CaixaResearch debate on multiple sclerosis, the disease with a thousand faces

On December 10, the online debate Multiple sclerosis, the disease with a thousand faces will take place, where various research and healthcare professionals will discuss multiple sclerosis, a disease that affects more than 2.8 million people worldwide.

Pablo Villoslada, head of the Neurology Service at Hospital del Mar and director of the Neuroscience Programme at the Hospital del Mar Research Institute (IMIM); Pablo Arroyo-Pereiro, neurologist in the Multiple Sclerosis Unit of the Neurology Department at Bellvitge University Hospital; and Mar Tintoré Subirana, clinical lead at the Multiple Sclerosis Centre of Catalonia (Cemcat), head of the Neurology/Neuroimmunology Service at Vall d’Hebron University Hospital, and principal investigator of the Clinical Neuroimmunology Group at the Vall d’Hebron Research Institute (VHIR), will speak at a new research and health debate organised by the ”la Caixa” Foundation on multiple sclerosis.

This autoimmune neurodegenerative disease causes damage to the central nervous system and affects more than 2.8 million people worldwide, the majority of whom are young women. Although there is still no definitive cure, advances in current research and treatments are transforming the prognosis and the quality of life of patients.

Known as “the disease with a thousand faces”, MS presents differently in every person. No two cases are alike: each individual experiences a unique combination of symptoms and progression. These symptoms may include fatigue, vision problems, cognitive changes, spasticity, pain, balance issues, bladder and bowel dysfunction, and difficulties walking or speaking, among others. This variability makes diagnosis more challenging and means the impact on quality of life varies greatly from one patient to another.

Despite there being no definitive cure, current treatments can alter the course of the disease, reduce the frequency of relapses and slow the progression of disability. Disease-modifying therapies have transformed the outlook for many patients, especially when started early. In addition, there are treatments available to manage relapses and symptoms, as well as rehabilitation programmes that include physiotherapy, occupational therapy and psychological support.

Research into MS is advancing rapidly and opening up highly promising pathways. In this debate, three experts will help us better understand the disease and the latest scientific developments. Has the number of cases truly increased, or are we simply diagnosing it better? Is it hereditary? What is the link between sun exposure and the risk of developing MS? Why does it affect women more than men? What role does the Epstein–Barr virus play in its development? Are there treatments capable of slowing its progression? Can artificial intelligence help us diagnose and treat the disease more effectively? Are we close to achieving a cure or a preventive vaccine?

Early diagnosis and the prompt start of effective treatment are essential to improving outcomes. In this vein, Pablo Arroyo is co-leading a project using artificial intelligence to predict the course of the disease by analysing clinical, laboratory and imaging data. The proposed tool was selected in the 2024 call of the CaixaImpulse Innovation programme. As Arroyo explains, “the early identification of patients at greater risk of progression through precise biomarkers will make it possible to implement more individualised and effective treatment strategies in multiple sclerosis.” 

Meanwhile, Pablo Villoslada is leading research focused on neuromodulation. His team is developing a device that applies low-intensity focused ultrasound to the spinal cord, with the aim of stimulating nerve cells and promoting the repair of myelin. This non-invasive technique, used alongside pharmacological treatments, could slow disease progression, promote neuronal regeneration and improve symptoms such as mobility and bladder control.

The project to develop an ultrasound device to stimulate the spinal cord and slow the progression of multiple sclerosis, led by Villoslada, was also one of those selected in the 2024 call of the CaixaImpulse Innovation programme. Villoslada, who is optimistic about the future of research, explains: “We are working to create a neuromodulation device capable of delivering low-intensity ultrasound in a personalised way that can succeed in slowing the progression of the disease.”

One of the most significant discoveries in recent years is the link between MS and the Epstein–Barr virus, which causes glandular fever. Nearly all people diagnosed with MS have been exposed to this virus, suggesting it may act as a trigger in individuals with a genetic predisposition. For neurologist Mar Tintoré, a leading international expert in the disease, this finding offers a glimmer of hope: a vaccine against the virus could prevent many cases in the future. She also highlights the importance of early diagnosis and healthy lifestyle habits as key factors in improving patients’ long-term outcomes.

Although recent years have seen an increase in cases, driven by earlier diagnosis and the detection of the disease in older people, Dr Tintoré remains optimistic: “Today, we already know some of the factors that cause multiple sclerosis, and pharmacology has advanced enormously in its treatment. We are detecting it earlier and more accurately all the time.”

Thanks to advances such as these, the outlook for MS is changing dramatically. Today, the condition is no longer seen as an inevitable sentence of disability. Treatments have succeeded in reducing the frequency of relapses by up to 80%, and increasingly safer and more effective therapies are being developed. However, research continues: much remains to be understood about the underlying mechanisms of the disease, and the major challenge for the future will be not only to halt its progression, but also to repair the damage already done.

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