Research: a case for combined neuroprotection and immunomodulation

Braley et al. Differences in Diffusion Tensor Imaging-Derived Metrics in the Corpus Callosum of Patients WithMultiple Sclerosis Without and With Gadolinium-Enhancing Cerebral Lesions. J Comput Assist Tomogr. 2012;36:410-415.
 

OBJECTIVE: To analyze differences in corpus callosum diffusion tensor imaging metrics among MSers with RRMS and SPMS with enhancing and nonenhancing cerebral lesions.

The corpus callosum is the white matter tract that connects the two cerebral hemispheres together.


Diffusion tensor imaging is MRI technique that assesses the integrity of white matter tracts, in other words how intact they are.
DTI image of the corpus callosum
RESULTS: The subjects with SPMS with enhancing lesions had significantly lower genu and body of the corpus callosum fractional anisotropy (FA) values than those with nonenhancing SPMS and significantly lower genu, body, and splenium FA values than those with RRMS. Regression models: Enhancement was associated with decreased genu FA (P = 0.014). Secondary progressive MS was associated with decreased genu (P = 0.002) and splenium FA (P < 0.001) and significantly increased mean diffusivity.



CONCLUSION: Patients with SPMS with enhancing lesions may be at increased risk for neuronal damage compared to nonenhancing SPMS and RRMS subtypes.


"Nothing really new here. MSers with more advanced disease and active lesions are more likely to have damage to the corpus callosum and the nerve fibres that connect the two halves of the brain. Best to try and stop this happening! How? Early aggressive treatment before your MS becomes secondary progressive. There is no point waiting for damage to occur before treating; this is why we have to lobby NICE to give you access to the emerging more effective treatments as early as possible."




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