Number of lesions

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Number of lesions

Postby bromley » Fri Jun 16, 2006 4:57 am

Someone asked about the number of lesions and the correlation with disability. Here is an answer from the Canada MS site.

http://www.msanswers.ca/QuestionView.aspx?L=2&QID=240

Dr Myles looks a bit scary!

New technologies will allow the damage to neurons and axons to be measured which should provide a more accurate prognosis. My difficulty is - what if the scans suggest that you will become very severely disabled? What's the point of knowing this unless they can do something to prevent it happening? Maybe you would be more prepared to take risks with a more extreme treatment (bone marrow transplantation?).


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Postby Dunmann » Fri Jun 16, 2006 6:10 am

Ian,

Perhaps having newer MRI technologies that can show the axonal/neuron losses will become part of clinical trials. This would then allow for more accurate measurements of disability based on a simple MRI. All we need now are some drugs that have an impact on disability.
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Postby bromley » Fri Jun 16, 2006 6:25 am

Dunmann,

I think this is currently an issue with treatments for re-myelination - they can't actually measure it at the moment. But the technology is getting better.

Disability appears to be caused by the degeneration of neurons / axons. Treatments to protect these are in the pipeline, but again, better technology is required to measure their effectiveness.

The real breakthrough will be treatments to regenerate axons and neurons. Once they've cracked this, MS and I imagine other CNS diseases will be a thing of the past.

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Postby HarryZ » Fri Jun 16, 2006 6:30 am

Dunman,

Up until now, most clinical drug trials (especially those involving the CRABs) have used MRI results in showing that their drugs have had an effect on the progression of MS. Yet, per Dr. Myles, there is a best at modest correlation between the number of lesions and disability.

So what good is it to learn that "drug X" showed a 35% reduction in the number lesions over placebo when that really doesn't mean much in pinpointing whether a drug has helped. While fewer lesions generally is better, it certainly isn't the best way to know how an MS patient is really doing. Yet this criteria is used in marketing these drugs!

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