I was interested in knowing more about the so-called “disease activity” that suggested angioplasty “may” make people worse and wondered if the “disease activity” they mentioned "may harm" people with MS was specifically related to data about lesions. From a CTV article, it sounds like the Buffalo info is dependent at least in part on what they found re: brain lesion activity.
Liberation Treatment Offers No Sustained Improvement for MS—Study
“MRI scans showed some patients had increased brain lesions, one of the hallmarks of the progressive neurological disease, after undergoing the vein-opening procedure, said neurosurgeon Dr. Adnan Siddiqui, co-principal investigator of the pilot study.”
Does anybody know if the study also included measurements on brain atrophy or iron deposition?
I seriously question (and always have) whether or not “lesion counts” are all that important, so I would really like to see the data on other MRI measures such as atrophy and iron deposition. I hope Buffalo included that in their analyses and will also release that data.
Are lesion counts all that significant?
Here are some snippets from a MS Discovery Forum article on MRIs:
More than Meets the Eye: the promises and pitfalls of MRI imaging in multiple sclerosis (emphasis added):
”A fundamental complication, however, is that MRI pictures and movies raise more questions than they answer.
Intuition tells us that lesions, or plaques, can’t be good for the brain, but their meaning for a person’s functional status and future is unclear.
The stumbling block is the so-called clinicoradiological paradox: Abnormal spots on MRI often don’t manifest in physical or cognitive symptoms.
As the movies from Boston illustrate, brain scans can be red herrings, pinpointing neural-tissue changes that don’t match up with how a patient feels. And physicians cannot always trace symptoms to a particular spot on a scan.”
Really, the neuros rely on intuition? LOL....
“Of all its uses in the MS field, MRI’s current ability to predict short- or long-term clinical outcomes is most controversial (Goodin, 2006).”
“Complicating the picture further, the plaque is not necessarily all bad news: Within it, some remyelination can be occurring.”
“MRI for monitoring and treating MS: A work in progress
But beyond diagnosis, MRI’s utility is less certain: Its helpfulness has not been clearly established for tracking disease course and treatment responses.”
“Moreover, “simple correlations [between MRI measures and clinical outcomes] are not what you want,” says George Ebers, a neurologist who studies MS epidemiology and genetics at Oxford University in the U.K.
To justify the time and expense of costly MRI scans, he says,
the important question is whether imaging contributes value “independently of everything else” in predicting disability, particularly in the long run. The answer is “no” for changes in T2 lesion volume and Gd-enhanced lesions, say Ebers and Martin Daumer, director of the nonprofit Sylvia Lawry Centre for Multiple Sclerosis Research in Munich.”
“In a nutshell, MRI as it is used is not a good investment” for predicting outcomes, Daumer says. (Nor does it have value for monitoring patients, he says, as it adds little information beyond symptoms or relapses.)”
LOL—they can about CCSVI too…..“The arguments and counterarguments about predicting outcomes with MRI can be downright dizzying.”
“Working with Ebers and others, Goodin determined in a multivariate analysis (at a group level) that T2-lesion and brain atrophy changes during the original 3-year trial did not independently correlate with the accumulation of severe physical disability at 16 years (Goodin et al., 2011). “
“Goodin acknowledges that his analysis represents only one data set, includes only two time points, and needs to be replicated.
Yet, the broader point, he says, is that the MS imaging community has “a technique that they’ve really never properly validated” as a proxy for long-term disability—the ultimate outcome that MS patients, doctors, and investigators care about.”
They're going to use "invalidated" techniques to dismiss CCSVI when all they can do is criticize Dr. Zamboni for his techniques? Really now....what's up with that?
Sorry this turned out to be so long….I just think info about CCSVI needs to be pursued and I for one do not want to be fooled about what “lesions” tell us, or, more accurately, what they don’t tell us. Apparently most neuros are totally enamored with lesion counts—too bad. Their true colors are shining through.
Back to my question, does anyone know if Buffalo also measured brain atrophy or iron deposition in their study?
Take care all….onward.