Some early brain changes in MS may result from mechanisms that are independent of lesion formation, according to research published in Brain.
Many patients have a first ‘episode’ of MS symptoms known as a clinically isolated syndrome, but not everyone who has a clinically isolated syndrome goes on to develop MS.
In their study researchers, including BRC supported Dr Declan Chard, assessed people who had had a clinically isolated syndrome . They looked for gradients in periventricular white matter, using magnetisation transfer ratio (MTR, an MRI technique used to investigate microstructurall abnormalities in brain tissues), and how these related to the development of MS.
The study was specifically designed to determine how early on in the clinical course of MS an abnormal gradient in periventricular white matter MTR occurs. The results showed a gradient in MTR abnormality around the lateral ventricles in those who had had a clinically isolated syndrome, with a steeper gradient in those who went on to develop MS within five years.
The findings raise the possibility that a factor external to the brain significantly influences the effects MS has on white matter, and that this is present early on in the course of MS and relevant to the development of MS following a clinically isolated syndrome.
Dr Chard said: “This finding has potential implications for the treatment of MS. The pathological process underlying it does not appear to be closely linked with white matter lesion formation, and so may not respond to current MS treatments that have been designed to suppress new lesion formation.”
