The MS Alphabet: Basal Ganglia, BDNF, Babinsky and More ‘B’ Words

When it comes to multiple sclerosis, mastering your own understanding of the disease means you need to mind your Ps and Qs, dot your Is, cross your Ts, and recite your ABCs. There is so much to know about this complex disease. But the more you know as a patient (or caregiver,) the more informed you will be in making critical healthcare decisions.

This week, I offer five terms for the letter “B” that you might encounter and wish to master as an MS patient. (You also may read about 10 “A” terms covered in this column.)

The Symptoms of MS

Babinski reflex: Also known as Babinski sign, this unusual foot reflex occurs in some with MS.

During a neurological reflex test, a pointed object is used to stroke the foot’s outer sole. If it causes the big toe to point upward, rather than downward, it’s referred to as the Babinski reflex.

Identifying this response helps the neurologist identify problems with the nerve signaling from the upper central nervous system to the rest of the body.

The Acronyms of MS

BDNF

Brain-derived neurotrophic factor (BDNF) refers to a cellular protein growth factor found in the brain and peripheral nervous system. It’s the most studied and understood of all the neurotrophins influencing MS disease course and progression.

BDNF interacts with specific kinds of nerve cells to protect their survival. It also promotes the growth of diverse new nerve cells and connecting tissues called synapses. The substance is shown to limit damage to nerves in research studies focused on animal models.

Paradoxically, BDNF also is known to prompt disease progression in MS. It supports immune system cells (autoreactive T-cells) which cross the blood brain barrier and attack the nervous system. This is the chief cause of nerve damage and destruction in MS.

Common terms of MS

Basket diagnosis

Also known as “wastebasket diagnosis” or “trashcan diagnosis,” this describes a vague patient diagnosis delivered without confidence, or provided for electronic medical records purposes to satisfy the demands of administrators, and insurance payers.

MS requires a diagnosis of elimination, in which all other causes for the patient’s symptoms must be ruled out by tests or screenings. A diagnosis of MS isn’t typically considered a “basket diagnosis.”

Yet, because it’s a disease that shares symptoms with other diseases, MS is a difficult diagnosis for some neurologists to deliver with confidence when tests remain inconclusive.

They often won’t diagnose a questionable case of MS until time has passed; by doing so, further testing (MRI) can confirm progression of disease course “across time and space.”  This accounts for the length of time it can take for some patients to receive a confirmed diagnosis.

When an MS diagnosis is sidestepped, it’s not likely due to the negligence. The neurologist is probably trying to avoid using MS as a “basket diagnosis.” Insurance and treatment protocols require objective clinical proof to rule it out (or confirm it) with confidence.

Patients concerned about misdiagnosis, or who remain undiagnosed despite suspicions of MS, have the right to demand clinical proof or insist on testing to rule out other causes.

The Biology of MS

Basal Ganglia

These groups of nuclei, located in the deep brain (on both sides,) use neurochemical controls to promote smooth physical, mental, and emotional function.

In terms of behavior, the basal ganglia are thought to support learning, cognition, and emotion. For motor skills, the basal ganglia are critical in preventing muscular overreactivity.

In MS, the basal ganglia don’t deliver neurochemical signals with fluidity. Signs and symptoms of dysfunctional basal ganglia include tremors, spasticity, weakness, and involuntary movements. It’s less well known how emotions, cognition, and behavior are influenced by problems within the basal ganglia.

The Drugs of MS

Baclofen

This antispasmodic medication treats muscular spasticity, pain, and stiffness by promoting relaxation of muscle fibers. This drug also is used to treat spinal cords diseases or damage. Baclofen is taken orally or by way of a pump embedded in the space surrounding the spine; it delivers medication on a pre-programmed schedule.

(Stay tuned for more columns about the MS alphabet.)

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.