New MS Phenotype: Myelocortical MS

[KoKo]

I found this interesting particularly "Although both MCMS and traditional MS patients had typical MS lesions in the spinal cord and cerebral cortex, only the latter group had MS lesions in the brain white matter. Despite having no typical MS lesions in the white matter, MCMS brains did have reduced neuronal density and cortical thickness, which are hallmarks of brain degeneration also observed in traditional MS."

It does sound like PPMS although I would have thought they would have made that connection in the article and not call it a separate subtype. How the heck does science figure out why the nerves are dying from the inside out? This brings up more questions and more complications than it solves for me.

I'd like to donate my brain somewhere, maybe the Cleveland Clinic is it.

Jules, also what do they mean by "traditional" MS patient brains used in the research? RRMS only, or any type?

Maybe they have to classify MCMS by itself for now (and not relate it to PPMS), since they are using only post mortem brains, and until they can figure out the technology on how to diagnose a living person with it. Confusing for sure!

I want to donate my brain also, Jules.

Take Care

[Jules A]

I found this interesting particularly "Although both MCMS and traditional MS patients had typical MS lesions in the spinal cord and cerebral cortex, only the latter group had MS lesions in the brain white matter. Despite having no typical MS lesions in the white matter, MCMS brains did have reduced neuronal density and cortical thickness, which are hallmarks of brain degeneration also observed in traditional MS."

It does sound like PPMS although I would have thought they would have made that connection in the article and not call it a separate subtype. How the heck does science figure out why the nerves are dying from the inside out? This brings up more questions and more complications than it solves for me.

I'd like to donate my brain somewhere, maybe the Cleveland Clinic is it.

[KoKo]

What interests me after reading your explanation is that I had an LP and no O-Bands. If O-Bands are "shedding of myelin", perhaps I have this newly identified subtype?? My myelin is not shedding but my nerves are?? Just a thought. This new discovery could explain why my MS always seemed so much weirder and why none of the current DMTs were not helpful...hmmmm....I will be keeping my eyes open for further information on this topic.

Tawanda, that's a very interesting notion about the clean LP and no myelin breakdown.

I too have thought about the way DMT's are not effective in the progressive types.

I bet you'll make a good researcher in your next life, Tawanda. You are quite inquisitive, and also you bring up good topics on this site for discussion and "brain-picking".

Take Care

[Tawanda]

Tawanda ~ you're pretty much pointing out the same new issues that the researchers are also pondering.

From the article:

“The importance of this research is two-fold.

The identification of this new MS subtype highlights the need to develop more sensitive strategies for properly diagnosing and understanding the pathology of MCMS,” said Daniel Ontaneda, M.D., clinical director of the brain donation program at Cleveland Clinic’s Mellen Center for Treatment and Research in MS.

“We are hopeful these findings will lead to new tailored treatment strategies for patients living with different forms of MS.”

I'm wondering if this is basically what's happening in PPMS?

Take Care

Hi Koko, this is part of Snoopy's response to the LP thread by Boudreaux:
"Hi Boudreaux.

I had a LP

I was told a positive LP (o-bands) indicates active demyelination, the shedding of myelin."

What interests me after reading your explanation is that I had an LP and no O-Bands. If O-Bands are "shedding of myelin", perhaps I have this newly identified subtype?? My myelin is not shedding but my nerves are?? Just a thought. This new discovery could explain why my MS always seemed so much weirder and why none of the current DMTs were not helpful...hmmmm....I will be keeping my eyes open for further information on this topic.

[KoKo]

This new research was performed on autopsied MS brain tissue. On some of the brains, they found damaged and destroyed nerve fibers, but oddly enough, the myelin coating was ok, and had not been attacked by the immune system.

In other words, there was neurodegeneration (nerve fiber death/damage) without the typical demyelination (attack on the myelin coating) as the cause.

Wow! This is a real game-changer! I am guessing they cannot figure out who has it and who doesn't in a live person as yet. If they do get there, I wonder how it the patient will be treated!

Tawanda ~ you're pretty much pointing out the same new issues that the researchers are also pondering.

From the article:

“The importance of this research is two-fold.

The identification of this new MS subtype highlights the need to develop more sensitive strategies for properly diagnosing and understanding the pathology of MCMS,” said Daniel Ontaneda, M.D., clinical director of the brain donation program at Cleveland Clinic’s Mellen Center for Treatment and Research in MS.

“We are hopeful these findings will lead to new tailored treatment strategies for patients living with different forms of MS.”

I'm wondering if this is basically what's happening in PPMS?

Take Care

[Tawanda]

This new research was performed on autopsied MS brain tissue. On some of the brains, they found damaged and destroyed nerve fibers, but oddly enough, the myelin coating was ok, and had not been attacked by the immune system.

In other words, there was neurodegeneration (nerve fiber death/damage) without the typical demyelination (attack on the myelin coating) as the cause.

Wow! This is a real game-changer! I am guessing they cannot figure out who has it and who doesn't in a live person as yet. If they do get there, I wonder how it the patient will be treated!

[KoKo]

To be perfectly honest, I saw this article in my email, read it twice, and still don't get it (then again, I could never figure out MRI reports or even my cell phone!).

Tawanda

I'll give it a try (the way I understand it).

Myelin is the fatty substance that coats the nerve fibers (axons). It helps to protect the nerve fibers in order to keep the nerve impulses flowing properly, at the right speed.

In typical MS, the immune system attacks the myelin, and can also cause damage down into the nerve fibers (axons) as well - disrupting, slowing down, and sometimes blocking nerve signals.

This new research was performed on autopsied MS brain tissue. On some of the brains, they found damaged and destroyed nerve fibers, but oddly enough, the myelin coating was ok, and had not been attacked by the immune system.

In other words, there was neurodegeneration (nerve fiber death/damage) without the typical demyelination (attack on the myelin coating) as the cause.

So, they have named this new MS sub-type Myelocortical MS.

That is my understanding (non-professional, of course).

Take Care

[Tawanda]

I need this dumbed down!

To be perfectly honest, I saw this article in my email, read it twice, and still don't get it (then again, I could never figure out MRI reports or even my cell phone!).

[pennstater]

Thanks, as always Marco. I knew for awhile they suspected there were these two processes. Gives me hope treatment will evolve, and research into causes will eventually lead to a cure. A huge thanks to those who donate their brains and body to science.



"The team’s findings support the concept that neurodegeneration and demyelination can occur independently in MS and underscore the need for more sensitive MRI imaging techniques for evaluating brain pathology in real time and monitoring treatment response in patients with the disease."

[headrift]

Interesting find, Marco. Good to know, thanks.

[Marco]

Researchers have identified a new subtype of multiple sclerosis (MS), one marked by nerve cell degeneration that occurs independently of immune system attacks against myelin, a process known as demyelination and considered a hallmark of MS.


The new subtype — called myelocortical MS — is indistinguishable from others in the MS spectrum using conventional magnetic resonance imaging (MRI), highlighting the need for more sensitive MRI imaging techniques.

https://newsroom.clevelandclinic.org...ple-sclerosis/