Timothy L. Vollmer, MD
Professor,Department of Neurology
University of Colorado Health
Co-Director of the RMMSC at
Anschutz Medical Center
Rocky Mountain MS Center
There have been recent advancements in the treatment of MS. Multiple sclerosis is one of the success stories in medicine today. Since 1993 we have actually have had a bear please approved by the FDA to try to prevent progress and disability in multiple sclerosis. We have three more that are currently [April 2012] being reviewed by the FDA and could be approved within the next year.
For the first time in history the field now has several ongoing clinical trials in humans using therapy to try and repair the nervous system. These initially were focused primarily on stem cells of various types and Dr. Corboy here is using a study using umbilical vein stem cells as a reparative strategy. However recently we also have become where there are other strategies that might work. For example there was an antibody called anti-lingo that is being studied and that's anti-body helps turn off the signals in the brain that prevents the repair process. So it allows the brain's own repair process to become more active. There are other such strategies in the future including actually exercise which we now think about as a reparative therapy.
We're much better preventing the progression of the disease not then we are reversing or repairing the nervous system. And some of the newer therapies are particularly effective and so in patients that can use these newer therapies, they actually have a very high chance that they will not develop significant disability over their lifetime with the modern therapies available today.
It turns out that the amount of disability that a patient has is not determined just by the MS activity, but also by other factors. For example if they develop hypertension or diabetes or obesity, that substantially increases the amount of disability they will have from MS. So one aspect is maintaining a good activity program and a diet to try and prevent secondary diseases from occurring or what we call co morbidities.
The second issue is that we now have good evidence that the brain actually can rewire itself but it requires input and that input is exercise. So if a patient is having effective exercise program that helps the brain make new connections that then allow the brain to recover function from the amount
of loss before and also helps give them sort of a
reserve function that the brain uses to mask the underlying damage that's occurring in the nervous system. So diet and exercise are just as important as the drugs that we used to try and prevent inflammation in the brain.