MS vs. Atherosclerosis
It would be easy to assume that multiple sclerosis (MS) and atherosclerosis are connected—after all, they share a common word in their name. MS is a disease that affects the central nervous system in the brain, while atherosclerosis affects the cardiovascular system (related to the heart). But are the two conditions related?
Howard L. Weiner, MD, a Mass General Brigham neurologist, cares for patients at Brigham and Women’s Hospital. He is the co-director of the Center for Neurologic Diseases at Brigham, where his research lab studies MS and other diseases. Dr. Weiner cautions that, though the terminology may be similar, they aren't necessarily linked.
"Both of them involve inflammation," he says. "There may be inflammation associated with atherosclerosis. And there is inflammation seen in MS. But that doesn't mean they're related."
Ultimately, MS and atherosclerosis are conditions with different causes, diagnoses, and treatments. Here's what you need to know to avoid confusion.
What is sclerosis?
Sclerosis is a hardening or stiffening of bodily tissues. Sclerosis appears in the names of several medical conditions, including:
Multiple sclerosis (MS)
Atherosclerosis
Amyotrophic lateral sclerosis (ALS), which affects the motor neurons that control movement, breathing, and swallowing
Systemic sclerosis, which affects the skin and joints
However, the exact effect of the sclerosis can vary. For instance, as a health care provider who’s cared for thousands of patients, Dr. Weiner wouldn't describe the changes MS causes in brain tissue as a stiffening or a hardening. Instead, the nerve cells of the brain develop scars or lesions. This subtle but important distinction can help patients as they seek care for either or both conditions.
What is MS?
MS is an autoimmune disease that affects the central nervous system, including the brain, spinal cord, and the optic nerves in the eyes. In MS, the immune system attacks and damages myelin, a fat-based substance wrapped around the nerves. Over time, lesions and scars can develop and impair the signaling between nerve cells.
"MS is usually diagnosed when a person has a symptom like weakness, loss of vision, or stumbling," says Dr. Weiner.
MS is most often found in adults between the ages of 20 and 40, and women are three times more likely than men to be diagnosed with the condition.
What are the signs and symptoms of MS?
The signs and symptoms of MS vary from person to person, but can include:
Numbness, tingling, or pain
Fatigue or weakness
Mobility issues like difficulty walking
Memory or focusing problems
Doubled vision or loss of vision
Depression
"MS has different stages. In the first stage or early MS, people have attacks and then recover. It's also known as relapsing MS. Later, it may become progressive," says Dr. Weiner.
A progressive disease gets worse over time. In progressive MS, symptoms continue to get worse without periods of remission, and patients may experience increasing disability. While MS has no known cure, early intervention slows the advancement of the disease. "We have many good treatments for relapsing forms of MS," Dr. Weiner confirms.
MS treatments
While there is no cure for MS, treatments can help manage symptoms and prevent relapses. Current options for treatment include:
Medications to dampen an overactive immune system
Stem cell therapy to reset the immune system using a person’s own cells
Physical therapy and exercise to help with mobility
Nutrition counseling to improve overall health
Mental health counseling and treatment to relieve anxiety and stress
MS research at Mass General Brigham
Researchers at Mass General Brigham, including Dr. Weiner, are actively investigating innovative new treatments for MS, including progressive MS. A new nasal spray treatment that targets the immune system, foralumab, has shown early potential at relieving symptoms and reducing inflammation. Foralumab is now in a phase two, double-blind trial. Dr. Weiner notes that foralumab is also being tested as a treatment for Alzheimer’s, ALS, Parkinson’s, and could be used in the future for long COVID-19.
Other promising research at Mass General Brigham includes:
Advanced imaging technology: Scientists at Massachusetts General Hospital are using advanced scanners like the Connectome 2.0 and new MRI techniques to take detailed pictures of the brain. These images help them see how MS damages the brain and affects memory and movement. This could lead to better ways to treat MS.
MRI study on axon damage: Mass General Brigham researchers are studying axon damage in MS, which can affect thinking and movement. Their research plays a key role in finding better ways to monitor and treat MS.
Wearable device study: Brigham and Women’s Hospital researchers are testing a smart insole that monitors MS symptoms, such as gait and balance, right at home. This device could help doctors detect changes in symptoms earlier.
Precision medicine and biomarkers: Researchers at Brigham and Women’s Hospital are working on ways to better match MS treatments to each person. They are studying certain genes, proteins, and other markers in the body that could help doctors predict how the disease will progress and which treatments will work best. This research could help create more personalized care for people with MS.
What is atherosclerosis?
Atherosclerosis is a form of arteriosclerosis, which is a broad term for hardened arteries. In the case of atherosclerosis, plaque builds up in the arteries, the main blood vessels that carry oxygen-rich blood to the rest of the body. Plaque deposits form from excess cholesterol and other substances in the blood. If too much plaque builds up on the artery walls, it can reduce blood flow.
Because plaque builds up over time, the risk of atherosclerosis increases as you get older. Men over 45 and women over 55 are at especially higher risk. People who have obesity, diabetes, high blood pressure (hypertension), high cholesterol, or a family history of heart disease are also more likely to develop atherosclerosis.
What are the signs and symptoms of atherosclerosis?
Atherosclerosis often develops without symptoms until it becomes severe. The signs and symptoms it causes may be related to serious complications like:
Coronary artery disease, when plaque builds up in the coronary arteries of the heart
Peripheral artery disease, when plaque builds up in arteries of the arms or legs
Signs and symptoms of these conditions can include:
Chest pain
Racing or pounding heart (or heart palpitations)
Fatigue
Shortness of breath
Atherosclerosis treatments
Treatments for atherosclerosis depend on how advanced the condition is, and can include:
Eating a healthy diet
Exercising regularly
Lowering stress
Taking medications like cholesterol-lowering statins
Interventions like bypass surgery
How multiple sclerosis and atherosclerosis are similar
While multiple sclerosis and atherosclerosis are primarily unrelated, care for both conditions can overlap in key ways. Patients should know that:
They are chronic conditions: People can have both MS and atherosclerosis at the same time. Both are chronic conditions that require long-term care.
Smoking is a risk factor: "Smoking can make atherosclerosis worse. And smoking is bad for MS," confirms Dr. Weiner.
Early treatment improves prognosis: Getting early treatment can prevent symptoms from getting worse and ward off more severe forms of the disease, like progressive MS or complex coronary artery disease.
