Multiple Sclerosis

EPHE 242
Alisha Wong
Normal Physiology/Function

•  Neurons
•  In CNS - brain and spinal cord
•  Grey matter – cell bodies, dendrites, and axon
terminals
•  White matter – myelinated axons

•  Action potential
•  Generated by voltage-gated channels
•  Synapses from cell to cell
•  Crucial for cell communication
Normal Physiology/Function
•  Myelin Sheath – protection/insulation
•  Wrapped around axon
•  Allows for quick transduction of impulse
•  Saltatory conduction – node of Ranvier

•  Oligodendrocytes – support/creates myelin sheath

•  Demyelination/remyelination
•  Maturation and proliferation of neurons
•  Oligodendrocytes

•  Immune cells – Cannot pass blood brain barrier

•  Cytokines – immune response communication between cells
•  Macrophages – white blood cell, “big eater”
 Multiple Sclerosis
•  Disorder
•  Auto-immune disorder
•  No known cause
•  Genetic and environmental factors
•  RRMS-> Symptoms worsen and improve over
time (85%)
•  PPMS -> Increase of symptoms over time

•  Diagnosis
•  MRI
•  Lumbar Puncture
 Multiple Sclerosis Physiology
•  T-cells pass through blood brain barrier
•  Recognizes myelin as foreign and attack
•  Release of cytokines
1. Further degradation of blood brain barrier
2. Recruit other immune cells
3. Attack myelin sheath

•  Demyelination
•  immune system attacks and destroys myelin

•  Remyelination
•  Failure of oligodendrocytes, overpowered by
immune system

•  Inflammation
•  Immune cells attack nervous cells
•  Lesions in white matter – Damaged tissue
•  Affects the conduction of nerve impulses and cell Figure 1. White matter plaque in brain MRI of patient with
to cell communication multiple sclerosis
Figure 2. Neuron affected by multiple sclerosis compared to healthy neuron
 Symptoms and Outcome
•  Sensory, motor and cognitive problems
•  Lack of coordination/difficulty walking
•  Weakness/Fatigue
•  Sensory loss
•  Tingling/spasms/tremors
•  Cognitive impairment
•  Vision impairment
•  Sexual dysfunction
•  Treatment
•  No known cure
•  Immunomodulatory therapy
•  Physical therapy
 Conclusion

•  Multiple Sclerosis is a disorder where the body’s

immune system attacks and destroys it’s own myelin
and nerve cells

•  Range of symptoms from motor impairment to

sexual dysfunction

•  No known cure, however lifespan is not significantly

shortened
 References
Dowling, K., & Hubbard, E. E. (2017). What Is the Function of Myelin? Retrieved September 25,
2017, from http://www.wisegeekhealth.com/what-is-the-function-of-myelin.htm

Fuente, A. G. de la, Errea, O., Wijngaarden, P. van, Gonzalez, G. A., Kerninon, C., Jarjour, A. A.,
Franklin, R. J. M. (2015). Vitamin D receptor–retinoid X receptor heterodimer signaling
regulates oligodendrocyte progenitor cell differentiation. J Cell Biol, 211(5), 975–985.

Multiple Sclerosis Society of Canada. (2017). Retrieved September 23, 2017, from
https://mssociety.ca/about-ms/what-is-ms

Smith, K. J., & McDonald, W. I. (1999). The pathophysiology of multiple sclerosis: the
mechanisms underlying the production of symptoms and the natural history of the
disease. Philosophical Transactions of the Royal Society B: Biological Sciences,
354(1390), 1649-1673.

Stanfield, C. L. (2017). Principles of Human Physiology (5th ed.). Harlow, Essex: Pearson
Education Limited.

Wingerchuk, D. M., Lucchinetti, C. F., & Noseworthy, J. H. (2001). Multiple Sclerosis: Current
Pathophysiological Concepts. Laboratory Investigation, 81(3), 263–281.
https://doi.org/10.1038/labinvest.3780235