#ECTRIMS2018 – Researcher Presents Data About Myelocortical MS, a New Disease Subtype

#ECTRIMS2018 – Researcher Presents Data About Myelocortical MS, a New Disease Subtype

A new subtype of multiple sclerosis (MS) — called myelocortical MS (MCMS) — is characterized by cortical neuronal loss, but not by loss of myelin in the brain’s white matter, according to a study.

Research on this new type of MS was presented today at the 34th congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), in a presentation titled “Myelocortical multiple sclerosis: cortical neuronal loss in the absence of cerebral white matter demyelination.” ECTRIMS is being held in Berlin, Germany, today-Friday (Oct. 10-12).

The presenter was Bruce Trapp, PhD, chairman of the department of Neurosciences at the Cleveland Clinic’s Lerner Research Institute.

Loss of myelin — the protective layer of nerve fibers — is regarded as the driver of neuronal degeneration and permanent neurological disability in MS. White matter, which is made of nerve fibers and makes up about half of the human brain, is the main target for immune system attacks in these patients.

However, studies using magnetic resonance imaging (MRI) have indicated that myelin loss and neuronal degeneration can occur independently.

Aiming to explore this further, researchers assessed if MS brains showed signs of neuronal loss in the cerebral cortex — a gray matter part of the brain involved in diverse functions, including memory, information processing, and motor control — independent of demyelination in the brain’s white matter.

Brains and spinal cords were removed at autopsy from MS patients. Of 97 brain samples analyzed, 12 had no signs of cerebral white matter demyelination.

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These 12 cases were compared to 12 other MS cases with white matter lesions, namely in the cerebral white matter, cortex, and in the spinal cord. The team compared atrophy (shrinkage,  an MS feature), MRI measures, and number of neurons between both MS groups, and investigated possible correlations between alterations in MRI and disease processes.

Results showed that cases without cerebral macroscopic (visible with the naked eye) lesions had myelin loss in the spinal cord and cortex, but no brain white matter demyelination.

However, these brains showed significantly greater cortical neuronal loss, cortical thinning, and MRI abnormalities in cerebral white matter, compared to brains from healthy controls. These features were similar to those seen in MS brains with cerebral white matter demyelination. This suggests that cortical neuronal loss is independent from white matter demyelination in patients with MCMS, the researchers noted.

Also, the 12 brains without cerebral white matter myelin loss showed swollen myelinated nerve fibers —  previously associated with central nervous system degeneration — in white matter areas with MRI abnormalities.

“A subtype of MS, which we call myelocortical multiple sclerosis (MCMS), is characterized by demyelination of spinal cord and cerebral cortex, but not of cerebral white matter. Cortical neuronal loss is not accompanied by cerebral white-matter demyelination and is therefore an independent pathological event in MCMS,” the researchers wrote.

Trapp also is the first author of a recent study describing MCMS.

8 comments

    • Mary says:

      Did your son have mono or Epstein Barr when he was younger? It’s likely caused by that virus presenting itself back and attacking the nervous system.

      Simply try an antiviral like Acyclovir or Valacyclovir. (Valtrex) My uncle was a renowned infectious disease specialist in Florida and gave his MS patients who were unable to walk a course of I think 1 gram of Valtrex per day and they got better in like 3-6 months – even able to walk and live a normal life. The cause of many autoimmune diseases are viral or bacterial infections like Epstein Barr or CMV, HHV6. Attack what is causing it and then your son will get better…those immune suppressant drugs will not get at the root cause and he will end up with some other disease on top of MS…they can do blood tests for the presence of all of those viruses…also check to see if he has an MTHFR Gene Mutation…that is worth researching…Also, look for two really good resources…Terry Wahls, and Matt Embry…two amazing people who can guide you…big pharma does not want to find a cure…it’s not good for business…just sayin…

    • Ciel says:

      Christine – Mouth ulcers are often a symptom of Systemic Lupus, another autoimmune disease, that can be concurrent with MS. I have both. There are blood tests for Lupus. Lupus can be treated with plaquenil and steroids. There are some prescription mouthwashes for mouth ulcers but I have not had good results. I typically use orajel or a similar ointment. For bad outbreaks, a dentist can use a laser to treat the ulcers. It is relatively painless and they disappear quickly after treatment.

  1. Libbie Frank says:

    Interesting post, Mary. I had mono at age 19 and have now had MS since 1984. Also, I’ve read the Wahls’ books and am currently on the Wahls’ diet. I don’t recall her mentioning taking an antiviral in her book and I wonder if that was part of her road to recovering her ability to walk, etc.

  2. Steve says:

    I had shingles last year and have been on 3 grams of valtrex a day since then. My last MRI in May showed progression. Thankfully I had HSCT this summer so hopefully I am done with MS!

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