Knowing about damage or not

Barts-MS rose-tinted-odometer: ★ (seeing orange; halfway between red and yellow) Do you want to know how badly damaged your MS brain is or would you prefer to put your head in the sand and ignore it? This is a dilemma facing a large number of you. Do you ask your neurologist if you have exaggerated or accelerated brain atrophy? Do you ask to have cognitive screening to see how good or bad your...

MS lesions that smoulder

Iron Rims image from Frontiers The characteristic feature of is multi-focal inflammatory activity; an infiltration of immune cells leading to loss of myelin and axons within these areas creating the appearance of round lesions. The natural evolution of these lesions like any area of injury in the rest of the body and shrink to a certain degree overtime. A fraction, however, continue to smoulder...

The central vein sign in MS

Multiple Sclerosis (From Reich et al NEJM 2018) Last week, I blogged on smoldering lesions visualized on MRI as a marker of progressive MS. Today, I will discuss the central vein sign. This publication in JAMA by the MAGNIMS group (a group of MRI bods from the world over) is therefore, timely. If you haven’t heard of the central vein sign, it is the presence of a vein within an MS lesion...

What is happening to my cortex?

A very common analogy is the comparison of MS to an iceberg. Why? Only one-eighth of an iceberg is visible above the water; to see what is below the water line requires specialised technology. The MS iceberg analogy refers to several observations: 1. For each clinical relapse, 10 or more MRI visible lesions are seen on MRI.2. For each visible white matter lesions on MRI, there are at least an...



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