Cumulative loss of axons lead to permanent disability...

This is a fascinating article from MSQR about myelin and axons.  

Some key facts I thought were important:

• Axons are severed even without inflammation
• These axons do not regrow
• This damage can occur anywhere in the brain - including the gray matter, which does not show lesion activity.

One of the most interesting paragraphs in this article...

"Damage from clinically silent lesions is significant. Magnetic resonance imaging (MRI) has been extremely useful in extending researchers’ understanding of MS. MRI scans show that there are many more lesions in the nervous system of many people with MS than might be expected from their disabilities. This seems to be because most lesions occur in parts of the nervous system that are not immediately responsible for some sort of behavioral output, like walking or speaking, or for sensory perception. Therefore, even during the “remitting” phases of RRMS, there is generally ongoing damage from MS in these clinically silent lesions. Therefore, damage to the nervous system can be much more extensive than would be guessed by looking at a patient’s symptoms alone."

http://www.unitedspinal.org/msscene/2007/04/24/nerve-fibers-are-severed-by-inflammation-in-ms-lesions-leading-to-permanent-disabilities/

[Wobbly]

good info... it looks like they are finding out more information all the time..

thanks for this

wobbly
undx

[Ufrustrated2]

really quite interesting. i didn't realize that lesions in the grey matter didn't show lesion activity. whoa!  glad you posted that info.

wonder what Justine's Myelin Repair Foundation comments would be on that article?

[Quixotic1]

This is another great comment on something we have said from the beginning.  It is what my HP called Lesions vs Symptoms is all about.

http://www.medhelp.org/health_pages/Multiple%20Sclerosis/Lesions-vs-Symptoms/show/61?cid=36

The Myelin Repair Foundation would not be at odds with this article.  Myelin can only be repaired on an intact, alive axon (nerve fiber).  Once it is severed, the entire nerve structure dies and repair of myelin is a moot point.

Axonal loss is known to be at the basis of our growing diability and it certainly can occur without the immune inflammation that characterizes our relapses.  So any therapies directed at MS must address both the inflammation and myelin damage (preferably by preventing the immune inflammatory attack in the first place, but also at repairing myelin that has been damaged) and must address this problem of axonal death.  It seems that at least two parts of the immune system are attackingt here - both the cell-mediated immune system and the antibody-mediated system.

I don't understand what they mean by the gray matter not showing lesion activity.  I think they are saying that gray matter that doesn't have lesions (appears normal) can also be showing damage.  We all know that grey matter lesions are known to occur regularly in MS.

Thanks, Jen.

Quix

[jensequitur]

>  I think they are saying that gray matter that doesn't have lesions (appears normal) can also be showing damage.  

Yes, sorry!  That's what I meant - I just didn't say it very well.  One of the most interesting things to me was that gray matter is obviously getting lesions, but MRI technology at this point is unable to image it properly.  (Mostly because there's not a lot of myelin in gray matter.)

[MRF_Justine]

Jen,
Thanks for sharing this article. Myelin Repair Foundation and our Principle Investigators are aware that damage to myelin may not be reflected in the severity of the patient's symptoms.

MRF is researching diagnostics tools such as a PET scan and blood based biomarkers that we can use to determine the damage to your myelin. If this is successful we will be able to tell what damage is occurring even if there are no symptoms.

If there any questions for our researchers, I can do my best to pass along your questions. We are having a chat on MSWorld.org tomorrow (Tuesday, May 12) at 5PM PT/8PM ET if you'd like bring up your questions then.

/Justine Lam
Internet Strategist
Myelin Repair Foundation


The content in this message from the Myelin Repair Foundation is offered for informational purposes only. The information is not provided for the purpose of giving medical advice or recommending specific treatment options. The Myelin Repair Foundation urges you to consult one or more licensed physicians who are trained to diagnose and treat the symptoms of MS and other neurological diseases.

[jensequitur]

How is research coming along to detect lesions in gray matter?  Will the new 7T MRI machines be able to see those lesions?  Or will we have to find a different way to image the gray matter?