Did you know multiple sclerosis (MS) means multiple scars? New research shows that the brain and spinal cord scars in people with MS may offer clues to why they developprogressive disability but those with related diseases where the immune system attacks the central nervous system do not. Researchers assessed if inflammation leads to permanent scarring in these three diseases.

In a study published in Neurology, Mayo Clinic researchers and colleagues assessed if inflammation leads to permanent scarring in these three diseases:

• MS.
• Aquaporin-4 antibody positive neuromyelitis optica spectrum disorder (AQP4-NMOSD).
• Myelin oligodendrocyte glycoprotein antibody associated disorder (MOGAD).

They also studied whether scarring may be a reason for the absence of slow progressive disability in AQP4-NMOSD and MOGAD, compared with MS.

«The differences in scarring that we found will help physicians distinguish these three diseases more easily to aid in diagnosis,» says Eoin Flanagan, M.B., B.Ch., a Mayo Clinic neurologist and senior author of the study. «More importantly, our findings improve our understanding of the mechanisms of nerve damage in these three diseases and may suggest an important role of such scars in the development of long-term disability in MS.»

In all three of these diseases, the body’s immune system targets the myelin, the insulation around nerves. This causes inflammation and leads to removal of myelin, called demyelination, within the brain and spinal cord. Visual problems, numbness, weakness, or bowel or bladder dysfunction are common symptoms. Areas of demyelination, known as lesions, appear as white spots on an MRI. The repair mechanisms within the body try to reinsulate the nerves and repair the lesions, but this may be incomplete, leading to a scar that remains visible on future MRIs. Just like an electrical cable without its insulation, this scar may leave nerve fibers vulnerable to further damage and to degenerate over time.

The study included 156 patients, consisting of 67 patients with MS; AQP4-NMOSD, 51; and MOGAD, 38. These patients had172 attacks, or relapses, combined.

Story Source:
Materials provided by Mayo Clinic. Original written by Susan Barber Lindquist. Note: Content may be edited for style and length.