A new study published online in this week's Neurology, the medical journal of the American Academy of Neurology, reports that a third of people who underwent an MRI (magnetic resonance imaging) for other brain-related problems, but whose scans also showed abnormalities suggestive of MS, went on to develop the chronic disease within an average of about five years.
The research raises medical and ethical questions that genetic researchers and patients have bandied about for years: If someone's at risk for a disease, should they be told? And will knowing make a difference in staving off the disease?
In the study by University of California-San Francisco researchers, 44 subjects underwent brain scans for medical reasons ranging from migraine headaches to head trauma, says study author Darin Okuda, assistant clinical professor of neurology at the UCSF Multiple Sclerosis Center.
All of the subjects' scans revealed irregularities that looked similar to those seen in MS patients. After other possible diseases were ruled out, the patients were monitored for years for symptoms of MS, including vision disturbances, tingling, weakness, and coordination and balance problems. Within 5½ years, 30% had developed symptoms.
The brain images of an additional 29% showed further abnormalities, but those people continued to live symptom-free.
Okuda and his colleagues coined the term "radiologically isolated syndrome," or RIS, to identify patients who are symptom-free but whose scans show MS-like brain plaques. "The significance of the research is that we are capturing MS at a much earlier time frame," he says.
Okuda says the long-term goal is to develop therapies to prevent MS symptoms from ever occurring. Currently, there are drugs to treat symptoms and disease progression, but there is no cure. Okuda says more research is needed to understand the imaging nuances that will help them determine which RIS patients will develop the symptoms of MS and which ones will not.
I hope UCSF continues to study the 2/3 majority of people who did not go on to develop MS, even if they had further MSy activity in their brains. What was different about their environment/lifestyle/genetic makeup? There are potentially millions of people walking around with MS-like activity in their brains right now, yet they are symptom free. Why?