Study may show why MS patients develop progressive disability

Pree release:

Did you know multiple sclerosis (MS) means multiple scars? New research shows that the brain and spinal cord scars in people with MS may offer clues to why they developprogressive disability but those with related diseases where the immune system attacks the central nervous system do not.

In a study published in Neurology, Mayo Clinic researchers and colleagues assessed if inflammation leads to permanent scarring in these three diseases:

MS.
Aquaporin-4 antibody positive neuromyelitis optica spectrum disorder (AQP4-NMOSD).
Myelin oligodendrocyte glycoprotein antibody associated disorder (MOGAD).

They also studied whether scarring may be a reason for the absence of slow progressive disability in AQP4-NMOSD and MOGAD, compared with MS.

“The differences in scarring that we found will help physicians distinguish these three diseases more easily to aid in diagnosis,” says Eoin Flanagan, M.B., B.Ch., a Mayo Clinic neurologist and senior author of the study. “More importantly, our findings improve our understanding of the mechanisms of nerve damage in these three diseases and may suggest an important role of such scars in the development of long-term disability in MS.”

In all three of these diseases, the body’s immune system targets the myelin, the insulation around nerves. This causes inflammation and leads to removal of myelin, called demyelination, within the brain and spinal cord. Visual problems, numbness, weakness, or bowel or bladder dysfunction are common symptoms. Areas of demyelination, known as lesions, appear as white spots on an MRI. The repair mechanisms within the body try to reinsulate the nerves and repair the lesions, but this may be incomplete, leading to a scar that remains visible on future MRIs. Just like an electrical cable without its insulation, this scar may leave nerve fibers vulnerable to further damage and to degenerate over time.

The study included 156 patients, consisting of 67 patients with MS; AQP4-NMOSD, 51; and MOGAD, 38. These patients had172 attacks, or relapses, combined.

With MS, the researchers found that areas of inflammation reduced only modestly in size and led to a moderately sized scar. When scars are in regions of the brain and spinal cord that control arm and leg muscles, nerve fibers can degenerate and lead to slow worsening of disability in the secondary progressive course of MS.

“Our study highlights the importance of the currently available MS medications that very effectively can prevent attacks, new lesions and subsequent scar formation” says Elia Sechi, M.D., a former Mayo Clinic fellow and first author of the study. Dr. Sechi is now at the University of Sassari in Sardinia, Italy.

But AQP4-NMOSD and MOGAD are different from MS in that they do not have the same slow worsening of disability typical of the progressive course in MS.

With AQP4-NMOSD, large areas of inflammation occur during attacks, which often results in severe symptoms. Scars are common, but they tend to be smaller and in less important locations than in MS. Thus, less long-term problems result from those scars.

With MOGAD, despite having large areas of inflammation during an attack, the researchers found lesions tended to disappear completely over time and not leave any scar. This fits well with the excellent recovery from episodes and overall good long-term prognosis without the slow worsening disability seen in MS.

The reasons behind this recovery are not clear, the researchers note. It may suggest an enhanced ability to put the covering back onto nerves, or remyelination.

“We hope that the improved understanding on the ways MOGAD repairs its lesions so well may lead to novel treatment avenues to prevent scar formation in MS,” Dr. Flanagan says.

Advertisement:

SaleBestseller No. 1
The Multiple Sclerosis Diet Plan and Cookbook: 101 Easy Anti-Inflammatory Recipes
  • DeSantis MS RD CDN, Noelle (Author)
  • English (Publication Language)
  • 228 Pages - 12/17/2019 (Publication Date) - Callisto (Publisher)
SaleBestseller No. 2
Multiple Sclerosis For Dummies
  • Kalb, Rosalind (Author)
  • English (Publication Language)
  • 384 Pages - 05/08/2012 (Publication Date) - For Dummies (Publisher)
Bestseller No. 3
50 Pack Pcs Multiple Sclerosis Awareness Orange Ribbon Stickers for Water Bottles Waterproof Vinyl Laptop Luggage Inspirational Sticker Packs Teens Adults Aesthetic Small Decals
  • AESTHETIC STICKERS FOR WATER BOTTLES - Funny stickers for laptop will make your cool things become more colorful. With this pack of 20 pcs, there are no duplicates. Cute stickers for adults are not a random sticker pack, and vibrant funny stickers for teens will add color to life.
  • COOL STICKERS FOR TEENS AESTHETIC - These funny stickers for water bottles are made from durable vinyl, these cute stickers for journaling can be applied to any smooth, clean surface. These cute aesthetic stickers for girls are easy to apply and remove.
  • VINYL WATERPROOF STICKERS FOR WATER BOTTLES - These waterproof stickers have a strong adhesive that will not peel off your scrapbooking and are designed to withstand all weather conditions. They are applied to the outside of the vehicle, water bottles, helmets, phone cases, suitcases, laptops, computers, journaling, cups, tumblers, luggage, bikes, and more.
  • EASY TO APPLY - Just thoroughly clean and dry the surface you want to use. The decal should be carefully peeled off of its backing, precisely positioned, and gently applied to the required region.
  • CUSTOMER SUPPORT - We will make every effort to bring your happiness with our stickers. If you have any questions regarding your package or shipping, we are willing to support you!
SaleBestseller No. 4
The MSing Link: The Essential Guide to Improve Walking, Strength & Balance for People with Multiple Sclerosis
  • Hawley, Dr. Gretchen (Author)
  • English (Publication Language)
  • 173 Pages - 07/05/2023 (Publication Date) - Piper Publishing (Publisher)
SaleBestseller No. 5
Overcoming Multiple Sclerosis: The Evidence-Based 7 Step Recovery Program
  • Jelinek MD, George (Author)
  • English (Publication Language)
  • 504 Pages - 10/01/2016 (Publication Date) - Allen & Unwin (Publisher)
Bestseller No. 6
In My MS Warrior Era Multiple Sclerosis Awareness Month T-Shirt
  • MS Tee, Multiple Sclerosis Tee, Multiple Sclerosis Tee, MS Gifts, In My Warrior Era, Multiple Sclerosis Awareness, MS Awareness Month, MS Warrior, Strong Against MS, MS Warrior Era, Support MS Fighters, Orange Ribbon Support.
  • Perfect for supporting loved ones fighting Multiple Sclerosis during their journey. Ideal for Multiple Sclerosis Awareness Month events, walks, or casual outings. A meaningful way to spark conversations and inspire hope in the fight against MS.
  • Lightweight, Classic fit, Double-needle sleeve and bottom hem
SaleBestseller No. 7
MS and Your Feelings: Handling the Ups and Downs of Multiple Sclerosis
  • Used Book in Good Condition
  • Shadday LSCW, Allison (Author)
  • English (Publication Language)
  • 240 Pages - 12/28/2006 (Publication Date) - Hunter House (Publisher)
SaleBestseller No. 8
Landical 60 Pcs Orange Cancer Awareness Pin Bulk Leukemia Awareness Product Kidney Cancer Lapel Pins Gun Violence Multiple Sclerosis Lymphoma Orange Ribbon Items for Charity Public Social Events
  • Wide Variety Pack: our package includes 60 pieces of orange cancer awareness pins in 12 styles, 5 pieces for each style; This not only caters to larger groups like workplaces, cancer awareness events, or communal gatherings but also allows for personal use as well; Keep them for yourself or share them with your loved ones, it's your choice
  • Cancer Awareness: these orange awareness ribbon pins are dedicated to promoting cancer awareness; By wearing them, you align yourself with the fight against this disease, expressing solidarity with those affected; Get people talking, raise questions, and spread awareness to work towards a common goal
  • Conscious Material Choice: our cancer pins are crafted from iron, a metal known for its robustness and weight; This material ensures that the pins are significant and hard wearing, able to sustain regular use without losing their shine or form
  • Suitable for Multiple Occasions: alongside their symbolic nature, the style of these orange push pins makes them suitable for various occasions; Whether it's a formal event, a casual gathering, a cancer awareness campaign, or a simple day at the office, these pins can easily blend in, leveling up your style quotient
  • Versatile Use: these lung cancer pins can be applied to clothes, backpacks, scarves, or any fabric item, making them good for comprehensive use across various scenarios; This could be during cancer awareness events, charity events, runs or marches, or even as a day to day symbol of support
Bestseller No. 9
Track Multiple Sclerosis: A Detailed One Year Journal to Record MS Symptoms, Triggers, Medications and More.
  • M.G. Fields (Author)
  • English (Publication Language)
  • 265 Pages - 11/12/2021 (Publication Date) - Greatwood Books (Publisher)
SaleBestseller No. 10
Navigating Life with Multiple Sclerosis (Brain and Life Books)
  • Costello, Kathleen (Author)
  • English (Publication Language)
  • 248 Pages - 02/03/2025 (Publication Date) - Oxford University Press (Publisher)

I get commissions for purchases made through links on this website. As an Amazon Associate I earn from qualifying purchases.