Ok, folks, billf has got us on another roll here. Let's see what WE can find that may explain or help treat what they are referring to in the news articles below. It appears like NOW we need to factor in iron deposits. hmmmmmmmmm......new direction altogether!
Any ideas, thoughts?
Deb
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New High-Tech MRI Shows Earlier Signs of MS
Researchers Hope Finding May Help Identify Those With More Aggressive Disease
By Peggy Peck
WebMD Medical News Reviewed By Charlotte Grayson, MD
on Tuesday, October 05, 2004
Oct. 5, 2004 (Toronto) -- A novel imaging technique shows that subtle, but ominous changes occur in unexpected parts of the brains of people with multiple sclerosis (MS) long before they develop symptoms.
Researchers are excited because the new high-tech MRI may help doctors identify "[those] patients whose MS is likely to progress to [cause] disability much earlier in the disease process than previously believed possible," Gerard Davies, MD, a researcher at the Institute of Neurology in London, tells WebMD.
Multiple sclerosis is a disease where the covering of nerves in the brain and spinal cord is gradually destroyed. This covering, called myelin, insulates the nerves and helps them transmit nerve impulses or messages between the brain and other parts of the body. These messages control movement and other functions. As the disease progresses patients typically experience problems ranging from weakness and balance problems to numbness, visual problems, and even impaired thinking.
Currently, MRI testing allows doctors to identify MS-related brain abnormalities in the so-called white matter of the brain where the myelin-sheathed nerves communicate with each other. The new technology images a different type of brain tissue called gray matter. Gray matter consists of the brain cells themselves; gray matter cells rely on the nerves in the white matter to communicate with each other.
gray Matter Examined
In his study, Davies studied 23 patients with relapsing/remitting MS, a form of the disease in which the disease manifests itself as a cycle of attacks separated by periods of relatively good health. The patients had all been diagnosed within the previous three years. "Each had at least two MS attacks," says Davies. He conducted brain imaging studies once a year for three years and compared those scans with yearly brain scans of 19 healthy volunteers.
Using the new imaging technology, the researchers found that "changes in both gray and white matter were evident on even the first scan," says Davies.
Other, sophisticated calculations show that the gray matter changes began nearly three years before the onset of symptoms whereas the white matter changes occurred shortly before the participant's first attack.
Robert Lisak, MD, professor and chair of the department of neurology at Wayne State University in Detroit, tells WebMD that the findings are very encouraging because "this is demonstrating for the first time that gray matter is involved very early in the disease." He says this shows that the purely white matter changes in a person with MS may actually be secondary to changes in the brain cells themselves.
But he cautions that while this finding is important, it will not translate into any immediate treatment strategy for MS patients. "It is good to understand how the disease starts and this may eventually lead to a treatment, but that is unlikely to happen in the short run."
Next, Davies says that these patients will be followed for at least 10 years, so that they "can determine if these subtle changes do predict disease progression."
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SOURCES: American Neurological Association 129th annual meeting, Toronto, Oct. 3-6, 2004. Gerard Davies, MD, Institute of Neurology, London. Robert Lisak, MD, professor of neurology, Wayne State University, Detroit.
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Here's an article from 2003:
Gray Matter Damage Linked to MS
Previous research had focused on the brain's white matter
By Kathleen Doheny
HealthDay Reporter
TUESDAY, Oct. 21 (HealthDayNews) -- The cognitive problems and walking difficulties experienced by multiple sclerosis patients is caused by damage in the brain's gray matter.
And that damage may be due to toxic deposits of iron.
That's the conclusion of a study by Dr. Rohit Bakshi, an associate professor of neurology, and his fellow researchers at the University of Buffalo. They presented their findings Oct. 21 at the annual meeting of the American Neurological Association in San Francisco.
"Conventional thinking has it that multiple sclerosis is a disease of white matter lesions or plaque detected by MRI [magnetic resonance imaging]," says Bakshi. "In the last five years, growing evidence suggests that MS is not just a white matter disease, but that gray is also involved. We now know it's a global disease of the brain and spinal cord. And it targets not only white matter but gray."
"Gray matter is the command-and-control center of the brain, where all the nerve centers are housed," Bakshi adds. "White matter simply connects the gray matter together."
Multiple sclerosis is believed to be an autoimmune disease of the central nervous system, including the brain, spinal cord and optic nerves. Surrounding the nerve fibers is protective fatty tissue called myelin, which helps nerve fibers conduct electrical impulses. Myelin is lost in numerous areas in MS patients, leaving behind scar tissue called sclerosis.
The damage to the myelin is the result, most experts believe, of an abnormal response by the immune system. Several factors are thought to be involved in the onset of MS, including genetics and environmental triggers such as viruses or trauma.
In one of two studies presented at the meeting, Bakshi and his team evaluated 47 people with multiple sclerosis who completed a timed 25-foot walk, commonly used to assess physical functioning in patients with the disease. The times were compared with the amount of unnatural darkness of each patient's gray matter, a condition called T2 hypointensity, which was detected on MRIs. The times were also compared with brain shrinking or atrophy and other brain changes known to occur with MS.
The amount of T2 hypointensity was the only brain change directly associated with impaired walking, Bakshi and his team found. The strongest association was with hypointensity in the dentate nucleus, a structure deep within the brain's cerebellum responsible for coordination and smooth limb movement, Bakshi says.
"That's a major finding and a completely new finding," he says.
In a second study, Bakshi evaluated 34 MS patients, some of them the same ones in the walking study, and 16 healthy controls, testing them for working memory and attention, and performing MRIs to evaluate hypointensity.
He found the hypointensity was independently related to problems with attention and memory and predicted the problems in the MS patients.
"The more hypointensity, the more impairment," he says.
Excess iron entering the brain may be what is damaging the gray matter, Bakshi says. Or, the high levels of iron -- which can increase as people age -- might be the result of the degenerative process that occurs in MS. For instance, high iron levels are seen in Alzheimer's disease, Bakshi says, and experts still debate the cause-and-effect of iron in that disorder.
Stephen Reingold, vice president of research programs for the National Multiple Sclerosis Society, says, "Gray matter damage in MS has been a topic of concern for some time, and it is important that this research group is pursing this systematically. The relative contributions of white matter and gray matter damage to the disease is an important issue that has yet to be determined," he says.
The potential role of iron, whether cause or effect, also remains unclear, Reingold adds.
In another study presented at the meeting, researchers from the University of California, San Francisco reported they have produced an MS-like condition in laboratory animals by exposing them to a virus called herpes hominis virus 6. It is one of several viruses believed by some to play a role in triggering MS.
More information
For more information on multiple sclerosis, check with the National Institute of Neurological Disorders and Stroke and the National Multiple Sclerosis Society .
SOURCES: Stephen Reingold, Ph.D., vice president, research programs, National Multiple Sclerosis Society, New York City; Rohit Bakshi, M.D., associate professor, neurology, University of Buffalo, N.Y.;
Oct. 21, 2003, presentation, American Neurological Association annual meeting, San Francisco
Copyright © 2003 ScoutNews, LLC. All rights reserved.
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Shoot, this theory goes back to 2002, even:
http://unisci.com/stories/20022/0520025.htm