More than 100 years after it was first described by the French physician Jean-Martin Charcot, multiple sclerosis remains a disease that has yet to reveal its inner workings.
According to the Multiple Sclerosis Society of Canada, three new cases are diagnosed every day in Canada, adding on to the 100,000 already identified patients. The disease is typically diagnosed in people between the ages of 15 and 40, 75% of whom are women. Multiple sclerosis progresses towards a severe handicap in 85% of all cases, and there is no known cure.
The origins of this disease are poorly understood. We do know that it is not contagious. The consensus among researchers is that its causes stem not only from genetic components, but also from environmental factors.
Clinicians can now call upon powerful tools to diagnose the disease. Following interviews and functional exams, nuclear magnetic resonance and lumbar puncture (spinal tap) are reliable means for formulating a verdict. Although it is impossible to predict how the disease will progress, there are two broad types (each with sub-types) according to the frequency and reversibility of the symptoms. The first type, which accounts for 85% of all cases, is called relapsing-remission MS (RRMS). It is characterized by episodes or attacks followed by periods of remission. Although a few drugs are available that help reduce the severity of relapses and ease the symptoms, there are none that prevent the appearance of new episodes. The remaining 15% of cases are quite different. These cases include various so-called progressive forms. No treatments exist to halt the constant and irreversible progress of the disease and its symptoms.
While little is known about the origins of MS, its manifestations are well documented. Research has shown that it is the result of the degradation of nerve fibres in the central nervous system. The main culprit is the immune system, responsible for defending our bodies against inflections and various forms of cancer. However, sometimes immune cells mistake their target and attack the myelin sheath, which both insulates nerve cells and facilitates the flow of nerve impulses. When the myelin sheath is damaged, as is the case in multiple sclerosis, a series of pathological conditions arise: pain, stiffness, fatigue, problems with balance, mobility and memory, anxiety, depression, infections, etc.
The CRCHUM and the CHUM are world leaders in multiple sclerosis research and treatment. A multidisciplinary team of some of the best scientists in the field work in close collaboration with a dedicated group of clinicians and healthcare professionals whose expertise and accomplishment serve as a reference. Together, they devote themselves and their expertise to the thousands of patients who have turned to them for help and solutions over the years. It is the convergence of observations and ongoing exchanges between patients and healthcare professionals that ensures both a mutuallyinforming dialogue and improved care, not to mention a source of crucial feedback and information for further research.
In this special edition of Multiple sclerosis:
- Chantal Girard: “The important thing is not what happens to you, but what you do with it.”
- Empathy, Honesty and Trust The patient-physician team (researcher: Marc Girard)
- Helping patients learn how to live with multiple sclerosis (clinical nurse: Josée Poirier)
- Discovering and validating new treatments (researcher: Pierre Duquette)
- Team work, ongoing dialogue and a better understanding of the disease ( researcher: Nathalie Arbour)
- Blocking the way for destructive cells: the search for new therapeutic targets (researcher: Alexandre Prat)