Multiple Sclerosis and Neurodegenerative Diseases

Abstract Multiple sclerosis (MS) is a neurodegenerative disease in which axonal loss is the major cause of irreversible neurological disability. Neurological deficits in MS patients are related to inflammatory demyelination and axonal degeneration. Axonal transection occurs at sites of inflammation and begins at disease onset but is clinically silent because the central nervous system (CNS) compensates for neuronal loss. Neuronal injury in the course of chronic neuroinflammation is a key factor in determining long-term disability in patients. Viewing MS as an autoimmune, inflammatory, and neurodegenerative disease has major implications for therapy, and CNS protection and repair is needed in addition to controlling inflammation. The availability of novel tools in molecular neurogenetics and increasingly sophisticated neuroimaging technologies, together with the revitalization of MS neuropathology research, has created a new paradigm for the multidisciplinary study of this disease. This chapter summarizes epidemiological, clinical, diagnostic tools, and current therapies for MS and other important neurodegenerative diseases such as neuromyelitis optica.