremors, and nystagmus (involuntary eye movements) that the deceased patient had when alive.
He was correct in his assumption about the lesions corresponding to the symptoms he described. However, Charcot was not able to determine the exact cause of the disease. He only described the disease and gave it a name. There was no treatment suggestion at that time. Even though Dr. Jean-Martin Charcot had been credited with the discovery of the disease, he had only thought that it was a just a very rare condition.
Multiple sclerosis was first recognized as a disease during the 1870s. In 1873, the disease was recognized by Dr. Walter Moxen in England, and later in 1878 by Dr. Edward Seguin in America. These two physicians observed a variety of neurological symptoms in a number of people. They discovered that females were more susceptible to the disease than males. They also identified that MS was not entirely genetic as parents did not necessarily transfer the disease to their children.
In 1878, myelin was discovered by Dr. Louis Ranvier, a French scientist. Myelin offers protection and support to nerve cells. Patients with MS have damaged myelin.
Further knowledge about MS could not have advanced unless there was a better understanding of biology and research tools. In the 19th century, scientists had first learned that the cause of most diseases were bacteria. However, later, in the beginning of the 20th century, it was discovered that even smaller organisms such as viruses existed with the help of developed techniques in the laboratory.
In 1906, Dr. Camillo Golgi and Dr. Santiago Ramon y Cajal were awarded the Nobel Prize in Medicine for observing individual neurons under a microscope. Through their microscopic scientific observation, they were able to see the specific damage caused by multiple sclerosis.
In 1916, Dr. James Dawson, a pathologist from the University of Edinburgh made a breakthrough in the pathology of multiple sclerosis. He was the first to describe the inflammation of the blood vessels and microscopic damage to the myelin.
There was an emergence of a new research in 1933 by Dr. Thomas Rivers, an American scientist. He proved that multiple sclerosis was not caused by a virus. He showed that the symptoms of the disease could be recreated in animals through the injection of healthy myelin along with an autoimmune reaction. The disease formed in animals was called as experimental allergic encephalomyelitis (EAE), which has led to treatment studies in mice.
1940s to 1950s
In 1946, the National Multiple Sclerosis Society was formed. The society was founded by an extraordinary woman from New York named Sylvia Lawry whose brother had MS.
She had placed an ad in the newspaper looking for other individuals who were also suffering from MS. Overwhelmed with the response she received on her ad, she started to gather her friends and advisers to start a society to raise money for MS research and treatment. Her efforts paid off and the first research grant was awarded to a microbiologist named Elvin Kabat from Columbia University. He went on to discover the various kinds of abnormal proteins present in the spinal fluid of individuals who suffer from MS.
Research on multiple sclerosis still continued despite global upheaval during the World War II. In 1943, the actual composition of myelin was discovered. Because of the war, researchers collected various information mostly from men in the military. They discovered that the disease was more prevalent in people who lived in the northern climates.
There was a major breakthrough, which happened in the year 1953, wherein a Cambridge University graduate student named Francis Crick and his fellow researcher named James Watson described the structure of DNA in detail. They also won a Nobel Prize and their research led the others to study how the genes control the biologic functions as well as its regulation of the immune system.
1960s to 1970s
During the 1940s and 1950s, the link between MS and the immune system was still being explored. However, the role of the immune system in multiple sclerosis was understood the following decade. In the 1960s up to the 70s, many scientists confirmed MS as an autoimmune disease.
There were further enhancements to the development of imaging techniques in the 1970s. The first CAT scans and a circular array of X-rays were first performed on individuals suffering from MS in the year 1978. During the 1970s, there were also further developments of MRI or CAT scans, which helped researchers to view the brain in much greater detail, thereby leading to develop better MS therapies.
1980s to 2000s
There were clinical trials being conducted on new treatments for MS in the 1980s. These trials had led to the availability of the first long-term treatment for MS in the early 1990s. Later on, there was a research conducted in the 1990s, which mostly concentrated on the brain area. There were also more treatments being developed, which included drugs that would reduce the severity as well as the frequency of MS flare-ups. By the year 2004, there were around six drugs identified that would alter the course of MS and thereby suppress the attacks. These drugs were available in the form of injections or IV infusions.
In the year 2010, the first drug approved by the FDA to treat relapsing forms of MS is fingolimod under the trade name Gilenya. It is an oral drug approved for MS. There have been more developments in drug therapies to be made available for MS. This also includes a new antibody known as ocrelizumab, which is given intravenously.