Mar Tintoré Subirana, head of clinical care of the Neurology/Neuroimmunology Service at Vall d’Hebron University Hospital and the Multiple Sclerosis Centre of Catalonia (Cemcat), and principal investigator of the Clinical Neuroimmunology group at the Vall d’Hebron Research Institute (VHIR); Pablo Villoslada, head of the Neurology Service at Hospital del Mar and director of the Neurosciences Programme at the Hospital del Mar Research Institute (HMRIB); and Pablo Arroyo-Pereiro, neurologist at the Multiple Sclerosis Unit of the Department of Neurology at Bellvitge University Hospital, took part in a new research and health debate organised by the ”la Caixa” Foundation on multiple sclerosis. This autoimmune neurodegenerative disease causes damage to the central nervous system and affects more than 2.8 million people worldwide, mostly young women. Although there is still no definitive cure, advances in research and current treatments are transforming prognosis and patients’ quality of life.

Known as “the disease of a thousand faces,” multiple sclerosis (MS) manifests differently in each person. No two cases are the same: each individual experiences unique symptoms and disease progression. Symptoms may include fatigue, vision problems, cognitive impairment, spasticity, pain, balance disorders, loss of sphincter control, and difficulties with walking or speaking, among others. This variability complicates diagnosis and means that the impact on quality of life differs greatly from one patient to another.

Although there is no definitive cure, current treatments can modify the course of the disease, reduce the frequency of relapses, and slow the progression of disability. Disease-modifying therapies have changed the prognosis for many patients, especially when initiated early. In addition, there are therapies to treat relapses and symptoms, as well as rehabilitation programmes that include physiotherapy, occupational therapy, and psychological support.

Research in MS is advancing rapidly and opening up very promising avenues. In this debate, the three experts helped shed light on the disease and the latest scientific advances. Has the number of cases increased, or are we simply diagnosing it better? Is it a hereditary disease? What is the relationship between sun exposure and the risk of developing MS? Why does it affect women more than men? What role does the Epstein–Barr virus play in its development? Are there treatments capable of halting disease progression? Can artificial intelligence help us diagnose and treat the disease more effectively? Are we close to achieving a cure or a preventive vaccine?

To improve prognosis, rapid diagnosis and the early initiation of effective treatments are essential. In this context, Pablo Arroyo co-leads a project that uses artificial intelligence to predict disease progression through the analysis of clinical, laboratory, and imaging data. The proposed tool was selected in the 2024 CaixaImpulse Innovation programme call. According to Arroyo, “the early identification of patients at higher risk of progression through precise biomarkers will make it possible to implement more personalised and effective treatment strategies in multiple sclerosis.”

Meanwhile, Pablo Villoslada is leading research based on neuromodulation. His team is developing a device that applies low-intensity focused ultrasound to the spinal cord with the aim of stimulating nerve cells and promoting myelin repair. This non-invasive technique, complementary to pharmacological treatments, could slow disease progression, encourage neuronal regeneration, and improve symptoms such as mobility or sphincter control.

The project to develop an ultrasound device to stimulate the spinal cord and slow the progression of multiple sclerosis, led by Villoslada, was also selected in the 2024 CaixaImpulse Innovation programme call. Villoslada, who is optimistic about the future of research, states: “We are working to create a neuromodulation system capable of delivering low-intensity ultrasound in a personalised way to halt disease progression.”

One of the most significant discoveries in recent years is the link between MS and the Epstein–Barr virus, which causes mononucleosis. Almost all people diagnosed with MS have been exposed to this virus, suggesting that it may act as a trigger in genetically predisposed individuals. For neurologist Mar Tintoré, an international reference in the study of the disease, this finding opens a door to hope: a vaccine against the virus could prevent many cases in the future. She also highlights the importance of early diagnosis and healthy lifestyle habits as key factors in improving patient outcomes.

Although an increase in cases has been observed in recent years—driven by earlier detection and the identification of the disease in older individuals—Dr Tintoré remains optimistic: “Today, we already know some of the factors that cause multiple sclerosis, and pharmacology has advanced enormously in its treatment. We are detecting it earlier and more accurately every time.”

Thanks to advances like these, the prognosis of MS is changing radically. Today, the disease is no longer seen as an inevitable sentence of disability. Treatments have managed to reduce relapse frequency by up to 80%, and increasingly safe and effective therapies are being developed. Nevertheless, research continues: much remains to be understood about the mechanisms of the disease, and the major challenge for the future will be not only to halt its progression, but also to repair the damage already done.