Diagnosing multiple sclerosis is not a simple process. It is often a question of ruling out other possibilities for the symptoms a patient is suffering and can be time-consuming. But researchers from The University of Western Ontario, Canada, may have found a way of speeding things up.
Iron deposits in the brain are a common feature of multiple sclerosis (MS), but it is not known if these are a cause or effect of the disease. Ravi Menon, PhD, from the Robarts Research Institute claims a new study brings us closer to finding the answer.
The research, published in Multiple Sclerosis and Related Disorders, found iron deposits in deep gray matter in patients’ brains, suggesting the accumulation begins at a very early stage in the disease.
As the National Multiple Sclerosis Society notes, the onset of MS can be a distressing time for patients. The range of symptoms are applicable to many diseases, which makes it a worrying time, and attacks may be separated by lengthy time intervals.
According to the Society, to reach a diagnosis of MS, doctors must:
- Find at least two areas of damage in the central nervous system, which includes the brain, spinal cord and optic nerves
- Find evidence that the damage occurred at least 1 month apart, and
- Rule out all other possible causes.
This means that diagnosis is seldom possible after the first attack – these patients are referred to as having clinically isolated syndrome (CIS) – although the study notes that at least half of CIS patients will go on to develop MS.
Menon and his colleague, PhD candidate Matthew Quinn, used 3-Telsa Magnetic Resonance Imaging (MRI) scans to look for iron deposits in the brains of 22 CIS patients, using 16 age and gender matched people as controls.
“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.
We also studied the veins that drain from the brain and looked for a correlation between the diameter of these veins and iron accumulation. One of the reasons to do this, of course, was the hypothesis proposed by Carlos Zamboni that if you had narrow jugular veins, this would give rise to additional iron and in turn cause MS.”
The results show that iron deposits among the CIS group were significantly higher than those of the control group. They also showed subtle damage to the brain’s white matter in the CIS group, even at this early stage.
And the researchers were able to rule out the connection between vein diameter and iron deposits.
“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. So the Zamboni hypothesis is incorrect as far as the iron being related to some kind of obstruction.”
By continuing to study the CIS patients every 4 months for the next 2 years, the researchers hope that this imaging technique will lead to an earlier diagnosis for MS patients.
“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.”