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MS Damage Found in "Normal" Brain Tissue

Okay, you can tell I've been surfing again, sorry, I'm just a noisy person I guess.  The effects of MS on the brain is one of my weaknesses, as I want to understand what is happening to all of us.

This is just a partial of an article written in 06, but I thought it was rather interesting.  The web site for the entire article is:  http:// www. sciencedaily.com/ releases/2006/08/060829080502. htm (take out spaces)

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ScienceDaily (Aug. 30, 2006) — The effects of multiple sclerosis (MS) extend beyond visibly affected areas into large portions of the brain that outwardly appear normal, according to a study appearing in the September issue of Radiology.

"This disease process in the normal-appearing brain tissue affects the brain globally and has substantial clinical impact," said the study's lead author, Hugo Vrenken, Ph.D., from the Multiple Sclerosis Center at VU University Medical Center in Amsterdam, The Netherlands.

"The areas of demyelination, or lesions, in patients with MS can be visualized with magnetic resonance imaging (MRI). However, the volume of lesions visible at MRI only correlates moderately with clinical disability measurements," Dr. Vrenken said. "This may be due to disease activity outside the visible lesions."

To gain a better understanding of the effects of MS on the whole brain, Dr. Vrenken and colleagues studied T1 changes in normal-appearing white and gray brain matter in patients with MS.

The researchers investigated T1 changes in 67 patients with MS and 24 healthy control volunteers. T1 graphs of normal appearing white and gray matter were significantly different for patients with MS than for controls. Moreover, these graphs differed among patients with MS based on the type of disease: secondary progressive (SP), relapsing-remitting (RR) or primary progressive (PP). The results were most pronounced in patients with SP disease, where at least 31 percent of normal-appearing white matter and 20 percent of cortical normal-appearing gray matter were affected. In RR disease, 16 percent of normal-appearing white matter and 9 percent of cortical normal-appearing gray matter were affected. In PP disease, the normal-appearing white and gray matter affected were 11 percent and 8 percent, respectively. These changes were found throughout the brain, including areas remote from localized lesions that are typically associated with MS.

"These findings demonstrate that in MS, disease processes outside MR-visible lesions are not limited to a few sites but act throughout the brain and affect large fractions of normal-appearing white and gray matter," Dr. Vrenken said.

The researchers also explored correlations between the areas of the brain being analyzed in the patients with MS and the level of atrophy or clinical disability present.

"The results suggest that the damage to normal-appearing brain tissue plays a larger role in the progression of atrophy and clinical disability than do the visible lesions," Dr. Vrenken said.

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Avatar universal
Thanks Jen!!
Helpful - 0
338416 tn?1420045702
Ahah!  Found it - the article refers to T2 hypointensity, and what they mean is unnaturally dark gray matter in the brains of MS patients.  Evidently it's iron deposited in the brain, and it's a more reliable way of judging clinical progression than brain atrophy.

http: // www.msrc.co.uk/index.cfm?fuseaction=show&pageid=1816
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Avatar universal
Doni, thanks for sharing this  .  .  .  I too, find the brain very fascinating!

Even though I am the “lucky” recipient of a Fibromyalgia diagnosis .  .  . AND a daily dose of Provigil to go with it  .  .  .  I really consider myself to be in limbo.  

I have multiple neurological "type" symptoms that don't seem to fit and I have been referred to Neuro #3  - - whom I will meet in January.

In the meantime, I enjoy surfing for new and/or different information to see if I can make any sense of all this “non-sense!”

So, whether it is the ever-SO-important information that is shared on this forum .  .  .  a health column that appears in our small town newspaper  .  .  .  or an in-depth article published in a medical journal that I have "googled" my way into .  .  .  I enjoy the read!

Thanks again!




Helpful - 0
338416 tn?1420045702
I think that recently they've discovered that the white and gray matter can contain iron deposits, even though it appears normal.  They still haven't figured out why the brain is putting iron deposits in these areas, but it might be something to do with axons and neurons being severed.
Helpful - 0
428506 tn?1296557399
I think another good question along these lines is what it means when there are lesions that are not typical of MS?  I struggle to understand what, if anything it means for me.  I wish I'd never had those pictures taken.

I have some really small hyperintensities, but I can try to imagine that they are mostly harmless and idiopathic.  (Note the key word is *imagine.*  I try to let those dogs lie!)

The larger lesions I guess are not in the right shape or location to be MS.  My neuro was initially deeply concerned, then dropped all concern when my follow up MRI was unchanged.  That confuses and upsets me.

While MRI findings seem to be weighted a great deal in diagnosing MS, it at the same time seems that other etiologies for lesions are not followed up.  There were many etiologies listed on my MRI report, but once MS was eliminated, I was told that I probably have fibro.  (This was disputed by other doctors/specialists.)

If MRIs are so important in dx-ing MS, then why are abnormal findings not consistnet with MS not taken seriously as well?  Damage is damage, seen or unseen, and as a patient I agree with you how upsetting it is to think about it.
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Avatar universal
Thanks ess.  

I've just been so questioning about brain stuff ever since my MRI came back clean.  I don't understand why I have so many cog issues if there are no lesions.

Speaking of cog issues, that's why I post some of these articles I find, so that everyone here can give their experience and ideas about what is in the article, cause sometime I have a hard time deciphering what the articles really mean.

Hope you are doing good and have a great weekend!!

Hugs,
doni
Helpful - 0
Avatar universal
Thanks, Doni. We've had other info on T1 changes, and this is a very important topic. I'm not sure how these are visualized, and why they have mostly been ignored. I guess it's easy to tell, upon autopsy, but these patients were very much alive. Wish I knew why neuros and radiologists seem to limit themselves to looking for white matter lesions, given all this emerging information.

If anyone knows, please chime in!

ess
Helpful - 0
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