Biomarkers of Early MS and Overactive Bladder Identified in New Study

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Researchers at theĀ University of Athens Medical School in GreeceĀ have found that people with early stage multiple sclerosis (MS) and overactive bladderĀ (OAB) have reductions in brain serotoninĀ and a stress-related hormone, cortisol. Serotonin is a chemical that helps nerve cells to communicate. The study, titled Neurochemical and neuroendocrine correlates of overactive bladder at first demyelinating episode appeared July 30th in the journal Neurourology and Urodynamics.

MS is a debilitating, progressive disease of the nervous system. It is caused by an immune attack on the body’s own myelin, aĀ fatty substance that wraps around nerve cells and allows them to conduct impulses and communicate. When myelin is lost, areas of damage called ā€œdemyelinationā€ result, which appear in the brain and spinal cord without warning and cause loss of movement, vision, pain and problems with sensation.

Bladder problems such as urinary incontinence also occur frequentlyĀ in people with MS, with approximatelyĀ 75% of individuals with MS suffering from this problem. In fact, OAB may be a sign of aĀ first MS episode.

The control of urination is complicated and involves many different components of the nervous system, including the brain, spinal cord and peripheral nervous system. Problems with urination are also experienced byĀ people withĀ anxiety and depression, which are conditions that are more prevalent in people with MS.

The scientists, led by Georgios Koutsis of theĀ Department of Neurology, University of Athens Medical School, were interested in understanding what biological markers are associated with early stage MS and OAB. They studiedĀ 101 people with MS andĀ a firstĀ demyelinatingĀ episode, which is an initial sign of MS onset. They assessed the study participants for signs of OABĀ and measured several biomarkers in the cerebral spinal fluid of these individuals. The biomarkers included neurotransmitters as well as stress hormones.

Overall, 15 study subjectsĀ (15%) hadĀ OAB. In those people a breakdown product of the neurotransmitterĀ serotonin (5-HIAA) was reduced when compared to people who did not have OAB. These subjects also had lower levels of the stress hormone cortisol.

In their report, the scientists state “MS patients with OAB syndrome at the first demyelinating episode show reductions in central serotonergic activity and stress hormones. Whether the same changes persist at later disease stages remains to be investigated.”

In future studies the investigators will examine whether these decreases also continue in people with OAB at later MS stages. The biomarkers could potentially be used clinically to identify people with MS and OAB and also to indicate a subgroup of those individuals who have MS.