A Response to Rex.
 

 Rex’s diagram, and the feedback loop between the immune system and the Central
Nervous System intrigued me. At the AGM, Richard Foster asked Rex “what about
triggers on the CNS, as well as the immune triggers?” So I changed an idea that I had
been brewing on for a few months. If you look at the CNS as being both the neural
network (this is where the demyelination happens), and also the chemical side of brain
activity (really the neuroendocrine system) then triggers to the CNS start popping up all
over the place. So I put Rex’s diagram on its side and split CNS into two parts - neural
and neuroendocrine (or chemical).

 Triggers and therapies could operate on all three boxes - immune system, neuro
endocrine and neural systems. There may be genetic susceptibility operating on all three. (polygenetic ?)  And, they all (?) contribute to the symptoms (pathology) of MS.
 There are two interesting consequences to modelling MS like this: 1. The Feedback
Loop and 2. The Role of the Neuro Endocrine system.

1 The Feedback Loop:  This might simply go around the circle (in either direction) or
there could be a feedback between only two of the systems. Perhaps looking at it
like this exposes a possible complexity of MS. Therapies can (and do) interrupt this
feedback. (sometimes).
2 The Role of the Neuro Endocrine system. There are lots of triggers and therapies
and symptoms involved here.

I think there are very real advantages for those of us who have MS to see the condition in these terms.
 Demyelination (neural) and autoimmunity (Immune) are what define MS. We see
the condition through these icons. But, in support groups, we talk about bladders,
memory, fatigue and pain. The medicines we take affect the neuro endocrine system.
(After all, chemicals do change chemicals.) Even when we know that a symptom is
caused by demyelination a drug can change things.I am not alone in taking a drug for one symptom (e.g. fatigue) and finding that a lot of other things improved as well.(e.g.
bladder)

  Again, we talk of stress, trauma and grief as triggers for exacerbations. These have their effect on the neuroendocrine system in most people.
There is some evidence in the scientific literature for MS starting from these. [Not much, but some.]

 Our neuroendocrine system can be changed by our own efforts, not only by drugs.
It is this system that Norman Cousins changed when he belly laughed his way through a
night of British comedy, and cured his illness. Laughter is the best medicine. Endorphins
(the natural morphine, or runner’s high) are released by exercise. [We can’t always cure ourselves. A positive attitude does help. But we can’t always just “snap out of it.”
Depression and fatigue are very real.]

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