Functional MRI in MS’ers without disability

Epub ahead of printColorado et al. Multi-task functional MRI in multiple sclerosis patients without clinical disability. Neuroimage. 2011 Aug 5.

The majority of MS’ers develop significant clinical disability, however a subset experiences a disease course with minimal impairment even in the presence of significant apparent brain tissue damage on magnetic resonance imaging (MRI). 

“Stated simply; despite evidence brain damage secondary to MS some MS’ers have very little disability.”

Functional magnetic resonance imaging (fMRI) in MS’ers with low disability suggests that compensation via increased use of other brain areas reduced the clinical manifestation of the disease. 
“fMRI is a research tool for looking at how much of the brain is being used to do a specific task; it works by indirectly measuring how much oxygen is being consumed by various areas of the brain.”
This study investigated whether, or not, non-disabled MS’ers show increased recruitment of other brain regions while performing various tasks. 
22 MS’ers with relapsing-remitting MS and minimal disability (EDSS ≤1.5) and 23 matched healthy controls were studied. 
Compared to control subjects, MS’ers demonstrated increased activation of other brain areas to complete the tasks assigned. 
Conclusion: These results support the mounting evidence of increased usage of other brain regions as a way the brain copes with the damage caused by MS. 
“You may be interested to know that the use of these other regions correlates with MS-related fatigue; the more brain power it takes to achieve a task the more tiring it is.”

Additional reading: fMRI

8 thoughts on “Functional MRI in MS’ers without disability”

  1. This is a very interesting post. It got me thinking about the correlation twixt oxygen in the brain and CCSVI. Is the lack of oxygen in the brain liked to the closing of veins delivering blood to the brain?

  2. Re: "Is the lack of oxygen in the brain liked to the closing of veins delivering blood to the brain?"Veins carry blood away from the brain not blood towards the brain that is the role of arteries.

  3. I wish all MSrs could be like this group. Is there any info on what makes them different? Why doesn't everybody's brain find new pathways?

  4. Re: "Why doesn't everybody's brain find new pathways?"I think they do; you are just not aware of it. It is when the brain's ability to do this is exhausted is when you do develop secondary progressive MS.

  5. re "… the brain's ability to do this is exhausted is when you do develop secondary progressive MS."What about PPMS? At what point does the brain's ability to find new pathways become exhausted because in our case we never had any relapses. We just developed a progressive worsening.

  6. The post says this group was a 'subset' with 'minimal impairment' despite 'significant apparent brain tissue damage' on MRI. So they were obviously unusual and that is why they were investigated. Why are other people with similar MRIs typically more disabled?

  7. Re: "Why are other people with similar MRIs typically more disabled?"This is a very good question. We don't know why. It may be genetic. It appears that some people with MS are very good at recovering from attacks or relapses and other are not. There are several research groups currently addressing this question. Unfortunately, there are no answers yet.

  8. Re: "What about PPMS? At what point does the brain's ability to find new pathways become exhausted because in our case we never had any relapses. We just developed a progressive worsening."I think PPMS and relapsing MS is the same disease. People with PPMS present on average 10 years later than relapse onset disease. I suspect they simply don't have lesions in clinically eloquent sites; i.e. sites that cause symptoms, otherwise they would have relapses. However, the same mechanisms are at play with both primary and secondary progressive MS; they progress at the same rate. Therefore any therapy that works in PPSM should work in PPMS.

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