But a new discovery from the University of Wollongong has shed light on the potential cause of the debilitating disease, for the first time giving researchers a clear target as they work towards a cure.

Professor Roger Truscott and Dr Michael Friedrich, from the Illawarra Health and Medical Research Institute, studied the molecular structure of myelin – the substance that coats and insulates the tiny cables (axons) that connect nerve cells in the brain and allow nerve impulses to be conducted quickly.

By tracking the decomposition of myelin basic proteins (MBP), the researchers found a key difference in the way these microscopic structures break down in the brains of people with and without MS.

Prof Truscott said the researchers had been able to determine that the proteins – which he likens to the plastic insulation cabling of an electrical extension cord – breaks down in all people, even those without MS, as part of the ageing process.

“But then on top of that, we found that, in people with MS, their cabling had been degraded in a different way,” he said.

“And we think that difference is what triggers this immune reaction.”

“The structure of the MBP from MS patients had two regions where specific changes have accumulated. We hypothesize, based on the novel structures formed here, that these two regions provoke an immune response.”

At present, there is very little understanding about the cause of MS, and no known cure. 

With symptoms like muscular spasms, visual disturbances and problems with weakness, coordination, balance and functioning of the arms and legs, it affects more than 23,000 people in Australia and drugs available aim to ease these symptoms rather than target the cause.

Prof Truscott said the UOW discovery could be “an essential missing ingredient” in working towards preventing the disease.

He said drugs could be designed to bind the two regions where there have been changes in the myelin proteins, therefore stopping the body from launching an autoimmune attack on its own nerves.

“Now we know the exact structure of the myelin basic protein in people with MS, we could develop compounds that can stick to it and block the break down, to stop the body from reacting,” Prof Truscott said.

“For the first time, it opens up the door to developing drugs that might even prevent MS. I do want to emphasise we’re not there yet, but for the first time we have a target.”

To conduct their research Prof Truscott and Dr Friedrich accessed Sydney’s “brain bank”, where people have donated their brains to science after their death. 

“We can apply to the brain bank to get samples of a very specific part of the brain, of people of different ages – so we tracked what happened to what happens in people’s brains with age,” he said.

“Once we’d done that and had all the data showing how people’s brains had changed, we thought ‘Well, I wonder if anything the same or similar has happened with people with MS?’.

“We went back to the brain bank and ask for samples of the brain from MS patients and that’s what we used to compare people with and without MS.”

“Without that brain bank, we really could not have done this work.”

Aside from the breakthrough which highlights the different way MS patients’ myelin basic proteins degrade, Prof Truscott said it was also “remarkable” to discover that all people experience a break down in their “cable insulators”.

“In a sense, it’s amazing to think that everyone doesn’t develop MS or something similar, because if everyone’s cabling is broken down why is it that we don’t mount an immune response in every person?” he said.

“That’s an area of its own that needs exploring that might shed light on how the body copes with these changing proteins. There’s more work to be done, but that could change how we look at some autoimmune diseases in the future.”