HEALTH

Multiple Sclerosis: The Role of Chronic Lesions

Mon Dec 23 2024
Multiple sclerosis (MS) causes increasing disability due to long-term inflammation in the brain and spinal cord. This ongoing inflammation, called smoldering neuroinflammation, is tough to treat with current medications. Chronic active white matter lesions are a big part of this problem. Initially, these lesions were only seen in autopsies. But now, we have advancements in brain imaging that allow us to see them in living patients. One type of lesion, called paramagnetic rim lesions (PRLs), shows up as a rim around the damaged area, made of cells containing iron. Another type, slowly expanding lesions, grows over time in a circular pattern. Recent studies suggest that people with these lesions might have a more severe form of MS. Because PRLs are specific to MS, they're now part of the diagnosis process. They could also help predict who will progress quickly. As we learn more about these lesions, we'll be able to understand MS better and develop new treatments. But first, we need to make sure the imaging techniques are reliable and easy to use.

questions

    What are the ethical implications of using advanced neuroimaging techniques to monitor CALs in MS patients?
    How do we ensure that the validation and standardization of in vivo biomarkers of CALs are objective and not influenced by industry interests?
    Could the focus on PRLs be diverting attention from more effective but less profitable treatments?

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