Early Brain Activity May Predict Future Course of MS
Submitted by art on Tue, 2007-02-27 07:48.
These researchers found that the rate of brain atrophy (shrinkage) in early MS seems to be indicative of the future course of the disease (i.e. more shrinkage early = more shrinkage later = worse outcome).
This brings up another point that I believe the pharma companies are starting to get - that lesion load isn't the measure we need to worry about the most. Stopping the atrophy seems to be the important factor and neuroprotection is way of the future.
atrophy
This research also discusses atrophy and the importance of gray matter involvement. Not so long ago MS was an auto-immune disease where the immune system attacked myelin (the white matter). Looks like this is just part of a much bigger problem.
Gray matter involvement in multiple sclerosis 27 February 2007
Istvan Pirko, MD, Claudia F. Lucchinetti, MD, Subramaniam Sriram, MD and Rohit Bakshi, MD
From the Department of Neurology (I.P.), University of Cincinnati, OH; Department of Neurology (C.F.L.), Mayo Clinic College of Medicine, Rochester, MN; Department of Neurology (S.S.), Vanderbilt Medical Center, Nashville, TN; and Departments of Neurology and Radiology (R.B.), Partners MS Center, Center for Neurological Imaging, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.
Gray matter (GM) involvement is detected even in the earliest stages of multiple sclerosis (MS), and GM atrophy occurs at a faster rate than white matter (WM) atrophy early in the disease course.
Studies published to date establish that 1) GM involvement and in particular cortical demyelination can be extensive in MS; 2) GM pathology may occur in part independently of WM lesion formation; 3) a primarily GM-related process may be the earliest manifestation of MS; 4) GM involvement is associated with physical disability, fatigue, and cognitive impairment in MS; and 5) GM disease might help explain the observed dissociation between markers of inflammatory demyelination (relapses, WM gadolinium enhancement, WM lesion burden) and disease progression.
It remains likely that GM damage is related to WM damage. However, continued studies of GM pathology as well as neuronal and axonal involvement in MS and related experimental models are necessary to better understand the etiology and pathogenesis of the degenerative components.
Source: Neurology 2007 68: 628-629. [Full Text] © 2007 American Academy of Neurology
GM involvement
Obviously there is damage happening at a molecular level in the Purkinje cells. Especially since a majority of neurological problems related to MS involve motor coordination--directly related to atrophy. The Purkinje cells are also aligned very close to the lateral ventricular areas. And, thus the problems of the BBB breakdown and leakage in those areas that lead to a definite Dx (diagnosis) of MS by neurologists usually referred to as "Dawson's Fingers."