Research: Having Relapses is Not Good For You

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Epub: Wang  et al.. Cerebrospinal fluid α-synuclein levels are elevated in multiple sclerosis and neuromyelitis optica patients during replase.J Neurochem. 2012 Mar.

The concept that the immune system plays a central role in the pathogenesis of MS and neuromyelitis optica (NMO) is indisputable 


“The question I have is this role primary or secondary?”

However, neurodegenerative pathological features including loss of axons and neurons were also found in the lesions of these diseases. α-Synuclein is one of the most abundant proteins in presynaptic terminals. 

“The synapse is the structure nerve cells use to talk to each other; the following YouTube video shows you how complex and beautiful the process is.”


Recently, research has shown that α-synuclein levels in cerebrospinal fluid (CSF) may reflect the progression of synaptic dysfunction and neuronal apoptosis. 

“The cerebrospinal fluid is the fluid that surrounds the brain and spinal cord. We sample it by doing a lumbar puncture. We often do this to help make the diagnosis of MS. In the future we will be measuring levels of proteins in the spinal fluid to monitor and predict the course of MS.”

“Apoptosis is a term we use for a specific way cells die.”

Whether the levels of CSF α-synuclein are changed in MS and NMO patients remain unknown. In this study, CSF α-synuclein was measured in MSers (n=18), NMOers (n=22), Parkinsoners’ (people with Parkinson’s disease) (n=9), and controls (n=11). The investigators found concentration of α-synuclein in MS and NMO patients were significantly higher than PD subgroup and the controls. Both MSers and NMOers revealed an increased disease disability with increased CSF α-synuclein. Thus, CSF α-synuclein may be reflect injure axons and neurons in inflammatory demyelinating diseases.

“Is this research important? Possibly. Someone needs to reproduce the results. If the results are reproducible α-synuclein may be a marker of poor prognosis and could be used to measure a response to treatment. If a drug works by protecting neurons from dying it should lower CSF α-synuclein levels. This is why repeated lumbar punctures are becoming important and should be included in all neuroprotective MS clinical trials. In aprticular studies in progressive MS.” 

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

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