Multiple Sclerosis Incidence Is Rising

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The MD Magazine Peer Exchange "Modifying the Course of Multiple Sclerosis in New Ways: The Latest Advances in Treatment" features a distinguished panel of physician experts discussing key topics in multiple sclerosis (MS) research and management, including the latest insights into MS pathophysiology, new medication options and their application in clinical practice, and more.

This Peer Exchange is moderated by Paul Doghramji, MD, who is a family physician at Pottstown Memorial Medical Center in Pottstown, PA, and medical director of Health Services at Ursinus College, in Collegeville, PA.

The panelists are:

• Fred D. Lublin, MD, FAAN, FANA, the Saunders Family Professor of Neurology and director of The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, and co-chief editor of Multiple Sclerosis and Related Disorders at the Icahn School of Medicine at Mount Sinai
• Patricia K. Coyle, MD, professor of neurology, vice chair of Clinical Affairs, and director of MS Comprehensive Care Center
• Suhayl Dhib-Jalbut, MD, professor and chief of the Department of Neurology at Rutgers, Robert Wood Johnson Medical School

Many patients will try things on their own that they have heard help MS, such as fad diets, supplements, or complementary alternative medicine techniques. Coyle said that she encourages patients to tell her which ones they are trying, but, she said, “I do explain to them that there’s very limited data on these techniques.” Aerobic exercises are “particularly key” for the MS population, said Coyle. “Swimming is excellent, yoga is excellent, tai chi is good.”

As for the neuroprotective agents, Dhib-Jalbut said, “understanding the microenvironment of the lesion can lead to new therapies.” Coyle agreed that we need to continue to study it. “There’s microscopic injury. And 70% of normal-appearing brain tissue is abnormal. We don’t see that on our routine MRI scans, and that’s this microenvironment.”

The incidence of MS appears to be rising among women. “It looks like worldwide, the incidence is increasing, and we’re seeing it in areas we never saw it in before — Asia and places such as that – and it is primarily in women. It’s been a rise over the last couple of decades so it’s too quick to be genetic, it’s got to be something environmental,” said Lublin. Possible factors he listed included birth control, smoking, diet changes, or workplace changes.