Less lesions, still unsteady

[Janice]

Hi all, I've been feeling less steady on my feet, so I went to my neuro, had a brain MRI and it showed no new lesions and that some of the lesions were actually shrinking. I've been on Avonex for 2 years. Can symptoms appear without lesion activity? Or are the lesions likely to be down my spine?

[HarryZ]

Janice,

Hi all, I've been feeling less steady on my feet, so I went to my neuro, had a brain MRI and it showed no new lesions and that some of the lesions were actually shrinking. I've been on Avonex for 2 years. Can symptoms appear without lesion activity? Or are the lesions likely to be down my spine?

Unfortunately, there isn't a lot of correlation between brain lesions shown on an MRI and the symptoms a MS patient may be experiencing. That's why they can't use MRIs as the sole diagnostic tool for MS. There is a possibility of lesions on the spine and only an MRI of the spine can determine that. They aren't done all that often in this area.

One concern I have and also expressed by others on this forum, is that many clinical trials for potential MS drugs almost focus entirely on the number of brain lesions that end up on an MRI. You will often hear the statement that " there was a 50% reduction of lesions on patients taking the drug versus those on the placebo". But what you don't hear is that the patient's symptoms may have continued to get worse and he/she is sicker than prior to the trial. What good is it to have "nicer pictures" of the brain when you have just lost your ability to walk?!

That's why it is so important to read the entire published studies of MS drug trials as opposed to the press releases by the company producing the drug.

Harry