Date of Award
Master of Physician Assistant Studies
Physician Assistant Education
Multiple sclerosis (MS) has a vast array of clinical presentations, yet the science of its pathophysiology has not evolved adequately to target or prevent the sequelae of the disease. What is known, however, is that MS is a chronic inflammatory and neurodegenerative disease of the central nervous system due to demyelination of the axons of white matter resulting from infiltration of lymphocytes and astrocytes. 1 This axonal loss leads to the neurologic and constitutional (or systemic) deficits: visual disturbances, tremors, weakness, fatigue, cognitive impairment, depression/anxiety, poor motor control, and overall very poor quality of life from reduced mobility. 2 The associated inflammation and degeneration is hypothesized to be caused by high imbalance of cytokine activity and disturbances in the blood-brain-barrier (BBB). 3 This pathophysiologic process causing high levels of inflammation, eventually leads to scarring of the neurons, producing plaques on brain MRI (magnetic resonance imaging), which assists in diagnosing MS. All these harmful sequelae are not only debilitating, but also significantly increase the risk of developing comorbidities in addition to direct neurologic damages. This progressive destruction of the CNS promotes a vicious cycle resulting in negative health effects.
Briggs, Nicole, "Effects of Exercise on the Progression of Multiple Sclerosis" (2020). Physician's Assistant Program Capstones. 47.