Is it already a proven fact that MS is primarily a demyelinating disease?
Well, good "catch", finn. (And I am addressing this directly and personally, as that was MY writing.)
I suppose I should have been even MORE literal in my statement. But I never stated that it WAS a "proven fact". OH...WAIT.....Damn, maybe I did!
Ok....clarification required if so!!!! (NOTE: Since intially writing this, I went back and double-checked my wording - clarification provided in second edit below - and my first assumption was correct. I did NOT state it as a "proven fact").
So far, according to the medical community, mind you, MS has "statistically" indicated that it is primarily a demyelinating disease.
Maybe I should have prefaced my discussions with "My understanding is", which I thought was a given assumption that anything I, or anybody, says is simply "my" or "their understanding"; and in this case is based on what the medical community presents to us (again a "given")......in my world, virtually next to nothing can be stated as a proven "fact" - from anybody -(but that's a discussion for a quantum physics or metaphysics message board, not this one).
So, let's say that right now, it is presented by the medical community to patients "at this point in time" that MS is primarily a demyelinating disease. (Why in the world would I have to state THAT so specifically, though?) So any subsequent words after that supposition (i.e. that MS is primarily a demyelinating disease) is derived from that initial assumption.
And yes, that's what we are also saying throughout all these threads. The fact (I use the term loosely) that there appear to now be other "patterns" of MS, that do not indicate that all patterns of MS are necessarily demyelinating. But even that is not known for "certain" yet.
As it stands right now, though, has the medical standard been changed as to the definition or description of MS? No. not to my knowledge. (I just get tired of having to personally say over and over before I speak to please remember that just because I personally say something, there's no reason for my posts to be given any more "weight" as it being "fact", as is given ANYBODY who posts and make "statements" on here. My way of speaking is no different than others'.) So, again, purely for clarification purposes........just because I (or ANYBODY) says something or speaks at all on any subject, does NOT make it fact.
What if changes in gray matter are the primary process, and different lesions (or lack of them) are the way that our system reacts against those changes?
Precisely. Lots of "what ifs" in MS, huh? Which I know you know, finn.
I played the "if/then" game with my first neuro one time. The problem with that is, you can only "guess" at the "then" part of that.
If you want ME to "guess", I'd say "if" [above], "then" it looks like there would have to be new hypotheses formed, test results and methodologies re-evaluated and/or discovered, diagnostic criteria re-formulated, and MS research may need to take or consider a turn toward another avenue of study.
What if different pathological and clinical signs of the disease are related to the differences in patients' immune reactions against the primary disease process (or lack of immune reaction), not vice versa?
Yes, I have myriad "what if" questions, also. And what you are presenting here for discussion (in my viewpoint) is the current constant "autoimmune" vs "non-autoimmune" argument. This is one of the "what ifs" that goes into my frustration statements when I mention the fact that I wish (and me "wishing" is a "fact" that I can reliably state) they would run more tests on patients in the first place, and make more ongoing immune correlations as a general rule. As an example, and the first one here may not be directly associated, of course, with immune system function; but how often IS a patient given MRS (or other newer types of MR methodologies), and how often is an MS patient tested via ELISPOT to help determine what their immune system is doing at any given point in time? How often are the levels of interleukins and/or cytokines even measured? I BEGGED my neuro to run an ELISPOT on me to see what my immune system might or might not be doing, and to no avail.
Hence why MS research is still ongoing. Anybody can provide their own individual hypotheses on many things in MS, but that's still what they remain - hypotheses. Especially (again a common sense "given") when the hypothesis(es) is/are being presented on a discussion board by lay people without the ability to even have ACCESS to laboratory facilities, etc. on their own.
And I'm actually surprised you asked these types of questions, as I know you yourself, finn, create and present your own hypotheses and opinions regarding MS, etc. So...........(and I'm asking this in a light-hearted manner)..........was this a test?
P.S. Stick around now! Oh, yea....and finn. Never would I refer to YOU as THAT much of a "layman".
EDIT: I've made a few edits for clarification.
I guess my "manner" of speaking (I've been told I speak confidently - ?) may "appear" that I am attempting to present my viewpoints as "fact", but please remember that is not necessarily the case. Confidence in manner of speaking does not immediately equate to something being automatically presented as "fact". Thanks!!
SECOND EDIT: I was correct the first time above, before I made edits to this post. I initially said that I had not said that MS is primarily a demyelinating disease as a "proven fact". I was correct. My exact statement in another post was:
Multiple sclerosis is primarily a demyelinating disease; therefore, existing mainly in the white matter (affecting "transmission" of information from the brain).
Note that I did NOT
say that 'It is a "proven fact" that Multiple sclerosis is primarily a demyelinating disease....' So my first response above that I did not say it was a "proven fact" was correct! Any inference at all that indicates that I did say that is therefore totally incorrect. Thanks!!!