Question about functional MRI

Has anyone every had a functional MRI and if so did it help in their DX process...My neuro is wanting to see if my insurance company will cover one....Looks like I will be heading to Temple Tx hopefully and getting MRI done on 3 T machine....I really pressed for it...so we will see it looks like my Neuro office will have to do some work to get me in there but that is why they get paid the big bucks...Right

Thank you for any comments,

Kelly

[wiggles94]

Hi Kelly,
I Had an MRI of my brain and spine, and it may help in the dx process, depending upon what they find. It's pretty standard if they think you have MS based on other things, and need more proof.  It's also good to have a baseline MRI so if you do have lesions, they can track them over time to see how you are doing if you go on meds or if you have other attacks.

3T is the way to go as it will pick up lesions that a 1.5 machine may miss. Closed machines are best.   MRI is just one part of the whole process of dx.  If you have lesions, they can be from many other things (other than MS).  The radiologist can't necessarily say what the lesions are caused by but can offer suggestions based on how they appear in your brain.  Lesions found in the spinal cord are always from MS (I think!)....Hopefully someone will correct me on that if Im wrong.

   ALSO, you can have MS and not have lesions show up on MRI.  Some people need to be followed for years before a definitive dx of MS is made.  Lesions on the spine are harder for MRI to pick up.

Keep in mind that MS is a diagnosis of exclusion - as there is NOT a definitive test for MS.  Lumbar puncture, visual evoked potentials, and of course your symptoms and clinical  exam are other important pieces of the puzzle.  Some people need all these to help get diagnosed with MS....others don't.  It just depends on how you present as to what testing you will need and of course, what your docs think.  A good neuro will keep looking and get to the bottom to find out what is going on  and won't dismiss your symptoms OR lesions (if you  have them.)  Always good to question why they want tests though!

Docs will rule out other diseases with bloodwork etc as there are many mimics of MS.  If you have only had one "attack" (symptoms that could be MS) and have lesions, they may call it a CIS.  Clinically isolated syndrome.  Many docs treat CIS with disease modifying meds to lessen further attacks, damage, and lengthen the time to convert to definitive MS.  A high percentage of patients with CIS convert to MS.  (depending upon their symptoms, lesions on MRI etc).

AS you may have read on this site, being dx can be a LONG drawn out, frustrating process and other docs may have to be consulted, such as rheum, and endocronlogist. One step at a time, and make sure you do your homework.

What other testing have you had done, and what are your symptoms?  How long have you been trying to figure out what is wrong with you?

Hopefully this info is helpful and good luck to you!
AND yes, it is the neuro's office's job to get you in for your MRI.  Mine had to fight for it, but finally I got approved, and we found LESIONS on the brain!  So for me, it's important, as most of my other testing is looking pretty good.  I'm diagnosed with CIS at this time and on meds.
I hope that it all goes well for you!
Carol

[sllowe]

I hope your doc gets this through the insurance. I look forward to hearing how it plays out for you.

I think the functional MRI would be of great use for many of us. I often wanted to sign up for the studies yrs back when I saw them in there.

-shell

[COBOB]

Here is what I remember about fMRI.  The technology is about 20 years old.  fMRI is more of a research than diagnostic tool.  It is a normal MRI machine with special software that is used to measure BOLD (Blood Oxygen Level Dependence.)  Areas of the brain doing the most work require the most blood flow to  deliver oxygen and glucose to the cells.  It is not a "real time" imaging technique.  Most insurance companies will not cover fMRI studies.  I'd say it has very little to do with MS, since no one has proven that there is any increase or decrease in arterial blood flows in the MS brain.

Bob

[wiggles94]

oops - sorry - totally missed the functional piece! - Never had one done.

[Lulu54]

If the CCSVI theory advances  the fMRI might be considered as part of the diagnostic tools arsenal.  Until that time, I think you will have trouble getting it covered by insurance. Is there a reason why fMRI and not the usual MRI?

Lulu

[houseofallboys]

Thanks for all comments.....I have had one mri with MS protocol in July...nothing was found...my neuro thought it might be post viral but has ruled that out ...she said that I would  have all ready hit my peak and not be adding on new symptoms....She said 10 years  ago with all my symptoms and O Bands found in spinal fluid I would be dx with MS...She wants to be 100 sure on dx which I'm happy for...

Since my initial MRI I have had new and many more symptoms.....She still thinks its something effecting my cerebellum ...????

So really I'm not sure why she wants the functional MRI ...all I know is I think I throw her for a loop asking about going to Temple for 3 T mri ...she said she didn't know enough about the difference between MRI's she would call her radiologist friend and get back to me... I appreciate her honesty....

So I guess I will wait and see what insurances companys says...if not the functional MRI at least I  can see if they will cover another MRI with ms protocol for the head and spine on the  3T ..keeping my fingers crossed

Thanks again

[Nancy T]

I ALMOST had one once... a tinnitus researcher here in town was intrigued by my "bursts" of "extra" tinnitus in my hearing-loss ear when I move my eyes sideways or when I'm sleepy or hear a sudden noise. He was all ready to set up some time at night when I would be sleepy, etc., but when I told him the noise only lasts one second or so, he thought that wouldn't be enough time to "catch" it on MRI. That was probably 7 or 8 or 9 years ago.

I don't think fMRI is different from getting a regular one, but I don't know that for sure. Strange that they would want to do that for MS.