New Study Evaluates The Role of MRI in Monitoring MS Progression

Multiple sclerosis (MS) is a devastating, progressive disease of the nervous system. It is caused by loss of myelin, a fatty substance that wraps around nerve cells and allows them to conduct impulses and communicate. When myelin is lost, areas of damage called “lesions” result, which appear in the brain and spinal cord without warning and cause loss of movement, vision, pain and problems with sensation.

A new study, published July 17th in the journal Public Library of Science (PLoS) One, evaluated whether imaging techniques can be used to track neurological damage in people with MS. The study also sought to understand whether people with different MS durations have different types of lesions.

Seventeen people with MS or clinically isolated syndrome (an early stage of MS) participated in the study. People were divided into two groups, those with short (less than 60 months) and 11 with long (more than 60 months) disease duration. The researchers used magnetic resonance imaging (MRI) to compare the damage to the nervous system in the study participants.

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The scientists, based in Berlin, Germany, found that fewer people in the long disease duration group had what is known as a “phase alteration pattern” when compared to those in the short disease duration group. These phase alterations could indicate that there is inflammation around the lesions, which means that the immune system is launching an attack against myelin. The researchers proposed that the difference might have to do with the older lesions no longer being a site of immune attack, but rather a region where death and damage had already taken place. In their report, they noted “Theoretical models hypothesized that lesional phase contrast disappears as consequence of neurodegeneration including axonal loss, neurofilament destruction, and integrity loss of the (magnetic) micro architecture.”

Overall, this study showed that the extent and duration of MS damage might be detected using MR imaging and by analyzing specific qualities of lesions. In the paper, the scientists noted that “This cross-sectional study identified different patterns of phase changes in lesions of MS patients with short and long standing disease. Longitudinal studies are warranted to prove that MR phase imaging is useful in determining the activity and the developmental stage of individual MS plaques.”

MRI could serve as a useful clinical tool for understanding how long MS has progressed, and for also understanding whether lesions represent areas of inflammation or already existing damage. In the future, this could also help direct the selection of MS treatments, individualized for the particular patient.