The 2024 theme "Asthma Education Empowers" underlines the importance of understanding asthma triggers, symptoms, severity,…
What is Multiple Sclerosis?
Multiple Sclerosis (MS) is a disease of the brain and spinal cord that affects millions worldwide. Each year on World MS Day, we reflect on advances in research, treatment, and support for those living with MS—while also recognizing the ongoing challenges.
This year’s World MS Day theme, “My MS Diagnosis” with the tagline “Navigating MS together,” shines a spotlight on the importance of timely and accurate diagnosis for everyone affected by MS. The campaign aims to break down barriers to diagnosis, share real stories, and advocate for better training, research, and support systems for people living with MS.
How Does Multiple Sclerosis Damages Brain and Spinal Cord
In multiple sclerosis (MS), the body’s immune system, which is supposed to protect us from infections, becomes confused and starts attacking the brain and spinal cord by mistake. The main target of this attack is the myelin, a protective layer that covers nerve fibers—think of it as the insulation around electrical wires. Myelin helps nerve signals travel quickly and smoothly throughout the body. When the immune system damages or destroys this myelin, the nerves can’t send messages as well as they should. This causes a range of symptoms, such as numbness, weakness, vision problems, or trouble with balance.
As the immune attack continues, the body tries to repair the damaged areas, but it often leaves behind scar tissue, which is called sclerosis. Sometimes, the damage goes even deeper and affects the nerve fibers themselves, not just the protective covering. When this happens, it can lead to more serious and lasting problems because the nerves can’t recover as easily. At first, people with MS might have symptoms that come and go, because the body can sometimes fix the myelin. But over time, as more damage builds up and scar tissue forms, the symptoms can become more permanent.
Multiple Sclerosis: A Disease with Many Faces
Multiple sclerosis comes in several types, each with its own pattern of symptoms and progression:
Clinically Isolated Syndrome (CIS): is a first episode of neurological symptoms caused by inflammation or demyelination in the central nervous system. Not everyone with CIS will go on to develop MS, but about 30–70% do.
Relapsing-Remitting MS (RRMS): is the most common form, affecting about 85% of people with MS at diagnosis. People experience attacks of symptoms (relapses) followed by periods of recovery (remission) when symptoms may disappear completely or partially. Over time, some people with RRMS may stop having clear relapses and remissions and instead notice a gradual worsening of their symptoms.
Secondary Progressive MS (SPMS): often develops after someone has had RRMS for several years. In SPMS, symptoms steadily worsen over time, with or without occasional relapses or minor remissions.
Primary Progressive MS (PPMS): About 10–15% of people with MS have this type. Symptoms get worse from the beginning, without early relapses or remissions. There may be occasional plateaus or minor improvements, but overall, disability gradually increases.
How Frequent is Multiple Sclerosis in the UAE and MENA Region?
MS prevalence is rising globally, and the MENA region is no exception. Over the past three decades, the worldwide prevalence of MS has increased by an average of 26%, with some countries seeing rates more than double since 1990. In the UAE, recent studies show prevalence rates of around 65 cases per 100,000 people, a significant increase from earlier decades. This places the UAE in the moderate prevalence category for the region, alongside neighboring Gulf countries like Qatar and Bahrain.
While North America and Western Europe have the highest MS prevalence globally, the MENA region has witnessed a steady rise, likely due to improved diagnosis, increased awareness, and possibly environmental and lifestyle changes. Factors such as urbanization, reduced sun exposure, higher body weight, and increased stress are believed to contribute to this trend.
Understanding the Causes of Multiple Sclerosis
The exact cause of MS remains unknown, but research highlights a complex interplay of genetic and environmental factors. Key contributors include:
Genetic predisposition: Certain genes increase susceptibility, but MS is not directly inherited.
Environmental triggers: Low vitamin D levels (linked to less sun exposure), viral infections (notably Epstein-Barr virus), smoking, and obesity are recognized risk factors.
Immune system dysfunction: MS is considered an autoimmune disease, where the body’s immune system mistakenly attacks the protective myelin sheath surrounding nerve fibers.
While the science continues to evolve, these insights guide both prevention efforts and the development of new treatments.
The National Multiple Sclerosis Society of the UAE: A Beacon of Support
The National Multiple Sclerosis Society (NMSS) of the UAE is at the forefront of advocacy, research, and patient support. As a non-governmental organization, NMSS brings together local and international experts, medical professionals, and volunteers to:
- Empower people living with MS through education and resources.
- Facilitate access to high-quality care and emotional support.
- Foster research collaborations to advance MS treatment and understanding.
- Organize events and workshops to strengthen the MS community.
NMSS also recently launched the UAE’s first MS Helpline, providing daily support, referrals, and guidance for patients and caregivers.
Landmark: The UAE’s First National MS Treatment Guidelines
A major milestone in 2025 was the introduction of the UAE’s first national MS treatment guidelines, developed by the NMSS in collaboration with leading neurologists and health authorities. These guidelines are tailored to the UAE’s unique healthcare landscape and patient needs, offering:
- Evidence-based recommendations for MS-modifying therapies.
- Guidance on treatment during pregnancy, lactation, and for pediatric patients.
- Strategies to improve prescription accuracy, reduce side effects, and ensure optimal care for the largest possible number of patients.
The guidelines are dynamic, with regular updates to reflect the latest research and clinical advances, including emerging therapies such as stem cell treatments for patients unresponsive to conventional therapies.
Treatment of Multiple Sclerosis: From Earlier Standard Therapy to New Approaches
The treatment landscape for multiple sclerosis (MS) has evolved significantly over the past decades, offering improved outcomes and more options for people living with this complex disease.
Earlier Standard Therapies
For many years, the mainstay of MS treatment was disease-modifying therapies (DMTs) that aimed to reduce relapses and slow disease progression, especially in relapsing-remitting MS (RRMS):
Interferon beta-1a and beta-1b: These injectable medications help regulate the immune system and reduce inflammation, thereby slowing the progression of MS and decreasing the frequency of relapses.
Glatiramer acetate: Another injectable therapy, glatiramer acetate works by altering the immune response and reducing inflammation in the central nervous system.
These therapies were effective for many, but often required frequent injections and could have notable side effects.
Newer Approaches and Innovations
Recent years have brought a wave of new therapies, offering more convenient options and, in some cases, greater effectiveness:
Oral medications: Drugs like fingolimod, teriflunomide, and dimethyl fumarate are taken by mouth and work by sequestering immune cells in lymph nodes, preventing them from attacking the nervous system.
Monoclonal antibodies: Treatments such as ocrelizumab, natalizumab, and alemtuzumab are given by infusion or injection and target specific immune cells involved in MS, providing higher efficacy for many patients.
B cell depletion therapies: Ocrelizumab and rituximab are examples of therapies that specifically target B cells, a type of immune cell involved in the MS disease process. These have shown strong results in reducing relapses and slowing progression, even in primary progressive MS.
BTK inhibitors: New drugs under investigation, such as BTK inhibitors, aim to further modulate immune cell activity and may offer additional benefits in both relapsing and progressive forms of MS.
Stem cell therapy: Hematopoietic stem cell transplantation (HSCT) and mesenchymal stem cell therapies are being researched for their potential to “reset” the immune system and promote repair of damaged tissue. Early results are promising, but these treatments are still mostly experimental and reserved for select cases.
Remyelination and neuroprotection: Several experimental therapies aim to repair myelin (the protective sheath around nerves) or protect nerve cells from further damage. These include anti-LINGO-1 antibodies and neuroprotective agents like ibudilast and riluzole.
Symptomatic treatments
Alongside DMTs, medications and therapies to manage symptoms such as muscle spasms, fatigue, pain, and bladder problems have long been part of MS care.
Looking Ahead: Hope and Resilience
World MS Day 2025 is a moment to celebrate progress, acknowledge the resilience of those living with MS, and renew our commitment to research, advocacy, and support. The UAE’s leadership—through the NMSS, pioneering guidelines, and a thriving MS community—offers a model for the region and the world.
The “My MS Diagnosis” campaign reminds us that an early, accurate diagnosis is the first step toward effective treatment and a better quality of life. By sharing stories, raising awareness, and advocating for better healthcare systems, we move closer to a world where everyone with MS receives the care and support they need—without delay.
TheKnowHow Independent Second Opinion Service
If you or a loved one is affected by MS in the UAE, reach out to the National Multiple Sclerosis Society for support, resources, and to connect with a vibrant community dedicated to overcoming MS together.
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Read more on PATIENTS and SECOND OPIGNION REQUEST
A contribution by Dr. Gabriele Stumm,
References
Multiple Sclerosis International Federation (MSIF).
World MS Day 2025 Campaign Toolkit.
National Multiple Sclerosis Society UAE.
About MS & UAE Guidelines.
