Abstract

This website will detail the condition of multiple sclerosis, the diagnosis process, some common types of treatments, how the normal physiology works, and our creative modification to a treatment method that currently exists on the market. As a group, we came across many disease models to discuss and develop improvements for, but multiple sclerosis was one that stood out the most. We decided to do this project on multiple sclerosis because it is a commonly known disease with many unknowns. Multiple sclerosis does not have a root cause therefore it is difficult to create a cure. Without the presence of a cure, physicians and researchers are only able to do is modify the disease physiologically and develop treatment plans towards managing its symptoms. There are a couple of treatments that exist today to treat multiple sclerosis, but they all come with various complications and side effects. There are three common ways to treat multiple sclerosis: injectable, oral, and infusion. We decided to take one of the injectable treatments that is most commonly used and modify it to reduce the side effects. While modifying the treatment, we also decided to create a monitoring device to help diagnosed patients know when an MS attack (like inflammation, tightness of the throat) is in the process of manifesting. We believe the development of our solution, the addition of a monitoring system and improved delivery system, can help prevent a MS attack in patients as well as offer a less confusing and simpler experience overall.

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is a neurodegenerative autoimmune disorder that impacts the central nervous system (CNS) . MS is referred to as a demyelinating disease because the immune system attacks and destroys oligodendrocytes and the myelin sheath. The myelin sheath is a type of fatty acid that covers the axon of healthy nerves and provides an insulation for saltatory conduction. The decline in myelin can lead to nerve inflammation and affects communication of electrical signals between nerve cells. According to most recent studies, there are 2.8 million people who have been diagnosed with MS as of 2020. [1]

For relapsing remitting multiple sclerosis (RRMS), patients cycle through periods of flare-ups or bouts, followed by a period of remission, and then a symptomless period. Throughout the patient’s lifespan, the flares increase in severity and require further medication and treatment. Secondary progressive MS (SPMS) is similar to RRMS in the beginning stages. The patient will experience the same cycle of bouts and remission. However, over time, the remission periods decrease. Eventually, there is no period of remission and the severity of symptoms and disability will continue to worsen drastically. Another category of MS is primary progressive MS (PPMS) which is characterized from the beginning of the disease. Unlike the other types of MS, patients with PPMS do not experience sudden symptomatic attacks. The severity of disability will steadily increase over time. Lastly, progressive relapsing MS (PRMS) is the least common diagnosis. Relapses and attacks happen often but symptoms will continue to worsen over the patient’s lifetime. [2]

The Signs and Symptoms

The most common symptoms for all forms of MS are dysarthria (weakness in speech muscles), nystagmus (involuntary eye movements), and tremors overall. These are often referred to as Charcot’s Neurological Triad. However the signs and symptoms vary widely depending on the severity of nerve damage and the location of the affected nerve fibers. Some patients that have more severe cases of MS may lose the ability to walk while others go through long periods of remission without experiencing any symptoms. In regards to motor function and movement, symptoms include numbness or weakness in one or more limbs, electrical shock sensations around the neck during motion, tremors, and overall loss of coordination. Damage to optic nerves can result in various issues with vision. Some of these symptoms include partial or complete loss of vision, pain during eye movement, blurry/ foggy vision, and double vision for extended periods of time. Patients can also experience fatigue, dizziness, pain throughout the body, and complications with sexual, bowel, and bladder functions.

Factors Connected to MS

Currently, the development of MS has been observed at any age. However, the most popular age has been between 20 and 40 years. Also, females are 2 to 3 times more susceptible to developing MS compared to males. In terms of race, Caucasians (particularly those from Northern Europe) are more likely to be affected. In the United States, roughly 6,700 people are diagnosed with MS annually. [2]

The root cause of MS is unknown and still at the forefront of much clinical research. The lack of cause limits the approaches and effectiveness of MS treatment plans. However, as a result, many factors (environmental, genetics, and viral/bacterial) have been connected to the development of MS in patients.

• Epidemiologists, scientists who study diseases, discover that MS is more common in areas farther from the equator. Studies also showed that people who were born in these areas were at higher risk compared to people who migrate to these areas. [2]

• Another study shows that vitamin D may play a role in MS. Low vitamin D levels in the bloodstream have shown substantial risks for multiple sclerosis. [2]

• Several studies have shown obesity in childhood and adolescence has a higher risk of multiple sclerosis.

• The probability of inheritance is much higher in relatives that have MS. However, this disease is not considered a "hereditary" condition.

• According to some research, some microbes have been proposed to trigger the disease but it is not confirmed.

• Viral and bacterial agents from diseases like Epstein Barr, human herpes, measles, rubella have been potentially contributing to the development of MS. [3]