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Summary
Early diagnosis of multiple sclerosis (MS) has improved with new techniques. While genetics play a role, an environmental factor, likely infectious, is implicated in MS aetiology.
Area of Science:
- Neurology
- Immunology
- Epidemiology
Background:
- Multiple sclerosis (MS) diagnosis accuracy has improved.
- Geographical distribution and migration patterns suggest environmental factors in MS aetiology.
- Genetic factors, potentially multifactorial and linked to immune regulation, contribute to MS.
Purpose of the Study:
- To review advances in multiple sclerosis diagnosis and aetiology.
- To discuss the potential environmental and genetic contributions to MS.
- To evaluate current therapeutic approaches for MS.
Main Methods:
- Evoked potential techniques.
- Electrophoresis of cerebrospinal fluid (CSF) proteins.
- Review of epidemiological, familial, and twin studies.
Main Results:
- Improved diagnostic accuracy for early multiple sclerosis.
- Evidence suggests an environmental factor, possibly infectious, in MS aetiology.
- Genetic predisposition, multifactorial and immune-related, is indicated.
Conclusions:
- Multiple sclerosis pathogenesis is at least partially immunologically mediated.
- Modifying the course of MS by targeting environmental agents is unlikely.
- Therapeutic strategies may focus on manipulating the immune-mediated pathogenesis of MS.