Iron deposits in the brain of multiple sclerosis (MS) patients have long been known to play a part in the pathology of the disease. But whether it’s been the cause or an effect of the disease has not been known, until now.
A small study led by Ravi Menon of the Robarts Research Institute found iron deposits in deep gray matter of the brains of undiagnosed MS patients, suggesting the accumulation occurs very early in the disease. Researchers also found evidence casting doubt on the controversial liberation therapy that constricted neck veins are to blame for MS.
The findings may lead to a faster diagnosis of MS, an autoimmune disease that affects an estimated 400,000 Americans and more than two million people worldwide. The findings were published in Multiple Sclerosis and Related Disorders.
“We wanted to know if the iron deposits happen early in the process, or whether it’s something that accumulates with time as the disease progresses,” said Menon, who holds a Canada Research Chair in Functional Magnetic Imaging.
Menon and his team from the University of Western in Ontario, Canada used magnetic resonance imaging (MRI) to look for iron deposits in the brains of 22 patients who had only one attack. Because they have yet to be diagnosed as having MS, they are referred to as having clinically isolated syndrome (CIS).
At least half the patients who have a single clinical attack will go on to be diagnosed with MS. The others may have a different disease.
The scientists found iron deposits in the CIS group that were well above the amounts found in a control group. The MRIs also revealed subtle damage to the brain’s white matter even at this early stage. Researchers also found no correlation between the iron deposits and diameter of the veins.
“So while the iron in the brain correlates with the disability of the subjects, the iron in the brain does not correlate with the actual diameter of the jugular veins,” said Menon.
Because diagnosing MS often involves ruling out other possible diseases a patient is suffering, the sooner doctors can identify MS, the sooner a patient’s treatment can begin.
Menon plans to follow the patients in his study every four months for the next two years to see what characterizes those that go on to be diagnosed with MS compared to those who do not.
“We’re looking at a couple of different approaches to diagnostics using this imaging research. In suspected MS cases –the very first time they appear in clinic, if they have an abnormally high amount of iron in the frontal cortex of the brain –that’s probably a pretty good sign they have MS or some other white matter disease,” he says.
MS is a chronic disease which attacks the body’s central nervous system and is characterized by the destruction of myelin, the membrane that protects nerves in the spinal cord and brain. Once damaged, it inhibits the nerves’ ability to transmit electrical impulses, causing cognitive impairment and mobility dysfunction, including loss of balance, impaired speech, double vision, extreme fatigue and paralysis.
Canada has one of the highest rates of MS in the world, with three Canadians being diagnosed every day.
Here is a video of Menon, explaining his research:
The most common form of MS, relapsing-remitting multiple sclerosis, is characterized by episodes of worsening neurologic function followed by periods of remission involving partial or complete recovery.
Symptoms may be mild or severe, ranging from numbness in the limbs to paralysis or loss of vision. The progression, severity and symptoms of MS are unpredictable. Over time, recovery periods may be incomplete, leading to progressive decline.
There is no cure for MS. The only therapies available are ones that modify its symptoms.