Columns The MS Wire - A Column by Ed Tobias MS Progression’s Speed Tagged to ‘Smoldering’ Brain Inflammation MS Progression’s Speed Tagged to ‘Smoldering’ Brain Inflammation by Ed Tobias | August 16, 2019 Share this article: Share article via email Copy article link The presence of chronic active lesions in the brain may provide a clue as to how quickly multiple sclerosis (MS) symptoms will progress. Researchers at the U.S. National Institutes of Health (NIH) call these lesions “smoldering inflammation.” Their study, just published in JAMA Neurology, indicates that the more lesions you have, the more likely your MS will be aggressive. These lesions, described as “dark rimmed spots,” are difficult to see. So the researchers used a super-strong MRI scanner to look for them. (You can see what one looks like in the image below). MRI image of a dark-rimmed spot (Courtesy: Reich lab, NIH/NINDS) Of the 192 people with MS in this study, 56 percent had at least one rimmed lesion, and 44 percent had only rimless lesions. Lesions were present in the brains of those receiving a disease-modifying therapy (DMT) and in those who were not being treated with a DMT. Many rimmed lesions mean faster MS progression According to an NIH news release, “patients who had four or more rimmed lesions were 1.6 times more likely to be diagnosed with progressive MS than those without rimmed lesions. Moreover, these patients developed motor and cognitive disabilities at a younger age than the patients who had no rimmed lesions.” The researchers also reviewed MRI images taken over 10 years or longer for a small subset of the study group. They found that their rimless lesions generally shrank over the decade, but their lesions with rims either grew or remained the same size. Study results may lead to new treatments Daniel S. Reich, PhD, a senior investigator at NIHās National Institute of Neurological Disorders and Stroke, said: āOur results support the idea that chronic active lesions are very damaging to the brain. We need to attack these lesions as early as possible. The fact that these lesions are present in patients who are receiving anti-inflammatory drugs that quiet the bodyās immune system also suggests that the field of MS research may want to focus on new treatments that target the brainās unique immune system ā especially a type of brain cell called microglia.” Microglia cells mediate immune responses in the central nervous system. Reich said the NIH Clinical Center is looking for patients who want to participate in studies like this one. āWe hope these results will help test the effectiveness of new therapies for this [aggressive] form of MS and reduce the suffering patients experience.” You’re invited to visit my personal blog at www.themswire.com. *** 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. Print This Page About the Author Ed Tobias People say to write what you know and Ed Tobias knows about MS. He's lived with the illness since 1980, when he was 32 years old. Ed's a retired, award-winning broadcast journalist and his column combines his four decades of MS experiences with news and comments about the latest in the MS community. In addition to writing his column, Ed is one of the patient moderators on the MS News Today Facebook, Twitter, and Instagram sites. Heās also the author of āThe Multiple Sclerosis Toolbox: Hints and Tips for Living with M.S.ā Ed and his wife split their time between the Washington, D.C. suburbs and Floridaās Gulf Coast, trying to follow the sun. Tags microglial cells Comments Dan Madden Would this suggest patients with rimmed lesions might want to stop using Anti-Inflammatory Drugs? Also, if you need a "super-strong MRI" how did these show up on 10 year old MRI's? Should patients request a review of their old MRI's? Thank you Reply Ed Tobias Hi Dan, I'm not qualified to suggest when someone might want to start or end a treatment. Regarding your second question, though 7T strength MRIs ("super strong") were only given FDA approval for clinical use about two years ago they've been used in research settings for over ten years. Ed Reply Anita All of this makes sense. Can our docs see these rimmed lesions on existing MRIs? Reply Ed Tobias The rimmed lesions would be appear only if the images were taken using a high contrast MRI, called a 7T. The 7T model was only approved for use in the U.S. less than two years ago and there are only a couple that are in use. They're also very expensive. So, unless your images were taken with a 7T, and that's very unlikely, the rimmed lesions wouldn't be seen. Ed Reply Leave a comment Fill in the required fields to post. Your email address will not be published. Your Name Your Email Your Comment Post Comment
April 24, 2024 News by Lindsey Shapiro, PhD Autoantibodies seen in blood years before MS diagnosis: Study
April 23, 2024 News by Mary Chapman Itās year 10 for MSAAās upcoming Improving Lives Benefit for MS
April 23, 2024 News by Margarida Maia, PhD AAN 2024: Subcutaneous Ocrevus led to nearly no relapses after year