diagnosis

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…

Cognitive impairment is common among patients with multiple sclerosis (MS) and can be assessed through touchscreen cognitive tests in clinical care, a British study reports. The study “Investigating Domain-Specific Cognitive Impairment Among Patients With Multiple Sclerosis Using Touchscreen Cognitive Testing in Routine Clinical Care” was published in the…

Magnetic resonance imaging (MRI) used to assess inflammation in multiple sclerosis (MS) patients should include scans of the spinal cord and not be restricted to the brain, because brain scans alone risk underestimating disease progression, a study suggests. These results were shared in the presentation, “Measuring disease activity in…

The Multiple Sclerosis Association of America (MSAA) announced that it will expand its MRI Access Fund to help meet the growing demand for magnetic resonance imaging (MRI) tests within the multiple sclerosis (MS) community. The fund is designed to help cover the costs of brain and spinal MRI scans…

It’s not unusual for someone with MS to have an annual MRI exam. Sometimes it’s even semiannual. And it’s not cheap. According to the website Healthcare Bluebook, an MRI of the brain, with and without contrast, can cost you anywhere from $826 to $4,780, depending on where you live…

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…

A North Carolina couple living with multiple sclerosis have raised more than $20,000 so far this year to support Discovery MS, a nonprofit research initiative that is part of Duke University’s School of Medicine. Specifically, the money will support program efforts  to improve MS diagnosis and prognosis, gain a clearer understanding…

Learning impairments in multiple sclerosis (MS) are detected differently by the two most commonly used neuropsychological tests, a new study by the Kessler Foundation shows. The research, titled “Comparing the Open Trial – Selective Reminding Test results with the California Learning Verbal Test II in multiple…

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…

Subtle changes in myelin, the protective layer of nerve fibers, may be an early event in multiple sclerosis (MS) prior to the inflammatory reaction, a new University of Calgary study shows. The study, “Biochemically altered myelin triggers autoimmune demyelination,” was published in the journal Proceedings…

Part two in a series. Read part one here. In the last column, I discussed gadolinium’s role in contrasted MRI procedures and a December 2017 warning by the U.S. Food and Drug Administration that the body can retain gadolinium in its tissues and brain for years. I also shared my personal experience with…

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…

Levels of a protein stemming from brain cell damage can mirror the severity and symptoms of multiple sclerosis, an analysis of combined data from three trials showed. Researchers will present this and related findings at the annual meeting of the American Academy of Neurology in Los Angeles, April 21-27. The…

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…

For years, my wife and I have disagreed about smells. She smells something and I don’t. I tell her that her nose is too sensitive. She tells me to get out the air freshener. Over the 37 years since my MS diagnosis, this conversation has happened thousands of times.

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…

People with multiple sclerosis (MS) can indeed have a poorer-than-usual sense of smell, with problems possibly starting at early diseases stages, a small Turkish study reports. This work supports previous research noting olfactory problems in MS patients. It also argues that longer disease duration and more relapses are associated…

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…

The Consortium of Multiple Sclerosis Centers (CMSC) has developed a Multiple Sclerosis Healthcare Associate (MSHA) Certification Examination for all non-licensed, educated and trained medical personnel working in multiple sclerosis (MS). The MSHA Certification Examination provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal…

The age at which a person is diagnosed with MS is usually between 20 and 50, according to the National Multiple Sclerosis Society. But it can be diagnosed in people much younger. In fact, of the estimated 400,000 people with MS in the United States, 8,000-10,000 are…

Something is! I had to be carted off to the hospital in an ambulance on Thursday of last week. It was either an infection my home-visiting doctor couldn’t spot or the dreaded relapse. She couldn’t diagnose any illness. At the hospital, they used the words “atypical infection.” One of…

Researchers found that patients with multiple sclerosis (MS) have increased heart problems suggestive of an intrinsic myocardial disease, and would benefit from cardiovascular examinations using more advanced techniques. The study, “Impaired Cardiac Function in Patients with Multiple Sclerosis by Comparison…

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."

A novel imaging approach enables assessment of key nervous system deterioration in multiple sclerosis (MS), a new study in mice suggests. The research, “Development of a PET radioligand for potassium channels to image CNS demyelination,” was published in the journal Scientific Reports. MS is characterized by damage to myelin (a process called demyelination), which is an insulating sheath around axons (the long projections of neurons) that enables effective neuronal communication. As a result, patients experience a variety of symptoms, including muscle stiffness and weakness, fatigue and pain. Although existing MS medications suppress immune responses and reduce flare-ups, none can cure the disease. Despite the importance of demyelination in MS, scientists and clinicians do not currently have a way to directly image myelin damage. Magnetic resonance imaging (MRI) is used, but it does not enable the distinction between demyelination and inflammation, which are common in patients with MS. Upon myelin damage, voltage-gated potassium channels (cellular membrane proteins) become exposed. As a result, cells leak potassium, which impairs proper neuronal communication. This prompted researchers to develop a tracer that targets potassium channels. "In healthy myelinated neurons, potassium channels are usually buried underneath the myelin sheath," Brian Popko, PhD, the study’s senior author, said in a press release. Popko is a professor of neurological disorders and director of the Center for Peripheral Neuropathy at The University of Chicago. Exposed potassium channels can be targeted by the MS medication 4-aminopyridine (4-AP; dalfampridine), which partially repairs nerve conduction and mitigates MS symptoms. Using mouse models of MS, the researchers demonstrated that 4-AP binding to potassium channels is greater in demyelinated axons in comparison with well-myelinated axons. The greater binding of 4-AP led to its accumulation in damaged axons. Then, the team evaluated several fluorine-containing derivatives of 4-AP, and found that the most effective in binding to potassium channels was 3-fluoro-4-aminopyridine (3F4AP), which can be labeled with radioactive 18F. This labeling enables detection of demyelinated regions with a novel strategy based in positron emission tomography (PET). "3F4AP is the first tracer whose signal increases with demyelination, potentially solving some of the problems of its predecessors," said Pedro Brugarolas, PhD, first author of the study. Existing PET tracers bind to myelin. This translates to decreases in signal in the presence of myelin loss, “which can be problematic for imaging small lesions” Brugarolas noted. Importantly, the findings in mice were confirmed in monkeys. Experiments showed that the radiolabeled 3F4AP enters the primate brain and accumulates in areas with less myelin. Collectively, “these data indicate that [18F]3-F-4-AP may be a valuable PET tracer for detecting [central nervous system] demyelination noninvasively,” the team wrote. "We think that this PET approach can provide complementary information to MRI which can help us follow MS lesions over time," Popko said. The novel PET strategy enables the evaluation of therapies to repair myelination and also could help assess how much myelin loss is involved in other neurological disorders, such as traumatic brain injury and spinal cord injury, but also in diseases not commonly linked to demyelination, "such as brain ischemia, psychiatric disorders, and neurodegenerative diseases, including Alzheimer's," Popko concluded.