Multiple Sclerosis: Current Perspectives on Disease Mechanisms, Clinical Management, and Therapeutic Advances
Abstract
Background: Multiple sclerosis (MS) is a disease whose incidence has been increasing statistically alongside the development and wider availability of advanced diagnostic methods. Despite extensive research investigating its etiology, clinical course, and therapeutic approaches, considerable uncertainty remains regarding many aspects of the disease. Aim: This review aims to synthesize current scientific evidence, contextualize recent findings within the existing database of literature, and relate them to the practical needs of patients living with MS. Materials and Methods: A literature search was conducted using the PubMed, Google Scholar, MEDLINE, and Journal of Education, Health and Sport (JEHS) databases. Relevant studies and meta-analyses addressing various aspects of this complex and heterogeneous disease were identified and analyzed. Results: The available evidence clearly indicates that, owing to its high diagnostic sensitivity, magnetic resonance imaging (MRI) remains the gold standard for the diagnosis of MS. Therapeutic management continues to rely predominantly on well-established immunosuppressive and immunomodulatory agents, which constitute the cornerstone of current treatment strategies. Conclusions: Current knowledge has enabled the identification of emerging directions in MS diagnostics, including the increasing use of Visual Evoked Potentials (VEP), Optical Coherence Tomography (OCT), and greater recognition of the nonspecific clinical manifestations that may accompany the disease. This review also highlights existing research gaps concerning more selective therapeutic approaches, such as alemtuzumab, cladribine, and chimeric antigen receptor T-cell (CAR-T) therapy. Furthermore, theoretical and patient-centered domains—including mental health and sexual functioning among individuals with MS—remain insufficiently explored and warrant further investigation in future research.