Multiple Sclerosis: Brain Lesions Don't Appear to Cause Severe MS Disabilities

Researchers say brain lesions don’t appear to be connected to severe disability in multiple sclerosis. SeventyFour/Getty Images

• About 1 million people in the United States live with multiple sclerosis.
• Some people with progressive forms of the disease develop severe disabilities while others do not.
• Researchers say that brain lesions don’t appear to be connected to the severity of these disabilities

The volume of brain lesions in people with multiple sclerosis (MS) does not indicate the degree of severity or disability, according to a study completed at the University of Buffalo and presented at the annual meeting of the Americas Committee for Treatment and Research in Multiple Sclerosis.

Brain lesions are areas of damage caused by injury or illness.

These are markers medical professionals use to determine MS progression and modify treatments to slow the accumulation of lesions.

However, the new study suggests that the volume of lesions in the brain’s white matter does not provide information on the degree of disability.

The findings have not been published yet in a peer-reviewed journal.

What study on lesions and multiple sclerosis revealed

For the study, researchers compared two sets of people with MS between the ages of 30 and 80.

They matched each participant with a “twin” who was the same gender and had similar durations of MS. However, they differed in physical and cognitive disabilities.

The scientists said they did not find material differences in white matter brain lesions. However, participants with a severe disability did have gray matter loss even though the whole brain volume was comparable in both groups.

The researchers reported that the more severely affected group also had:

• Pronounced atrophy of the connection between the brain and the spinal cord.
• A more advanced loss of neurons.

The importance of the MS research

Despite the many treatments available, it’s estimated that 10% to 15% of people with MS develop primary progressive MS, which in some cases can lead to disability at a relatively young age.

The researchers hoped to find information that could help explain why some people become severely disabled quickly and others much more slowly.

“This study builds on previous work demonstrating that MS is not just a white matter disease; there can be extensive grey matter involvement,” said Dr. Barbara Giesser, a multiple sclerosis neurologist at the Pacific Neuroscience Institute in Santa Monica, California.

“Grey matter and spinal cord involvement tend to correlate with more severe disability, independent of white matter involvement,” she told Healthline. “If this can be demonstrated to serve as a prognostic indicator, it could help guide treatment toward earlier and more aggressive therapies in these patients.”

What you need to know about multiple sclerosis

Around 1 million people in the United States live with MS, according to the National Multiple Sclerosis Society. Women are three times more likely than men to have the disease.

Multiple sclerosis is a chronic and unpredictable central nervous system disease. It is considered an immune-mediated disorder, where the immune system attacks healthy tissue. This disrupts communication from nerve cells between the brain and spinal cord,

Scientists have found some genetic factors that could increase risk, but the condition is not considered hereditary. Environmental factors, low vitamin D, and cigarette smoking may increase the risk of developing MS. 

The National Multiple Sclerosis Society lists the symptoms of MS as follows:

• Depression and emotional changes
• Fatigue
• MS hug (dysesthesia), a squeezing sensation around the torso that feels like a tightening blood pressure cuff
• Numbness or tingling of the face, body, or extremities (arms and legs)
• Pain and itching
• Problems with memory and concentration
• Spasticity
• Vision problems, including optic neuritis, blurred vision, poor contrast or color vision, and pain in eye movement 
• Walking difficulties
• Weakness

The disease typically appears between the ages of 20 and 40.

“Progression of MS generally refers to the gradual accumulation of symptoms,” says Dr. Tyler Smith, a clinical assistant professor at NYU Langone Health’s Multiple Sclerosis Comprehensive Care Center in New York.

“We aim to start treatments shortly after diagnosing MS,” he told Healthline. “Typically, we schedule a dedicated office visit to review the various treatment options and select one that would be the best fit for each patient. In addition to disease-modifying therapy, we have additional medications, often used with physical, occupational, or speech therapy, that can help manage or treat symptoms.”

Disease-modifying therapy (DMTs) are treatments intended to delay the development of new brain lesions and, therefore, delay disability, according to the American Association of Neurology.

“DMTs do not treat symptoms,” Giesser explained. “They reduce clinical attacks and lesions, and in some cases have been demonstrated to slow progression. Other types of medications and non-drug strategies are used to treat symptoms.”

Multiple Sclerosis: Brain Lesions Don't Appear to Cause Severe MS Disabilities
Source: Pinoy Lang Sakalam

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