Multiple sclerosis is an autoimmune disorder that affects the myelin in the central nervous system, which consists of the brain and spinal cord. When an individual has multiple sclerosis, her immune system attacks the myelin sheath in the central nervous system, resulting in nerve damage. The resulting nerve damage affects neuronal communication.
An estimated 400,000 people in the United States have multiple sclerosis, according to the National Multiple Sclerosis Society.
Currently, there is not a specific diagnostic test for multiple sclerosis. Instead, the diagnosis is made by ruling out other conditions, according to the MayoClinic.com.
Patients may undergo several lab tests, such as a blood test or a lumbar puncture, in which the health care professional takes a sample of the patient’s cerebrospinal fluid from her spinal cord.
Imaging, such as an MRI, may be done to look for lesions in the brain. Different techniques can be used with the MRI that help with diagnosing multiple sclerosis.
For example, magnetic resonance spectroscopy, or MRS, shows data on the biochemistry of the brain. If magnetization transfer imaging, or MTI, is used it can show abnormalities in the brain before an MRI would show a lesion.
Another diagnostic tool used is an evoked potential test, which measures the brain’s electrical signals. This test allows the health care provider to look at the patient’s nerve functioning.
New research is investigating diagnostic techniques that can help health care providers diagnose multiple sclerosis. One study, which was conducted by researchers at Harvard Medical School and Brigham and Women’s Hospital, looked at a molecular technique that may help diagnose more aggressive types of the disease.
The study included 363 individuals who had relapsing-remitting multiple sclerosis, which is the most common type of multiple sclerosis.
Some patients who have relapsing-remitting multiple sclerosis may develop more progressive forms of the disease, such as secondary-progressive multiple sclerosis, noted the National Multiple Sclerosis Society.
The individuals in this study had not received treatment.
The researchers examined molecularly the participants’ peripheral blood cells, finding two different subsets that they called MSa and MSb. Of the two, MSa appears to be a more aggressive subtype.
While this diagnostic technique is not ready for clinical use, the hope is that it can be used to diagnose who will develop more severe forms of the disease, thus personalizing treatment.
Another study, which was published in the Archives of Neurology, used an imaging technique called optical coherence tomography to look at the thickness of the retina, which may also help predict how the disease will progress.
The study included 84 patients who have multiple sclerosis and 24 controls. The lead researcher, Dr. Shiv Saidha, a neurologist at Johns Hopkins University, told HealthDay News that “The inner and outer retinal layer thickness, measured by optical coherence tomography, may reflect global and potentially distinct central nervous system processes in multiple sclerosis.”
This finding has the potential to help health care professionals evaluate the effectiveness of the individual’s treatment.
References
National Multiple Sclerosis Society. Who Gets MS?. Web. 3 October 2012
http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/who-gets-ms/index.aspx
MayoClinic.com. Multiple Sclerosis: Tests and Diagnosis. Web. 3 October 2012
http://www.mayoclinic.com/health/multiple-sclerosis/DS00188/DSECTION=tests-and-diagnosis
MedlinePlus Medical Encyclopedia. Multiple Sclerosis. Web. 3 October 2012
http://www.nlm.nih.gov/medlineplus/ency/article/000737.htm
National Multiple Sclerosis Society. Four Disease Courses in MS. Web. 3 October 2012
http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/what-is-ms/four-disease-courses-of-ms/index.aspx
HealthDay News. Screening Tool Reveals Two Multiple Sclerosis Types Web. 3 October 2012
http://consumer.healthday.com/Article.asp?AID=669010
HealthDay News. Retina’s Thickness May Be Tied to Severity of MS, Study Suggests. Web. 3 October 2012
http://consumer.healthday.com/Article.asp?AID=669188
Reviewed October 3, 2012
by MIchele Blacksberg RN
Edited by Jody Smith