When someone inquires about the Multiple Sclerosis pathophysiology they will usually get a very complex explanation filled with medical jargon not understood by the layman.  But MS pathophysiology can be broken down into simpler explanations that don’t need a Doctorate degree to decipher.  The phrase Multiple Sclerosis pathophysiology means, in simple terms, to describe the functional changes that are associated with the disease of Multiple Sclerosis, or the physiology of the diseased organisms or their parts.


So what is the Multiple Sclerosis pathophysiology?


To get a handle on Multiple Sclerosis pathophysiology let’s start with a simple explanation of the disease.  It is an auto immune disease in which the body’s immune system starts to destroy itself.  The immune system destroys the fatty tissue myelin that insulates the axon/nerves in the spinal and brain area.  The destruction of this myelin sheath is called demyelination. The disease affects the Central Nervous System, or CNS, and inflames the brain’s white matter, creating plaque.  White matter is just below the top layer of the brain and spinal cord.  The plaque then blocks the signals that the nerves try to send each other and prevent proper communication signals from being sent to the rest of the body.  This is, in its simplest explanation, the MS pathophysiology.  It is the plaque blocking the signals, and the lesions formed on the brain that causes the majority of symptoms and problems.  As the disease progresses, the nerves themselves begin to be destroyed.

The MS pathophysiology is such that the disease progresses through 4 stages in most patients, each being worse.  The goals of most treatments are to stop the progression of the disease, and in the early stages of the relapsing-remitting form, to lengthen the time between relapses.


MS pathophysiology in a little more detail


To take the MS pathophysiology a little further we might describe the immune system and what happens to it as MS takes hold and progresses.  The healthy immune system is a network of specialized organs and cells that defend the body against attack from foreign invasion of things like bacteria, virus, fungi, parasites, etc.  When these invaders enter the body, it is the immune systems job to kill them off.  The immune system has different antigens that cause a different response depending on what has invaded the system.  The antigen suited to destroy a particular invader will multiply enough to kill it off.

T-cells play an important role in the MS pathophysiology.  They help to keep the immune system organized and directly destroy the infected or damaged cell.  It’s important that the T-cells know that the cell they attack is an invader or unwelcome in the body.  In each of our cells there is a marker that tells the immune system whether it is our own cell or foreign. Since MS is an autoimmune disease affected person’s body doesn’t know the difference between cells.

Another component of MS pathophysiology is the blood-brain barrier (BBB).  The BBB is a membrane surrounding the brain that allows the right substances only to cross from the blood to the CNS.  As MS progresses, the BBB is breached and some of the immune system defense cross unintentionally and cause damage to the CNS.


MS pathophysiology – the progression of the disease


  • Relapse-remitting MS (RRMS):  The symptoms are not always present.  They go into complete or partial remission for various lengths of time then return, or relapse.
  • Primary-progressive MS (PPMS):  This is marked by a continuous decline with no remissions.
  • Secondary-progressive MS (SPMS):  This stage of starts with RRMS symptoms and continues on to become similar to PPMS.
  • Progressive-relapsing MS (PRMS):   This is rare. The Progressive decline continues accompanied by acute and debilitating attacks


While simple and very non technical, this hopefully gives the reader a concise and easy to understand explanation of Multiple Sclerosis pathophysiology.