Has this been turned into a Health Page yet?
Quix -
I found the health pages and a wealth of info ... printed it out to add to my pleasure reading when I get a moment or two ... thanks
- Alisa
From my reading to date the only thing that I have able to confirm is that the gray matter lesion volume is highly related to cognitive disability. One group looked at it with regard to fatigue and were surprised to find no relationship.
Alisa - For your notebook. Have your read some of the Health Pages on MRI's? A few of them have some basic info also.
And, Thank you ALL very much for your praise. It really did make me feel good, because I didn't think I was quite ready to writie this and was truly not sure if I was saying what you all wanted to know. I have another blurb planned soon to describe some of the different MRI techniques - especially fMRI or functional MRI also known as MRI Spectroscopy.
quix
QUIX,
VERY NICELY WRITTEN AS USUAL, ZILLA AND I HAD A SIMILIAR CONVERSATION ON THE PHONE THE OTHER DAY THAT THE CORRECT NEUROLOGIST ARE FINALLY ACCEPTING GREY MATTER LESIONS AS PART OF THE DISEASE.
THANK YOU
T-LYNN
Wow can you send this to all my old neuro's. JK! I just show no normal lesions and all of the mimics are ruled out except fibro which just doesn't fit. (Not that I want MS). It just makes me wonder if the problem it that the damage being done is not visible to the MRI's of today.
Tahiri
Add my accolades! Nice and easy to understand with just gobs of info! (Gobs being a highly technical term!) Very informative - thanks! Granny Jo
Now that was so much easier to understand than what I was trying to google and look up on my own. Thanks so much for doing the research and putting it in language we can all understand.
But, I have one more question...If we do have lesions in the gray matter that are not visible, what might we see other than cognitive issues that would hint at the symptom may be coming from a GM lesion? Just wondering.
Thanks again.
Julie
Awesome Job, Quix !
This will fill the gap in my research notebook titled "MRI's for Dummies" which is currently empty. Thanks for the easiest explanation that I've personally come across in my search ( never-ending ) for ANSWERS .
Thanks !
Alisa
Excellent stuff, as always... Something else to remember - they've found that the brain with MS responds differently to the T2 MRI signal - there's a part of the brain that 'jumps' differently from normal people's brains during the MRI, even though the results may not show lesions in that area. It shows that there's activity going on in the brain, even without lesion formation.
Fantastic!!! I would never expect any less, you never let us down. Thank you for your hard work.
doni
This is a masterpiece! And, there will be more to come! We are so spoiled.
Well done! Better than well! It's superb!
Thank you so much Mama Q!
-Shell
This is awesome.
I am copying it to a word file to save!
Bravissimo!
Wow Quix - great explanation. I trust you will post this as a HP so it is readily accessible to everyone looking for information. Bravo!! - Lulu
Wow, Quix. Nicely written, nicely explained. Good stuff. Thanks for working this up. I can see that there's been a lot put into it, and I know everyone is going to get a lot out of it.
Bio
(con't)
GRAY MATTER LESIONS
Now we know that there are many lesions in the gray matter also, even early in MS. The problem is that our regular, or conventional, MRIs do not show these gray matter lesions well at all. In order to see these gray matter lesions we have to use newer MRI techniques that are used in research, but not usually available to the doctors in practice. These techniques include "Magnetization Transfer" (MT MRI) and "Diffusion-Weighted" (DW MRI). There are many others. There are all miracles - in that I cannot really understand what they do - but they do it anyway, lol.
A heavy load of gray matter lesions is associated with greater cognitive disability - this is what interrupts our thinking, our attention and our memory.
Gray matter lesions have a relationship with the number and volume T2 Lesions. Since the gray matter is the area where the cell body of the nerve fibers is, then we think that GM lesions may represent the final death of nerves which suffered severe demyelination from which the nerve could not recover.
Gray matter lesions occur very early in MS and it is hoped that with better ways to visualize these lesions we will be able to use information from them to diagnose MS earlier. One of the studies I read showed that GM lesions were very numerous, surprisingly so.
Also, we can view the GM from the standpoint of which areas are active during certain tasks, an MRI technique called "functional" MRI or fMRI. We can see that there is often a large activation of the nerve cells around a lesion indicating the attempt of the brain to compensate for a lost area. This is part of the process of using other areas of the brain to perform a lost ability - the process known as "Neuroplasticity." In fact, when patients with optic neuritis were studied using fMRI, those with a larger area of activation in the visual center of the gray matter had better recovery from their visual deficits, than the patients with less. The brain actually can reorganize itself to compensate for injury.
NORMAL-APPEARING WHITE MATTER (NAWM) LESIONS
When the neurologist points to there area around the T2 lesions and says "Now, this is the normal part of your brain," it isn't technically true. It appears normal on the conventional MRI image, but studies using other MRI techniques, like functional MRI show different. Even in very early MS disease we can see that there are changes in the normal appearing brain tissue, that show changes in metabolism, that show some of the chemicals that result from injury and show a change in the normal patterns of nerve activation.
These changes in the NAWM are seen at the very earlist stages of MS, such as before it can be definitely diagnosed in the person with CIS, or Clinically Isolated Syndrome.
So, we can see that Multiple Sclerosis is a disease that involves almost all of the tissues of the central nervous system. It is made up of FAR more than the "MS Lesions" that we always talk about. This is why our disease seems so much more complicated than our MRIs might show. It is! When the newer imaging techniques become more available to the doctors out in practice we should see less misunderstanding. Then all doctors should see that the current MRI image - no matter what the strength - is not the sum total of our disease.
Quix