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http://www.medicinaeinformazione.com/ Multiple Sclerosis - a demyelinating neurodegenerative disease that affects numerous areas of the brain, causing deficits and disabilities - usually begins around the age of thirty, affects women in a more or less aggressive way - the ratio is 3 women for every man affected - and has a progressive course with periods of remission. Especially in the initial phase, the symptoms are among the most varied - sensory, strength, balance, vision disorders... - and also difficult to interpret because often, after their first manifestation, they spontaneously regress even for years and this causes a diagnostic delay that consequently leads to starting therapies when the disease is in a more advanced phase. We talk about Multiple Sclerosis with Prof. Diego Centonze, Director of the Multiple Sclerosis Center at the Policlinico Tor Vergata in Rome, who explains to us how far along the research is in identifying the exact degenerative process caused by the disease, how important it is to arrive at a certain diagnosis not only with the clinical examination of the patient but with instrumental tests such as magnetic resonance imaging and visual evoked potentials, starting treatment as early as possible to reduce the risk of relapses and limit possible disabilities over time. The Professor then talks to us about the management of relapses to limit their duration and severity. Alongside the therapies, lifestyle is also of great importance, with a diet rich in antioxidants and all those complementary therapies - including rehabilitation, which plays a primary role in the long-term management of the disease because, in addition to helping resolve balance or mobility problems, it significantly interferes with the mechanisms of action of the disease - which can help better manage the symptoms and control them. In drug-resistant cases there are alternative options such as hematopoietic stem cell transplantation that helps to rebuild the immune system or transcranial magnetic stimulation, a non-invasive technique that stimulates certain areas of the brain to reactivate them if they are damaged. We then address two issues that have raised much hope in recent years, namely chronic cerebrospinal venous insufficiency and the involvement of heavy metals in the onset of multiple sclerosis. We then hear from Prof. Centonze about the latest research news - for example, at the moment they are investigating the interaction between inflammation and neurodegeneration to understand the involvement of the immune system while in the pharmacological field a drug is coming that will be taken orally, greatly improving the quality of life of patients. And finally, let's tackle the psychological aspect because, in addition to the natural depression that a diagnosis of multiple sclerosis often brings, depression is itself an expression of the disease - as the inflammation interferes with the brain circuits and must be addressed and managed not only from an emotional point of view but also from a clinical one, considering it to all intents and purposes one of the symptoms of multiple sclerosis.