Monday, 20 May 2013

Destructive white matter changes in early MS

MS cause destruction of tissue structure in children with MS. #MSBlog #MSResearch

Epub: Blaschek et al. Early White Matter Changes in Childhood Multiple Sclerosis: A Diffusion Tensor Imaging Study. AJNR Am J Neuroradiol. 2013 May 16.

BACKGROUND AND PURPOSE: Loss of integrity in nonlesional white matter occurs as a fundamental feature of MS in adults. The purpose of this study was to evaluate DTI-derived measures of white matter microstructure in children with MS compared with age- and sex-matched controls by using tract-based spatial statistics.

DTI = diffusion tensor imaging; DTI allows the mapping of the diffusion process of molecules, mainly water, in the brain and spinal cord non-invasively. Molecular diffusion in tissues is not free, but reflects interactions with many obstacles, such as fibres, membranes, etc. Water molecule diffusion patterns can therefore reveal microscopic details about tissue architecture, either normal or in a diseased state. The unit that DTI uses is very technical term called fractional anisotropy; the higher the fractional anisotropy the more tissue structure the lower the fractional anisotropy the less the tissue structure the greater the damage.

MATERIALS AND METHODS: 14 consecutive pediatric MSers (11 female/3 male; mean age, 15.1 ± 1.6 years; age range, 12-17 years) and age- and sex-matched healthy subjects (11 female/3 male; mean age, 14.8 ± 1.7 years) were included in the study. After they obtained DTI sequences, data processing was performed by using tract-based spatial statistics. 

RESULTS: Compared with healthy age- and sex-matched controls, children with MS showed a global decrease in mean fractional anisotropy (P ≤ .001), with a concomitant increase in mean (P < .001), radial (P < .05), and axial diffusivity (P < .001). The most pronounced fractional anisotropy value decrease in MSers was found in the splenium of the corpus callosum (P < .001). An additional decrease in fractional anisotropy was identified in the right temporal and right and left parietal regions (P < .001). Fractional anisotropy of the white matter skeleton was related to disease duration and may, therefore, serve as a diagnostic marker.

CONCLUSIONS: The microstructure of white matter is altered early in the disease course in childhood MS.


"This study confirms that MS causes destruction of microscopic tissue structure. We know this already. The worrying thing is that even in children with MS they don't have sufficient regenerative capacity to compensate. MS is bad disease no matter what age you are."

5 comments:

  1. MS is a bad disease - I've heard this so many times on this site, but no solutions are ever proposed. I'd appreciate some sort of timeline as to when some of these more effective DMTs might become available, when we might see some neuro-protective drugs and something about repair. Is anyone doing anythign about repair? Is see that Dr Coles (his website) mentions a planned trial for a drug to repair brain damage. This is what I want to see. Given his work on Campath, a further success would put him in Nobel prize territory. Come on Team G, less blogging and more results. The only point of any research is to get drugs that help people to market.

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    1. Maybe less time chastising and more time reading... there are plenty of examples mentioned......

      P.S. I'm bleeding already

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    2. I suspect Campath will get a 2nd or 3rd line license and be given too late to help most people with MS. The reality is that it is too toxic and most neurologists won't prescribe it. I am betting on ocrelizumab stealing the show. Let's hope it is not too expensive.

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    3. The price of Lemtrada will no doubt be so high so UK neuroloigist wont get the option toprescribe...surely time for cheaper alternatives.

      Ocrelizumab and costs....if it is active....then with regard cost..don't hold your breathe I suspect

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  2. Affordable drugs if poss. A bit harsh but I must admit the above blog probably articulates what we are all thinking!.

    Peter

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