Friday, April 4, 2008
Another Piece of the Puzzle
I forgot to mention in my last post that I asked Dr. Murray that all important question about frustration: Do he and other researchers get frustrated with not knowing the unknowns of MS? Short answer is yes. Longer answer is that's why so many researchers continue what they do; because they want to know the unknowns.
Now the stuff that I've been really thinking about this week, especially since my post on Wednesday:
It appears that MRI is a good way to help diagnose MS, as a way to confirm a clinician's observations and a patient's symptoms. But there is so much more going on in our brains than can be detected with this particular machine.
We (not me personally) have discovered that normal appearing white matter (NAWM) is affected by MS, even if it doesn't show up on MRI - hence the name normal appearing. There may be axonal damage or destruction. It appears that this has greater significance to the prognosis of an individual than the number of lesions.
So how do we measure the axonal damage? We can only measure chemical processes in the brain and that includes chemical volume. All week I've been thinking about this. I should have asked someone first as I didn't know what to look for on the net...until I had a lightbulb moment. We need a mass spectrometer of course. If you've ever watched an episode of CSI or some other criminal/forensic show you'll know that a mass spectrometer is a machine that measures the chemicals in tissue samples. So we just need a mass spectrometer big enough to stick our heads into and we'll be all set. (In discussing this with the Wookie tonight though, I realized that since with a mass spectrometer you have to vaporize the tissue sample then shine a beam of light through it, there are limitations for its live human use.)
A little more wondering about that, and if someone has undertaken the task, led me to discover that again, I have no original thought. They've had Magnetic Resonance Spectroscopes since 1973! An MRI -type machine. Who knew? Apparently everyone but me. But it seems that it hasn't been refined enough yet to be an accepted standard modus operandi for determining how "progressive" or not your MS is. *Sigh*
It's a similar type of machine as an MRI so it's big and costs a lot of money. But the applications for its use are incredible. Imagine having a picture taken of your body instead of having blood drawn to determine if your cholesterol medication levels are too high or two low. Or if the chemo is going to the places it's supposed to go to. Or if your brain is producing enough serotonin so you're not depressed. Or if the axons in your brain are severed and producing a tell-all chemical to indicate their dysfunction.
There are some of these machines in use around the world. I just can't seem to find too many of them. There was even an article published in a neurological journal of some sort about how these machines can be used for people with MS, but I can't read the article without joining or paying for it.
So what's the point? The point is that until recently we didn't know that stuff was going on in NAWM. We suspected it. If you cut your finger, your body goes through a whole whack of processes to detect intrusions, intruders, and bad bacteria; then it aims to clean up the wound, seal it, and then heal it. All of that activity takes a number of chemical processes to get to completion. It stands to reason the same things happen in our traumatized brains: chemicals swishing around in there as a result of the disease process. Too much of one chemical shows that axonal damage has occurred. Too much of another reveals inflammation. You get the idea. So this really shows that like MS involving entire families and not just an individual, it's a whole brain disease. But again, "What's the point?" *Sigh*
If I were a pessimist, I would say big deal. That just shows us that MS is a bigger question mark than before. Now we have to worry about the stuff we can't see happening.
Well, firstly, if MR Spectroscopy is as good a tool as I think it appears to be, not only will an earlier diagnosis be possible, but earlier drug treatment can be implemented if your brain shows a propensity for axonal loss.
Secondly, it can give us a better picture of any drug's actions in the brain. Is it actually preventing neuronal damage or loss?
Thirdly, it's another piece of that giant puzzle. I'm not really sure where the piece goes just yet, but it's another piece just the same. After all, the more you know about a problem, the easier it is to figure out. At least, I hope it is for all those neuroscientists.