Lorenzut Simone, Negro Ilaria Del, Pauletto Giada, Verriello Lorenzo, Spadea Leopoldo, Salati Carlo, Musa Mutali, Gagliano Caterina, Zeppieri Marco
Neurology Unit, "Head, Neck and Neurosciences" Department, University Hospital of Udine, 33100 Udine, Italy.
Neurology Unit, S. Tommaso dei Battuti Hospital, 30026 Portrogruaro (Venice), Italy.
J Integr Neurosci. 2025 Jan 21;24(1):25081. doi: 10.31083/JIN25081.
The complicated neurological syndrome known as multiple sclerosis (MS) is typified by demyelination, inflammation, and neurodegeneration in the central nervous system (CNS). Managing this crippling illness requires an understanding of the complex interactions between neurophysiological systems, diagnostic techniques, and therapeutic methods. A complex series of processes, including immunological dysregulation, inflammation, and neurodegeneration, are involved in the pathogenesis of MS. Gene predisposition, autoreactive T cells, B cells, and cytokines are essential participants in the development of the disease. Demyelination interferes with the ability of the CNS to transmit signals, which can cause a variety of neurological symptoms, including impaired motor function, sensory deficiencies, and cognitive decline. Developing tailored therapeutics requires understanding the underlying processes guiding the course of the disease. Neuroimaging, laboratory testing, and clinical examination are all necessary for an accurate MS diagnosis. Evoked potentials and cerebrospinal fluid studies assist in verifying the diagnosis, but magnetic resonance imaging (MRI) is essential for identifying distinctive lesions in the CNS. Novel biomarkers have the potential to increase diagnostic precision and forecast prognosis. The goals of MS treatment options are to control symptoms, lower disease activity, and enhance quality of life. To stop relapses and reduce the course of the disease, disease-modifying treatments (DMTs) target several components of the immune response. DMTs that are now on the market include interferons, glatiramer acetate, monoclonal antibodies, and oral immunomodulators; each has a unique mode of action and safety profile. Symptomatic treatments improve patients' general well-being by addressing specific symptoms, including pain, sphincter disorders, fatigue, and spasticity. Novel treatment targets, neuroprotective tactics, and personalized medicine techniques will be the main focus of MS research in the future. Improving long-term outcomes for MS patients and optimizing disease treatment may be possible by utilizing immunology, genetics, and neuroimaging developments. This study concludes by highlighting the complexity of multiple MS, including its changing therapeutic landscape, diagnostic problems, and neurophysiological foundations. A thorough grasp of these elements is essential to improving our capacity to identify, manage, and eventually overcome this intricate neurological condition.
被称为多发性硬化症(MS)的复杂神经综合征,其典型特征是中枢神经系统(CNS)的脱髓鞘、炎症和神经退行性变。管理这种致残性疾病需要了解神经生理系统、诊断技术和治疗方法之间的复杂相互作用。MS的发病机制涉及一系列复杂的过程,包括免疫调节异常、炎症和神经退行性变。基因易感性、自身反应性T细胞、B细胞和细胞因子是该疾病发展的重要参与者。脱髓鞘会干扰CNS传递信号的能力,从而导致各种神经症状,包括运动功能受损、感觉缺陷和认知能力下降。开发量身定制的治疗方法需要了解指导疾病进程的潜在过程。准确诊断MS需要进行神经影像学检查、实验室检测和临床检查。诱发电位和脑脊液研究有助于验证诊断,但磁共振成像(MRI)对于识别CNS中的独特病变至关重要。新型生物标志物有可能提高诊断准确性并预测预后。MS治疗方案的目标是控制症状、降低疾病活动度并提高生活质量。为了阻止复发并缩短疾病进程,疾病修正治疗(DMTs)针对免疫反应的多个组成部分。目前市场上的DMTs包括干扰素、醋酸格拉替雷、单克隆抗体和口服免疫调节剂;每种药物都有独特的作用方式和安全性。对症治疗通过解决特定症状,包括疼痛、括约肌障碍、疲劳和痉挛,来改善患者的总体健康状况。新型治疗靶点、神经保护策略和个性化医疗技术将是未来MS研究的主要重点。利用免疫学、遗传学和神经影像学的进展,可能改善MS患者的长期预后并优化疾病治疗。本研究最后强调了多发性硬化症的复杂性,包括其不断变化的治疗前景、诊断问题和神经生理学基础。全面掌握这些要素对于提高我们识别、管理并最终战胜这种复杂神经疾病的能力至关重要。