Epidemiological aspects of progression in multiple sclerosis

Multiple Sclerosis (MS), usually begins with "relapses", short periods of neurological problems, with full or partial recovery afterwards. Over time, however, most patients develop "progressive MS", in which disability worsens relentlessly, and without recovery. In this three-part research project, we will use a unique population-based MS database to learn more about factors associated with the onset of progressive MS. Although most MS patients are young women, little is known about the role of pregnancy and childbirth in the disease course. In the first part of this study, we will investigate whether pregnancy and childbirth influence the onset of progression. There is some evidence that there may be a familial form of progressive MS, which would be an important MS-subtype for genetic studies. The second part of the project will therefore deal with differences in the onset of progression between familial and nonfamilial MS. While current MS treatments help against relapses, there is currently no treatment with any meaningful effect on progression. It would be a major breakthrough if a drug could postpone the onset of progression. In the third part of the project, we will therefore examine the effect of immunomodulatory drugs on the onset of progression.