Multiple Sclerosis, Migraine And Dementia: New Insights From Neuroimaging



There really are some insights here, especially the part about brain
atrophy and fatigue syndrome
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ENS 2010: Multiple Sclerosis, Migraine And Dementia: New Insights From
Neuroimaging

22 Jun 2010

"Innovative imaging techniques such as functional MRI or diffusion
tensor imaging occupy an important place in modern neurology today.
With their help we can better understand diseases such as multiple
sclerosis, dementia, amyotrophic lateral sclerosis or Alzheimer's
disease," says Prof. Massimo Filippi (Milan), committee member of the
Annual Meeting of the European Neurological Society (ENS), taking
place in Berlin between 19 and 23 June, 2010. Over 3,000 neurologists
from around the world are meeting in Berlin.

The proven imaging techniques in neurology, also referred to as
neuroimaging, include technologies such as functional magnetic
resonance imaging (fMRI), diffusion tensor imaging or voxel based
morphometry (VBM). These technologies provide precise images of the
structure of the brain and allow doctors to observe the functional
processes in the human brain, from cellular changes to processes
activated when people act, think and feel. "We have to learn to
understand the central nervous system. That is the only way we can
gain insights into the development of diseases and improve
treatments," says Prof. Filippi.

Changes in white matter in the brain presage dementia

Neurologists await with interest the results of numerous neuroimaging
studies presented at the ENS congress. "We have gained interesting
insights particularly in the area of early detection and diagnosis of
dementia, multiple sclerosis, Parkinson's, ALS and migraine," says
Prof. Filippi. As an example he mentions diagnosis of dementia at an
early stage, a pattern of disease found also in patients with
Alzheimer's, and which affects around 35 million people worldwide. "We
have discovered that the development of dementia in older people can
be more precisely predicted on the basis of changes in white matter in
the brain."

Better assessment of primary progressive multiple sclerosis up to five
years

"When we know how damage is accumulated in the brain, we can respond
better to diseases and intervene more selectively," says Prof.
Filippi. He and his research team presented a study investigating
primary progressive multiple sclerosis (PPMS) at the ENS congress.
PPMS presents one of the most severe courses of disease among MS,
because the disease does not occur in phases, but instead the
patient's condition constantly deteriorates. Using diffusion tensor
imaging, researchers have examined the grey matter in the brain of MS
patients. It could be demonstrated that the extent of tissue damage
in the thalamus predicted the accumulation of MS related disability
five years after.

MS patients with fatigue suffer greater grey matter atrophy

In another study, scientists assessed "fatigue syndrome", one of the
most common symptoms of MS. These patients suffer continual exhaustion
and thus significant loss of quality of life. Using a procedure known
as voxel based morphometry (VBM), researchers were able to compare MS
patients with and without fatigue and matched healthy volunteers.
Significant differences were noted: MS patients with fatigue syndrome
exhibited more severe grey matter atrophy in several frontal lobe
areas of the left hemisphere, than the control groups.

Changes in the brain in migraine patients: a progressive disease?

Neuroimaging techniques don't always provide indicators for better
diagnosis, early detection or improved etiopathology. Sometimes the
entire clinical picture has to be re-thought. Thus scientists now
assume that migraine is a progressive disease. "We have been able to
establish that the brain matter of migraine patients deteriorates with
the duration of the disease," says Prof. Filippi. This assumption is
based on a study comparing 82 migraine patients with different
clinical characteristics. The results show that grey matter is
affected in migraine patients according to the differing
characteristics and duration of the disease.

Neuroimaging will continue in future to play an important role in
research and treatment of neurological diseases. The goal is to
improve techniques even further. Scientists are already focussing on a
combination of functional MRI and EEG. They hope with this combination
to gain new insights into how the human brain works.

Source:
European Neurological Society (ENS)
Article URL: http://www.medicalnewstoday.com/articles/192515.php

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