UCLA study on brain changes in MS/depression

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UCLA study on brain changes in MS/depression

Postby cheerleader » Mon Jul 05, 2010 10:23 am

There's an article and podcast in Scientific American this week regarding a new study at UCLA. It looks at brain changes in pwMS who have depression. The researchers found on MRI that the hippocampus is smaller in pwMS, and that the HPA axis (the neuroendocrine system which regulates stress and other functions) is hyperactive.

Here's the link and podcast
link

For those who have been following my writings on hypoxic injury to the brain, slowed perfusion and slowed mean transit time as studied in pwMS, you'll know that there are many studies in the literature showing that there is a slower transit of blood in the brains in MS. It takes longer for blood to get out of the MS brain (venous stenosis, anyone?) This means it takes longer for oxygenated blood to get into the brain. This slowed transit of blood leads to lower oxygenation of brain tissue.

Interestingly enough, those with hypoxic injury show atrophy of the hippocampus and hyperactive HPA axis. JUST LIKE pw MS

Here are some studies to back this up:
Several reports suggest that the activity of the hypothalamo-pituitary-adrenal axis (HPA-axis) is increased following hypoxia/ischaemia and that this might be associated with increased neuronal vulnerability


http://www.ncbi.nlm.nih.gov/pubmed/7496805

Hypoxia damages multiple organ systems especially those with high oxygen utilization such as the central nervous system. The purpose of this study was to compare the neuropathological and neuropsychological effects of hypoxia in patients with either carbon monoxide poisoning or obstructive sleep apnea. Neuroimaging revealed evidence of hippocampal atrophy in both groups...


link

I talked about this at length with Dr. Haacke last year. I know that he and Dr. Hubbard are looking at oxygenation levels in pwMS before and after angioplasty using fMRI BOLD technology, and they are finding that patients indeed have lower oxygen levels in their brains before, and better oxygenation after.

This chronic, low-level hypoxic injury is what I believe caused my husband's first MS flare. He was at high altitude for a week, and came home with a numb left side. His brain just couldn't take the additional low oxygen situation. That's when he got an MS diagnosis. I believe this is why people who live in Colorado (and other high elevation locations) have higher MS rates.

The pieces fit together when we look at MS as a disease of chronic venous insufficiency.
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http://ccsviinms.blogspot.com
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Postby cheerleader » Mon Jul 05, 2010 10:27 am

For those who haven't read the hypoperfusion/hypoxia thread, here it is:

http://www.thisisms.com/ftopict-7708-hypoxia.html

great research thread started by Shayk (Sharon)

cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby cheerleader » Tue Jul 06, 2010 12:18 pm

I guess I'm just talking to myself, but I think this is a fascinating study, since it is the first to link an actual physical change in the brain to MS depression. And this physical change has also been linked to cerebral hypoxia.

Here's the UCLA release:

Now, in the first such study in living humans, researchers at UCLA suggest a cause, and it's not psychological, but physical: atrophy of a specific region of the hippocampus, a critical part of the brain involved in mood and memory, among other functions.

Reporting in the early online edition of the journal Biological Psychiatry, senior study author Dr. Nancy Sicotte, a UCLA associate professor of neurology, Stefan Gold, lead author and a postdoctoral fellow in the UCLA Multiple Sclerosis Program, and colleagues used high-resolution magnetic resonance imaging to identify three key sub-regions of the hippocampus that were found to be smaller in people with MS when compared with the brains of healthy individuals.


link

So, it's not just in your head. There is a physical change. But I don't have MS, so I guess there's no excuse for me talking to myself....
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http://ccsviinms.blogspot.com
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Postby JCB » Tue Jul 06, 2010 12:29 pm

Good Articles and great info. that ties everything together.

-and-
"It's all right to talk to yourself. It's all right to answer yourself. It's not all right to say 'huh, what did you say?'"

Thanks Jim

PS - you can talk to yourself all you want, I'm listening and learning
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Postby Cece » Tue Jul 06, 2010 1:34 pm

listening as well....

Do you think hypoxia from sleep apnea would affect the brain similarly? I'm the MSer in our family, but my hubby has the sleep apnea and depression. (We are both really tired....)
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition
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Postby cheerleader » Tue Jul 06, 2010 2:06 pm

Cece wrote:listening as well....

Do you think hypoxia from sleep apnea would affect the brain similarly? I'm the MSer in our family, but my hubby has the sleep apnea and depression. (We are both really tired....)


Cece, I don't know how sleep apnea affects oxygenation in the normal population, but my husband, the MSer used to have it--this is what really made Dr. Dake think about what were MS/neurological symptoms, and what symptoms are caused by venous insufficiency and hypoxia.

Jeff used to have horrible sleep apnea. He's had it our whole married life (26 years now!) and since his MS diagnosis, it had gotten really bad. He would wake up, gasping for air. It really scared me, because he would just stop breathing. His doctor had scheduled him for a sleep study, but he ended up going to Stanford before it...

After his angioplasty, the apnea just went away. No more gasping, not even a snore. He sleeps like a baby thru the night, and wakes up refreshed. He remembers his dreams, and fatigue and depression are gone.

Jeff also used to get altitude sickness when hiking or skiing. Since angio, he has gone skiing and snow-shoeing at high altitude, with no problem.

The only thing that is different for him is that he now has jugular return. More studies need to be completed to look at oxygenation levels in MS brain before and after angioplasty. In the meantime, maybe try inclined bed therapy for you and your hubby? See if it helps you both sleep better.
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http://ccsviinms.blogspot.com
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Postby ppicklee » Tue Jul 06, 2010 2:30 pm

I love that. Talking to your self I mean. :-) What you say? Just kidding! :-)
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Postby Daisy3 » Tue Jul 06, 2010 3:14 pm

You are not talking to yourself..lol..

I read the posts too. I don't always have anything (interesting) to say so I read and keep quiet..

Thanks for the flow of info though, it keeps me hopeful.
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Postby cheerleader » Tue Jul 06, 2010 4:52 pm

thanks, Daisy.
I enjoy finding new research and posting it...I know, old-fashioned :wink:

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Postby PCakes » Tue Jul 06, 2010 4:56 pm

me too!.. i learn so so much from your posts.
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Postby Chrystal » Tue Jul 06, 2010 9:17 pm

We are all learning so much from your posts. Thank you!
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Postby Ruthless67 » Tue Jul 06, 2010 10:07 pm

Hi Cheerleader,

I try to read all the posts you initiate, they are always interesting and informative. I often don't have anything to contribute, so I stay silent.

I found the section on hypoxic injury/damage very interesting.

I moved from sea level to high altitude Lake Tahoe, NV and three years later I started experiencing my first MS symptoms. Then, two years later and Wham-O, the MS diagnosis!

Very interesting indeed, Joan, I think you just helped me add another piece to my personal MS jigsaw puzzle.

Thanks again for all that you do in front of as well as behind the scenes.

Lora
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Postby Cece » Tue Jul 06, 2010 10:27 pm

Sleep apnea can cause hypoxia too, so I'd think that would be a double burden for any person with MS. Amazing that it went away, though.

My hubby is tonight sleeping on an inclined bed for the first time, he is snoring through his CPAP. *sigh*
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition
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spine

Postby THEGREEKFROMTHED » Wed Jul 07, 2010 7:56 am

Cheer,
The info on hypoxia is just too ironic (no pun intended)and makes perfect sense. In my case fortunately i do not suffer from fatigue, nor do I suffer congitive issues (my wife may refute that!), rather all my activity is in the spine. Interestingly when i was liberated my wife was shocked at the three days following how quietly I slept without my typical log cutting! Shortlived unfortunately.

My question through all of this continues to be the relation to the venous insufficiency with regards to cspine and tspine activity and lesions? Is it due to valve issues in the azygos? Is it the IJV's? Both? OR are we still learning? The lesions (2 or so) in my brain are so tiny that they are barely viewable, yet my IJV's have greater than 75% stenosis?
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