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New High-Tech MRI Shows Earlier Signs of MS

Researchers Hope Finding May Help Identify Those With More Aggressive Disease
By
WebMD Health News

Oct. 5, 2004 (Toronto) -- A novel imaging technique shows that subtle, but ominous changes occur in unexpected parts of the brains of people with multiple sclerosis (MS) long before they develop symptoms.

Researchers are excited because the new high-tech MRI may help doctors identify "[those] patients whose MS is likely to progress to [cause] disability much earlier in the disease process than previously believed possible," Gerard Davies, MD, a researcher at the Institute of Neurology in London, tells WebMD.

Multiple sclerosis is a disease where the covering of nerves in the brain and spinal cord is gradually destroyed. This covering, called myelin, insulates the nerves and helps them transmit nerve impulses or messages between the brain and other parts of the body. These messages control movement and other functions. As the disease progresses patients typically experience problems ranging from weakness and balance problems to numbness, visual problems, and even impaired thinking.

Currently, MRI testing allows doctors to identify MS-related brain abnormalities in the so-called white matter of the brain where the myelin-sheathed nerves communicate with each other. The new technology images a different type of brain tissue called gray matter. Gray matter consists of the brain cells themselves; gray matter cells rely on the nerves in the white matter to communicate with each other.

gray Matter Examined

In his study, Davies studied 23 patients with relapsing/remitting MS, a form of the disease in which the disease manifests itself as a cycle of attacks separated by periods of relatively good health. The patients had all been diagnosed within the previous three years. "Each had at least two MS attacks," says Davies. He conducted brain imaging studies once a year for three years and compared those scans with yearly brain scans of 19 healthy volunteers.

Using the new imaging technology, the researchers found that "changes in both gray and white matter were evident on even the first scan," says Davies.

Other, sophisticated calculations show that the gray matter changes began nearly three years before the onset of symptoms whereas the white matter changes occurred shortly before the participant's first attack.

Robert Lisak, MD, professor and chair of the department of neurology at Wayne State University in Detroit, tells WebMD that the findings are very encouraging because "this is demonstrating for the first time that gray matter is involved very early in the disease." He says this shows that the purely white matter changes in a person with MS may actually be secondary to changes in the brain cells themselves.

But he cautions that while this finding is important, it will not translate into any immediate treatment strategy for MS patients. "It is good to understand how the disease starts and this may eventually lead to a treatment, but that is unlikely to happen in the short run."

Next, Davies says that these patients will be followed for at least 10 years, so that they "can determine if these subtle changes do predict disease progression."

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