MS has been considered as an inflammatory-demyelinating disease of the central nervous system, mainly affecting the white matter. However, the grey matter involvement has been shown to play an important role as well in this disease. Moreover, the exact mechanisms by which the increase of disability occurs in MS are not yet fully understood. In this study the authors have found that the grey matter damage, studied by means of the MTR, a relatively new technique of MRI, could be more strongly related to long-term disability than the white matter damage.
authors: Fisniku L, Altmann D, Cercignani M, Tozer D, Chard D, Jackson J, Miszkiel K, Schmierer K, Thompson A, Miller D
The grey matter involvement in MS has been proven to be important. In this study the authors have studied the behaviour of grey matter lesions over time and their relationship with cognitive function. They concluded that the number of lesions appearing in the cortical grey matter seems to increase over time and, more interestingly, that these cortical lesions are related to cognitive decline.
In MS, a disease characterised by the appearance of inflammatory-demyelinating lesions in the white matter, some abnormalities, generally diffuse and not well-defined, in the brain tissue which does not contain the typical lesions can also be seen with the conventional MRI techniques. The meaning of these diffuse abnormalities is not fully understood. In this article the authors have studied the brains (post-mortem) of people with MS and have looked at these regions containing diffuse abnormalities. They concluded that these regions reflect the chronic loss of myelin and axons. As these regions are likely to be contributing to disability in MS, the authors proposed that these abnormalities could be considered as MRI markers of disease progression.
authors: Seewann A, Vrenken H, van der Valk P, Blezer EL, Knol DL, Castelijns JA, Polman CH, Pouwels PJ, Barkhof F, Geurts JJ
The diagnosis of MS is based on the demonstration of dissemination in space and time of the inflammatory-demyelinating processes characteristic of MS. Over the recent years the diagnostic procedure has evolved and has been simplified, but still at present is quite complex. While before 2001 at least two relapses were required to diagnose MS, since then, the demonstration that new lesions have appeared on the MRI, by comparing two different scans performed in different moments after the first relapse, was enough to have the diagnosis of MS. The authors of this study have demonstrated that with just a single MRI scan of the brain, even performed very early after the first episode, the diagnosis of MS can be made, when certain features indicating dissemination in space and time are present. The results of this work are very important because they might lead to a simplification of the current diagnostic criteria for MS.
authors: Rovira A, Swanton J, Tintoré M, Huerga E, Barkhof F, Filippi M, Frederiksen JL, Langkilde A, Miszkiel K, Polman C, Rovaris M, Sastre-Garriga J, Miller D, Montalban X
In 2007, a clinical trial of glatiramer acetate (GA, Copaxone®) in primary progressive MS (PPMS) was carried out. Though GA did not turn out to be effective in PPMS, when only the male population was observed, some hints of efficacy of GA were suggested. In this article the authors aimed to investigate whether the effect of GA during the clinical trial could have caused different effects in men and in women. However, the authors finally concluded that GA would seem to have caused the same (not significant) clinical effects in men and women. Then, if some differences between both sexes were observed during the trial, these should be attributed to other incidental clinical factors apart from gender.
authors: Wolinsky JS, Shochat T, Weiss S, Ladkani D; for the PROMiSe Trial Study Group