What are the causes of Multiple Sclerosis (MS)?

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Last updated: May 8, 2025View editorial policy

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From the Research

The exact cause of multiple sclerosis (MS) remains unknown, but it's believed to be an autoimmune disorder where the body's immune system mistakenly attacks the protective covering of nerve fibers called myelin in the brain and spinal cord, with genetic and environmental factors, such as vitamin D deficiency, Epstein-Barr virus infection, obesity, and smoking, contributing to the risk of developing MS, as supported by recent studies 1. The development of MS is a complex process, involving the interaction of multiple genetic and environmental factors.

  • Genetic predisposition plays a role, as having family members with MS increases risk, though no single gene has been identified as the cause.
  • Environmental factors are important, particularly vitamin D deficiency, as MS is more common in regions farther from the equator with less sunlight exposure.
  • Certain viral infections, especially Epstein-Barr virus (which causes mononucleosis), may trigger MS in genetically susceptible individuals.
  • Smoking increases MS risk and can worsen disease progression.
  • Women are two to three times more likely to develop MS than men, suggesting hormonal factors may be involved.
  • MS typically develops between ages 20-40, indicating age-related factors in disease onset. These various factors likely interact in complex ways to initiate the autoimmune response that damages the central nervous system and leads to the characteristic symptoms of MS, as discussed in recent reviews 1, 2. The evidence for the association of Epstein-Barr virus infection, vitamin D deficiency, obesity, and smoking with increased risk of MS has further accumulated, and, in cases of obesity and vitamin D deficiency, the evidence for causal association has strengthened, as reported in a recent study 1. Interactions between genetic and environmental factors have been studied more extensively, and dietary factors and changes in the gut microbiota are emerging as possible modulators of the disease risk, as noted in recent research 1.

References

Research

Multiple Sclerosis Risk Factors and Pathogenesis.

Continuum (Minneapolis, Minn.), 2019

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