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CUREosity explains: Multiple Sclerosis

This new article in the series "CUREosity explains" is dedicated to multiple sclerosis. We would like to show what is behind the disease and what treatment options are available. Our VR therapy system CUREO can also be used for the therapy of MS and help to mitigate the course of the disease.



What is multiple sclerosis?


Definition autoimmune disease

Is a disease in which the immune system works against the body's own structures (e.g. specific cell types or organs). Many different structures in the body are conceivable, which can result in a wide range of autoimmune diseases (e.g. rheumatism, MS and type 1 diabetes).


Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) and usually progresses in relapses. This means that during a relapse, new symptoms develop, old symptoms recur or worsen. The relapses are triggered by an acute inflammatory focus in the CNS and last between 24 hours and several weeks. During a relapse, the protective sheath of nerve cells is attacked, and thus damaged (demyelination).


The protective sheath, or myelin, has two functions in our nervous system: on the one hand, it protects the underlying nerve cells from injury, and on the other, it ensures the fast and efficient transmission of stimuli. Thus, if the protective sheath is damaged or completely lost due to a relapse, this leads to a wide range of occurring symptoms. After a relapse, the damaged protective sheath around the nerve cells is often rebuilt (remyelination), so that symptoms can disappear again, but not always completely.


However, multiple sclerosis can also occur in a progressive manner (progression of the disease) without relapses. In this case, the disease state and symptoms gradually worsen, although there may also be phases in which the progression of the disease temporarily stops.


Symptoms multiple sclerosis


The following symptoms, among others, can be seen in multiple sclerosis:

  • Sensory disturbances (such as tingling in the legs).

  • Weakness to paralysis of the extremities,

  • gait disturbances

  • Disturbances in bladder emptying

  • Sexual dysfunction

  • Visual disturbances

  • Persistent tiredness and rapid exhaustion (fatigue)

  • Concentration problems

  • Depressive moods


Diagnosis multiple sclerosis


As already presented, multiple sclerosis presents with a wide spectrum of symptoms that initially complicate the diagnosis of multiple sclerosis. During the diagnostic process, other possible diseases must first be excluded so that a clear diagnosis can be made.


In addition to the symptoms, magnetic resonance imaging (MRI), nerve fluid analysis (CSF) and the examination of the transmission of impulses by means of an electroencephalogram (EEG) are particularly helpful in establishing the diagnosis.


First, a discussion is held about the previous history and current symptoms (anamnesis). If multiple sclerosis is suspected, an MRI is usually performed as an imaging procedure of the brain and spinal cord. Doctors can thus locate old and current foci of inflammation in the brain and spinal cord. If a patient has both old and new identifiable foci of inflammation, multiple sclerosis is very likely. In addition, there is still the option of taking cerebrospinal fluid from the patient and testing it for "specific" signs (e.g., antibodies) of multiple sclerosis, but not every multiple sclerosis patient has these signs in the cerebrospinal fluid. Another test often performed is the EEG.


As described above, damage to the protective sheath around the nerve cell leads to impaired transmission of stimuli. With the help of the EEG, one can measure the speed of nerve conduction, which can be reduced in multiple sclerosis, but also in other neurological diseases. It is not always possible to clarify the diagnosis after the first examinations, which is why it is often necessary to wait for another episode for a clear diagnosis to be made.


MS treatment


A cure for multiple sclerosis is currently not possible, but mortality as a direct result of multiple sclerosis is also low. Early diagnosis of the disease in combination with appropriate therapy is essential. The later the start of treatment after the onset of the disease, the more severe the degree of disability later on. Progression-modifying therapy is used to slow the progression of the disease, and relapse therapy is used to alleviate acute relapses by administering high doses of cortisone drugs. In recent years, progression-modifying therapy in particular has become increasingly important in the treatment of multiple sclerosis. The aim is to influence the patient's immune system in such a way that the relapses can be reduced or stopped completely. The selection of the appropriate therapy here is very patient-specific and must be adjusted precisely to the patient. Unfortunately, this type of therapy is not yet possible for every patient with multiple sclerosis.


In addition, the patient is supported by symptomatic therapy, which may include physical and occupational therapy, but also medication for pain, to improve mobility, and for psychiatric symptoms such as depression.


VR therapy for MS with CUREO


As already described above, the course-modifying MS therapy is supported by symptomatic therapy. The guideline "Diagnosis and Therapy of Multiple Sclerosis" (AWMF register number: 030/050) recommends in particular occupational and physical therapy to alleviate spasticity, tremor and movement coordination disorders. Cognitive disturbances and fatigue are more difficult to address and can be partly improved by attention training and a structured daily routine.

With CUREO, CUREosity offers a therapy system that also provides added value in therapy for multiple sclerosis patients. Thus, movement sequences can be practiced and trained in various therapy games. Typical exercises from occupational and physiotherapy are recreated in virtual reality. Patients experience a new type of therapy that motivates and spurs them on. Cognitive disorders can also be addressed with CUREO. The "cogni" module makes it possible to practice cognitive tasks in virtual reality in a playful way. Breathing and relaxation exercises can be used to counteract pain and exhaustion. Particularly positive experiences and successes in (VR) therapy help to increase patients' quality of life.






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