diagnosis

Scientists have found that a usually-overlooked signal from MRI scans indicates brain regions of nerve cell death and may help in the understanding of brain development and the early diagnosis of brain disorders like multiple sclerosis (MS),…

Multiple sclerosis (MS) that appears to be "genuinely benign" 15 years after diagnosis is evident in a small number of patients, a large population-based study from the U.K. reports. But, its researchers note, the term “benign” is often not clinically accurate as used, because it is based largely on perceptions of disease impact. The study “How common is truly benign MS in a UK population?” was published in the Journal of Neurology, Neurosurgery & Psychiatry. The concept of benign MS is controversial, especially among clinicians. Still, long-term epidemiological studies have consistently identified a small fraction of patients whose MS progresses very slowly over a long span of years. Determining the prevalence of this type of MS in the population has been difficult, as estimates can vary significantly depending of the definition of “benign” that is adopted. Researchers sought to determine an accurate estimate of benign MS in the U.K. population, using a rigorous and comprehensive clinical definition of a truly benign disease. This definition included minimal physical disability (EDSS score of less than 3), and no significant fatigue, mood disturbance, cognitive impairment or interrupted employment in the absence of treatment with disease-modifying therapies over 15 years or more years after symptom onset. They screened an U.K. population-based registry containing data on 3,062 MS patients to identify those with "unlimited walking ability" 15 or more years after diagnosis. A representative sample of 60 patients  from this pool was analyzed (45 women and 15 men, mean age of 57); they had a mean disease duration of 28 years. Nine out of these 60 (15%; 8 women and one men) fulfilled the study’s criteria for truly benign disease. These nine people had a mean age of 27 at symptom onset, a median EDSS disability score of 1.5 (minimal signs of disability), and a mean disease duration of 31 years. "Those nine individuals with truly benign MS all remained in a relapsing–remitting state," the study noted. "However, only two out of nine showed disease arrest within the first decade; the remainder all continued to experience relapses well into their second or third decade of MS," but the rates of such relapses were low. MS in the remaining patients was not classified as benign, mostly due to evidence of cognitive difficulties (57%), and the disease's impact on employment status (52%) with many taking early retirement. Based on these results, a population frequency for "benign MS" under the definitions used was estimated at 2.9%. But the researchers noted that a large proportion of patients (65%; 39 patients out of 60) reported their disease as benign, according to a lay definition. Their self-reported status poorly agreed with the clinical assessments done throughout the study. "There is no accepted definition to offer patients when exploring whether they feel their MS is benign; the definition we chose incorporates the fundamental principles of low impact on a person, absence of complications and a favourable outcome and is in line with definitions provided by third-party support groups," the researchers wrote. Many  considering themselves with benign disease did so based on their "perception" of their disease, the team added, and one that "appeared to be driven as much by mood, fatigue and bladder function as by physical ability."  “In conclusion, after detailed clinical assessment, a small minority of people with MS appear genuinely unaffected by symptoms after 15 years,” the researchers added. They also called attention to the fact that EDSS-based definitions of benign MS and the inconsistency between patient and clinician perception of benign MS compromise the use of the term ‘benign’ in clinical practice. They also emphasize that studying individuals with benign MS “has the potential to uncover clues to mechanisms underlying favorable outcomes in MS, provide insights into new therapeutic targets and have implications for patient counselling, individual patient management and the construct of clinical trials.”

A meta-analysis of 13 case-control studies shows that the levels of the protein neurofilament light chain (NFL) are significantly higher in both the cerebrospinal fluid and blood of multiple sclerosis (MS) patients, compared to healthy controls. This finding adds to previous evidence supporting the usefulness of NFL as a…

Abreos Biosciences announced the U.S. launch of moNATor, a laboratory-developed test that can help physicians monitor the levels of Tysabri (natalizumab) in patients with multiple sclerosis (MS). Tysabri (approved for relapsing forms of MS, by Biogen) administered at a dose of 300 mg every four weeks is known to be…

Researchers have identified a new subtype of multiple sclerosis (MS), one marked by nerve cell degeneration that occurs independently of immune system attacks against myelin, a process known as demyelination and considered a hallmark of MS. The new subtype — called myelocortical MS — is indistinguishable from others in the…

The ice water test, a tool used to evaluate the function of the bladder in patients with neurological disorders, was successfully used to identify undiagnosed cases of bladder dysfunction in patients with multiple sclerosis (MS), according to researchers from Germany. The findings of the study, “Ice water test…

The number, location, and size of lesions can help predict the risk of progression from clinically isolated syndrome (CIS) to multiple sclerosis (MS) within one year, a new study shows. The study, “MRI in predicting conversion to multiple sclerosis within 1 year,” was published in the journal…

Quanterix’s ultra-sensitive Simoa assay has the potential to open new uses for the brain biomarker known as neurofilament light chain, including the possibility to detect early evidence of neurological diseases like multiple sclerosis (MS), Parkinson’s, and Alzheimer’s, and ably evaluate efforts to treat and prevent them, the company…

Higher-than-usual levels of specific antibodies in the blood of patients with clinically isolated syndrome (CIS) may predict a faster progression to multiple sclerosis (MS), an Australian study reports. The specific antibody is known as IgG3, an immunoglobulin known to promote inflammation. The study, “Higher Serum Immunoglobulin G3 Levels May Predict…

IQuity, a data analytics company, announced the launch of an analytics platform that uses machine learning to predict, identify, and monitor chronic disease within large populations of patients, including multiple sclerosis (MS). The platform was validated using a pilot study that assessed the healthcare claims of 20 million people…

It’s not unusual to hear someone say, “I was diagnosed with MS in [fill in the year], but I probably should have been diagnosed five or 10 years earlier.” Now a study reports that during the five years before someone is diagnosed with multiple sclerosis (MS), it’s quite…

Many patients report a history of other conditions such as migraine headaches, irritable bowel syndrome, fibromyalgia, and mood and anxiety disorders, before being diagnosed with multiple sclerosis (MS). According to a new study, these symptoms could be warning signs of MS and help in its early detection. “Prodrome” is a…

I am told I have primary progressive multiple sclerosis (PPMS), and my symptoms appear to be in line with that diagnosis. I continually have a slow gait, leg weakness, balance issues, and fatigue. There is never a break from those symptoms. Intermittently, I have cognitive issues, slurred speech, and burning…

Atrophy (shrinkage) of brain lesions correlates with physical disability in patients with multiple sclerosis (MS), new research reports. The study, “Atrophied Brain Lesion Volume: A New Imaging Biomarker in Multiple Sclerosis,” was published in the Journal of Neuroimaging. Magnetic resonance imaging (MRI) scans are used routinely on MS patients…

The American Autoimmune Related Diseases Association (AARDA) is partnering with Allegheny Health Network (AHN) and its newly opened Autoimmunity Institute — based in Pittsburgh, Pennsylvania — to study the costs of autoimmune disease to patients in the U.S., including that of just getting a correct diagnosis. AARDA, a non-profit that…

B-cell alterations in peripheral blood may predict the conversion of clinically isolated syndrome (CIS) to multiple sclerosis (MS), a recent study suggests. Conducted in Turkey, the study, “Peripheral blood memory B cell frequency predicts conversion from clinically isolated syndrome to multiple sclerosis,” was published in…

A potential biomarker — the ratio of antibody proteins in cerebrospinal fluid at the time of diagnosis — was seen to predict which  multiple sclerosis patients will progress into full-blow disability some five years after being diagnosed in a new study. If confirmed in larger clinical studies, this biomarker could to…

At times I find myself speaking of and referencing my life before my MS diagnosis. My thoughts led to the creation of the following epistle. I believe that words are curative and the spirit absorbs what we speak. As you read my letter to multiple sclerosis, remember that you…

Analysis of a potential blood biomarker linked to brain cell damage can help define disease activity in patients with relapsing-remitting multiple sclerosis (RRMS). Results of a study showed that determining blood levels of neurofilament light chain, or NfL, could help in establishing “no evidence of disease activity,” or NEDA, status…

The United States and Australia have issued patents on Sonde Health‘s voice-analysis technology for diagnosing and monitoring multiple sclerosis and other diseases that affect speech. Sonde, which has dubbed its invention vocal biomarker technology, said the U.S. patent is  9,936,914 and the Australian one 2014374349. Both patents cover Sonde’s…

Professor Frederik Barkhof, MD, PhD, has won the 2018 John Dystel Prize for Multiple Sclerosis Research for pioneering the use of magnetic resonance imaging (MRI) to improve multiple sclerosis (MS) diagnosis and understanding of the disease. The prize, decided by a peer committee, is awarded annually by…

I have lived with the diagnosis of primary progressive multiple sclerosis (PPMS) for almost eight years. For many years prior to that diagnosis, I was confused by what could be causing my abnormal gait, extreme fatigue, blurred vision, and trouble concentrating. During that time, I completed many diagnostic tests, dealt…

After I wrote about pediatric MS earlier this month, a reader commented: “I think it would behoove your editorship to follow up to address to audiences…symptoms that typify the early-age demographic.” That’s a good point. So, I drilled deeper into how MS is handled in people younger than…

Last updated April 25, 2023 At the intersection of hope and despair is a bench to sit and rest. At least, I hope there is. The bench gives us an opportunity to take a breather from the stresses of the world. It’s a chance to sit and think about which…

The U.S. Food and Drug Administration has approved technology that the Swedish company SyntheticMR developed to give doctors more information from magnetic resonance imaging scans. This means the company can begin selling its SyMRI NEURO packages to American medical facilities. Traditional MRIs offer only one level of contrast when depicting tissue. SyMRI NEURO…

Multiple sclerosis patients have high levels of a protein called osteopontin in their cerebrospinal fluid and blood, making it a potential tool for diagnosing the disease and predicting its course, a study suggests. The research, “Osteopontin (OPN) as a CSF and blood biomarker for multiple sclerosis: A systematic review and meta-analysis,” was published in the journal PLOS One. Researchers wanted to know if levels of osteopontin in cerebrospinal fluid and blood could be a reliable biomarker for MS. To arrive at answer, they “conducted a systematic review and meta-analysis" of studies that had measured the protein's levels in cerebrospinal fluid and blood "in MS patients and controls." The team searched for studies in three databases — PubMed, Web of Science and Scopus. Out of 27 that met their criteria, they used 22 in the meta-analysis. All four types of MS were represented in the studies — clinically isolated syndrome, relapsing-remitting MS, secondary progressive MS, and primary progressive MS. There were three types of controls in the articles — healthy people, people with non-inflammatory neurological disorders, and people with inflammatory neurological disorders. Researchers' first observation was that all of the MS patients had higher levels of osteopontin than controls. The protein's levels were significantly higher in relapsing-remitting MS patients than in those with clinically isolated syndrome, the group with the lowest osteopontin levels. Levels were similar in the other types of MS. Patients with an active disease had significantly higher levels of the protein in their cerebrospinal fluid than those with a stable disease. The results supported previous studies' findings that osteopontin levels are higher than normal in the cerebrospinal fluid and blood of MS patients, strengthening the notion that it could be used as a biomarker for MS. “Given the fact that OPN [osteopontin] levels are higher during relapses, we think that by monitoring this biomarker,  we might be able to predict the disease course," the team wrote. "We propose that developing drugs modulating OPN concentration may be a new treatment strategy for MS."

Multiple sclerosis patients whose first treatment is Genentech's Rituxan (rituximab) stay on it longer than other disease-modifying drugs that patients start with, a Swedish study reports. When they stop taking Rituxan,  it usually isn't for lack of effectiveness or side effects...

As we all know, MS is difficult to diagnose. Put another way, it’s easy to misdiagnose. There’s no single diagnostic test for MS. Neurologists use their clinical examination, the patient’s medical history, and lab tests. They also rely on MRI imaging of the brain and sometimes of the…

FDA Warns of Risks Linked to Gadolinium-based Contrast Agents Used in MRI Scans I had a brain MRI a couple of weeks ago and I asked the technician about the FDA warning about the dye that she was going to inject. She wasn’t aware of it. I…

An international panel of multiple sclerosis (MS) experts has proposed revising the McDonald criteria guidelines to improve and expedite the diagnosis of this disease. Co-chaired by Dr. Jeffrey Cohen of the Cleveland Clinic and Dr. Alan Thompson of the University College London, the 30-member panel reviewed newly available research…