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Brain Scans May Explain Thinking, Memory Problems in Some MS Patients
Date:3/6/2013

By Denise Mann
HealthDay Reporter

WEDNESDAY, March 6 (HealthDay News) -- Besides problems with gait and vision, people who have multiple sclerosis often complain they have trouble remembering things, and now new research may explain why.

According to a small study from the Netherlands, people with MS who report memory and thinking problems have more extensive damage to the white matter in their brains than their counterparts with MS who don't report such problems.

Up to 70 percent of all people with MS will experience a mental decline at some point, said study author Hanneke Hulst at the VU University Medical Center, in Amsterdam. And the new research "confirmed that cognitive symptoms in MS have a biological basis," Hulst said.

The findings were published online March 6 in Neurology.

MS is an autoimmune disease that occurs when the body attacks myelin, a fatty substance that insulates the nerve fibers of the central nervous system. The brain's white matter is surrounded by myelin. Symptoms range in severity and may include problems with gait, balance, vision, memory and thinking abilities.

To get a better picture of what was going on in the brains of people with MS, Hulst and colleagues used a new type of brain scan called diffusion tensor imaging along with traditional MRI scans on 20 people with MS-related thinking problems, 35 people with MS whose thinking ability was not affected by the disease and 30 people without MS.

More damage appeared in the brain's white matter of people with MS who reported memory and thinking impairments than in those who had MS but no such complaints about mental declines: 76 percent vs. 49 percent, respectively. This was especially apparent in areas of the brain charged with memory, attention and concentration, the researchers said.

"Imaging can now be used to capture a wider spectrum of changes in the brains of people with MS, and will therefore help determine more accurately whether new treatments are helping with all aspects of the disease, including cognitive [mental] impairment," Hulst said. "Unfortunately, at the moment there are no treatments available to prevent or cure cognitive problems in MS."

Dr. Steven Mandel, a neurologist at Lenox Hill Hospital in New York City, said the new study validates some of the complaints he hears from people with MS. "The test is not ready for prime time, but in the future, it can help us sort out how impaired these individuals are in regard to everyday life and daily living." It may also serve as a marker to assess whether a treatment is making a difference, he said.

Dr. Fred Lublin, director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Medical Center in New York City, said that memory and thinking problems are common in people with MS, but they are usually subtle.

"People with MS are more aware of [these problems] than are the people around them," Lublin said. Still, he added, "this is an important finding that helps us better understand how cognitive impairment occurs and therefore can be a marker for treatments in the future."

More information

Learn more about how MS affects memory and concentration at the National Multiple Sclerosis Society.

SOURCES: Fred Lublin, M.D., director, Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center, New York City; Steven Mandel, M.D., neurologist, Lenox Hill Hospital, New York City; Hanneke Hulst, M.Sc., VU University Medical Center, Amsterdam; March 6, 2013, Neurology, online


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