Multiple Sclerosis: Pathophysiology and treatment

• DOI: https://doi.org/10.22533/at.ed.1595232528054

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• Abstract:

  Multiple sclerosis (MS) is a chronic inflammatory and autoimmune disease that affects the central nervous system and is marked by demyelination and axonal degeneration, which compromises nerve conduction and leads to progressive neurological deficits. This literature review discusses the pathophysiology of MS, highlighting the role of T and B lymphocytes in the autoimmune response and the importance of compartmentalized inflammation in the progressive forms of the disease. In addition, typical clinical manifestations are described, such as muscle weakness, fatigue, visual, cognitive and sphincter alterations, which significantly impact patients' quality of life.
  The study also looks at the evolution of MS treatment, with an emphasis on the early use of high-efficacy disease-modifying therapies (HETA), such as ocrelizumab, which demonstrate better long-term functional outcomes. Other emerging approaches include immunosuppressants, cell therapies (such as TACTH), remyelinating agents, BTK inhibitors and neuroprotectants. In addition to pharmacological treatment, rehabilitation strategies such as telerehabilitation, virtual reality and transcranial stimulation have shown efficacy in improving patients' mobility, cognition and well-being.
  Although therapeutic advances are notable, challenges remain, especially in the treatment of progressive forms of the disease. The search for biomarkers and personalized interventions, combined with the development of technologies such as artificial intelligence and big data, point to a promising future in the construction of precision medicine aimed at controlling MS and preserving patients' functionality and autonomy.