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<p class="publishdate"><span property="dc:date" datatype="xsd:dateTime" content="2019-08-27T00:00:00-04:00" class="date-display-single">August 27, 2019</span></p><div class='syndicate'><h1>Brain scans reveal marker for severe MS</h1><div class="callout callout-with-border"><h3>At a Glance</h3>
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<ul>
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<li>Researchers found that dark rimmed spots on the brain may be a hallmark of more aggressive and disabling forms of multiple sclerosis.</li>
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<li>The findings suggest that targeting the brain’s unique immune system may be an avenue to explore for new disease treatments.</li>
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</ul></div><div class="media-float-right"><div class="ds-1col file file-image file-image-jpeg view-mode-floated_media clearfix">
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<picture title="Female patient lying down for an MRI exam">
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<!--[if IE 9]><video style="display: none;"><![endif]-->
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-large/public/news-events/research-matters/2019/20190827-ms-mri.jpg?itok=JlBJwXUR&timestamp=1566829645 1x" media="screen and (min-width: 960px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2019/20190827-ms-mri.jpg?itok=S4x75B_V&timestamp=1566829645 1x" media="screen and (min-width: 800px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium-small/public/news-events/research-matters/2019/20190827-ms-mri.jpg?itok=u7d_8Dd9&timestamp=1566829645 1x" media="screen and (min-width: 600px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-small/public/news-events/research-matters/2019/20190827-ms-mri.jpg?itok=2w8K2YtR&timestamp=1566829645 1x" media="screen and (min-width: 480px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-tiny/public/news-events/research-matters/2019/20190827-ms-mri.jpg?itok=8-Mt7hDF&timestamp=1566829645 1x" media="screen and (min-width: 0)" />
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<!--[if IE 9]></video><![endif]-->
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<img src="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2019/20190827-ms-mri.jpg?itok=S4x75B_V&timestamp=1566829645" alt="Female patient lying down for an MRI exam" title="Female patient lying down for an MRI exam" />
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</picture><span class="caption">The ability to detect aggressive forms of MS would enable researchers to test and assess potential therapies.</span><span class="credit">andresr / E+ via Getty Images</span></div>
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</div><p>Multiple sclerosis (MS) affects more than 2 million people worldwide. It’s caused by the immune system attacking the protective coating around nerve cells in the brain and spinal cord.</p>
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<p>MS can affect each person differently. Initial symptoms may include blurred or double vision and problems with muscle strength, balance, and coordination. Some people have a longer lasting, progressive form of the disease, which can cause debilitating problems including paralysis, loss of bladder control, and problems with attention, thinking, and memory. </p>
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||
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||
<p>The immune system’s attack on the nervous system produces lesions that appear as spots on MRI scans of a patient’s brain. While some lesions heal, completely or partially, others remain chronically inflamed. Chronically inflamed lesions have a dark outer rim surrounding them on MRI scans and appear to actively expand for many years. These dark rims accumulate brain immune cells called microglia, which can sustain low-grade, or “smoldering,” inflammation.</p>
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||
<p>To investigate the role these chronic active lesions play in MS, a team led by Drs.Martina Absinta and Daniel S. Reich at NIH’s National Institute of Neurological Disorders and Stroke (NINDS) followed 192 patients with MS and assessed lesions and disease severity over seven years. Results were published online on August 12, 2019, in <em>JAMA Neurology.</em></p>
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-large/public/news-events/research-matters/2019/20190827-ms.jpg?itok=wOyk0vRy&timestamp=1566913258 1x" media="screen and (min-width: 960px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2019/20190827-ms.jpg?itok=kDlWTQnx&timestamp=1566913258 1x" media="screen and (min-width: 800px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium-small/public/news-events/research-matters/2019/20190827-ms.jpg?itok=vTvtyXC8&timestamp=1566913258 1x" media="screen and (min-width: 600px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-small/public/news-events/research-matters/2019/20190827-ms.jpg?itok=SotDzFSn&timestamp=1566913258 1x" media="screen and (min-width: 480px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-tiny/public/news-events/research-matters/2019/20190827-ms.jpg?itok=_qb-KFqA&timestamp=1566913258 1x" media="screen and (min-width: 0)"></source>
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<!--[if IE 9]></video><![endif]-->
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<img class="media-element" src="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2019/20190827-ms.jpg?itok=kDlWTQnx&timestamp=1566913258" alt="Brain MRI image highlighting a lesion with a dark outer rim" title="Brain MRI image highlighting a lesion with a dark outer rim" />
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||
</picture><span class="caption">Dark rimmed spots, representing ongoing “smoldering” inflammation, may be a hallmark of more disabling forms of multiple sclerosis.</span><span class="credit">Reich lab, NIH/NINDS</span></div>
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</div></div>
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<p>Most of the study participants (56%) had at least one chronic active lesion—including those who were receiving the most current treatment options. The researchers classified the patient results into three groups: no rims (84 people); one to three rims (66 people); and four or more rims (42 people). </p>
|
||
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||
<p>Patients with multiple chronic active lesions showed a more aggressive form of MS. Those with four or more rim lesions were 1.6 times more likely to have MS that progressed compared with those without any rim lesions. They were also more likely to experience physical and cognitive disabilities at a younger age.</p>
|
||
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||
<p>“We found that it is possible to use brain scans to detect which patients are highly susceptible to the more aggressive forms of multiple sclerosis. The more chronic active lesions a patient has, the greater the chances they will experience this type of MS,” Absinta says. “We hope these results will help test the effectiveness of new therapies for this form of MS and reduce the suffering patients experience.”</p>
|
||
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||
<p>In addition, the findings suggest that future studies on new treatments could target the brain’s unique immune system, particularly microglia.</p></div><h2 class="label-above">Related Links</h2><ul class="spaced print-urls"><li><a href="https://www.nih.gov/news-events/nih-research-matters/how-drugs-could-repair-damage-multiple-sclerosis" target="_top">How Drugs Could Repair Damage from Multiple Sclerosis</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/stem-cell-transplant-induces-multiple-sclerosis-remission" target="_top">Stem Cell Transplant Induces Multiple Sclerosis Remission</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/drugs-lessen-multiple-sclerosis-damage-mice" target="_top">Drugs Lessen Multiple Sclerosis Damage in Mice</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/vitamin-d-levels-predict-multiple-sclerosis-progression" target="_top">Vitamin D Levels Predict Multiple Sclerosis Progression</a></li><li><a href="https://newsinhealth.nih.gov/2019/01/managing-multiple-sclerosis" target="_top">Managing Multiple Sclerosis: Treatment Can Delay Future Attacks</a></li><li><a href="https://www.ninds.nih.gov/Disorders/All-Disorders/Multiple-Sclerosis-Information-Page" target="_top">Multiple Sclerosis Information Page</a></li><li><a href="https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Multiple-Sclerosis-Hope-Through-Research" target="_top">Multiple Sclerosis: Hope through Research</a></li></ul><p class="footnote"><strong class="label-inline">References: </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/31403674">Association of Chronic Active Multiple Sclerosis Lesions With Disability In Vivo.</a> Absinta M, Sati P, Masuzzo F, Nair G, Sethi V, Kolb H, Ohayon J, Wu T, Cortese ICM, Reich DS. <em>JAMA Neurol.</em> 2019 Aug 12. doi: 10.1001/jamaneurol.2019.2399. [Epub ahead of print] PMID: 31403674.</p><p class="footnote"><strong class="label-inline">Funding: </strong>NIH’s National Institute of Neurological Disorders and Stroke (NINDS); National Multiple Sclerosis Society; Conrad N. Hilton Foundation.</p>
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