

RMS and the Central
Nervous System
Let’s break down what happens in the body when relapsing multiple sclerosis (RMS) is present. Read on for more on the science of RMS.
The where, how, and why of RMS
It all happens in your body’s main control center—the central nervous system (CNS), which is made up of the the brain and spinal cord. Here, lesions can develop and interfere with the brain’s ability to send messages to the rest of the body. This is the reason for impaired physical and cognitive abilities.
Inflammation targets myelin
Scientists believe that RMS begins with inflammation in the CNS. When inflammation occurs, the immune system is stimulated to mistakenly attack and destroy myelin—an insulating layer that protects the nerves.
Myelin is damaged
When myelin is damaged, nerve fibers form scar tissue in the affected areas. Much like scabs that form on the skin, this tissue is stiff and hard, and blocks the signals coursing through the axon. These areas of damage are typically called plaques or lesions.
Did you know?
The word sclerosis means scars. In RMS, people develop multiple areas of scars (also called lesions) that develop along a neuron's axon.
Symptoms occur
These lesions or “scars” can disrupt nerve signals to and from the brain and cause tissue loss. This results in a range of symptoms depending on where the tissue damage is in the brain. And while all lesions contribute to brain volume loss, they don’t always cause a relapse.
Scientists don’t know the exact cause of RMS, but they believe that it could be triggered by a combination of factors. Research is ongoing, and more is being learned every day in the following areas:
- Immunologic factors: Immunology is the study of the body’s immune system. Scientists are researching the body’s immune response by studying cells and processes that could be involved in RMS.
- Environmental factors: Areas farther from the equator are known to have higher numbers of cases of RMS than areas closer to it. Growing evidence also suggests low vitamin D levels, smoking, and obesity contribute to an increase in the risk of developing or exacerbating RMS.
- Infectious factors: Scientists are also researching viruses and bacteria to determine if they’re involved in the development of RMS. These include: measles, canine distemper, human herpes virus-6, Epstein-Barr virus (EBV), and Chlamydia pneumonia.
- Genetic factors: RMS isn’t an inherited disease, meaning it’s not passed down from generation to generation. However, there is an increased genetic risk in families who already have a member with RMS, because family members carry some of the same genes. For instance: the risk of developing RMS is about 1 in 750 - 1000. In identical twins, if 1 twin has RMS, the risk that the other twin will develop RMS is about 1 in 4.
Normal neuron vs RMS neuron




Neuron
Neurons (or nerve cells) form connections and networks in the central nervous system (CNS).
Axon
Each neuron has a long fiber called an axon that carries messages.
Myelin
Myelin coats and protects the axon and helps signals travel efficiently.
Damaged Myelin
When myelin is damaged by RMS, the signals traveling along your nerve cells slow down. This damage affects messages (or nerve impulses) that tell other parts of the body what to do.
Once the myelin around the nerve is completely gone, the signal may become blocked altogether. This means messages between your brain and the rest of your body can become disrupted, and it’s this disruption that eventually leads to the various symptoms of RMS. It’s also why RMS symptoms can be so unpredictable, because there is no way of knowing which messages might be affected.
Boosting your brain health knowledge
Did you know that leading a healthy lifestyle can help protect your brain? Here are some strategies you can use to promote good brain health.
There are several types of healthcare professionals that can help you understand how well your current treatment is working, monitor the progression of your condition, and give you other ideas on how to keep your brain healthy.
Looking after your physical health with higher levels of aerobic fitness could help you preserve brain tissue volume. This means that the more physically active you are, the better your chances are of preserving your brain health.
Cigarette smoking increases risk of development and progression of RMS. It also may cause development of antibodies that lower the effectiveness of certain treatments. Visit www.smokefree.gov for assistance with quitting smoking.
Reading. Learning a new language. Taking up a new creative hobby. Any activity that challenges your mind can help protect against cognitive problems in RMS when pursued over a lifetime.
Higher levels of stress may be associated with an increased risk of developing some types of lesions. Prioritizing some “me time” and relaxation is important in keeping the brain in good condition.
Staying on top of vitamin D intake can help boost brain health. People with RMS who are lacking in vitamin D have more exacerbations and are more at risk of progression than those who have sufficient vitamin D.
Next Up: Processing an RMS diagnosis
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