MRI in MS: Amazing NEW video to understand different MRI changes seen in multiple sclerosis: T2, FLAIR, contrast, black holes, and atrophy.
mri
Your guide to having an MRI
Magnetic Resonance Imaging, also know and MRI, uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body.
This infographic will give you great insight to the history of MRI and the future. You will also learn the difference between the 1.5T and the 3T technology. It will give you a better understanding of an MRI as well as how to prepare for one.
Multiple sclerosis – some ideas about the causes of MS
Multiple Sclerosis Journey
Exactly why someone develops multiple sclerosis (MS) isn’t known. It’s not caused by anything you’ve done and it’s not clear whether it can be prevented.
What is known so far suggests it’s caused by a combination of genetic and environmental factors.
What happens in MS
MS is an autoimmune condition, which means your immune system mistakes part of your body for a foreign substance and attacks it.
In the case of MS, it attacks the myelin sheath in the brain and/or spinal cord. This is the layer that surrounds your nerves, protecting them and helping electrical signals travel from the brain to the rest of the body.
The attacks cause the myelin sheath to become inflamed in small patches (plaques or lesions), which can be seen on a magnetic resonance imaging (MRI) scan.
These patches of inflammation can disrupt the messages travelling along the nerves. It can slow them down, jumble them, send them the wrong way, or stop them from getting through completely. This disruption leads to the symptoms and signs of MS.
When the inflammation goes away, it can leave behind scarring of the myelin sheath (sclerosis). These attacks, particularly if frequent and repeated, can eventually lead to permanent damage to the underlying nerves.
Why do people get MS?
It’s not clear what causes the immune system to attack the myelin sheath.
It seems likely that it’s partly caused by genes you inherit from your parents and partly by outside factors that may trigger the condition.
Some of the factors that have been suggested as possible causes of MS include:
your genes – MS isn’t directly inherited, but people who are related to someone with the condition are more likely to develop it; the chance of a sibling or child of someone with MS also developing it is estimated to be around 2-3%
lack of sunlight and vitamin D – MS is more common in countries far from the equator, which could mean that a lack of sunlight and low vitamin D levels may play a role in the condition, although it’s not clear whether vitamin D supplements can help prevent MS
smoking – people who smoke are about twice as likely to develop MS compared to those who don’t smoke
viral infections – it has been suggested that infections, particularly those caused by Epstein-Barr virus (responsible for glandular fever), might trigger the immune system, leading to MS in some people
More research is needed to further understand why MS occurs and whether anything can be done to prevent it.
Multiple sclerosis – How is MS diagnosed?
New Multiple Sclerosis Treatment
It can be hard to tell whether your symptoms might be caused by multiple sclerosis (MS) at first, as some of the symptoms can be quite vague or similar to other conditions.
See your GP if you think you have symptoms of MS. Letting them know about the type and pattern of symptoms you’re experiencing in detail will help them determine whether you might have the condition.
If your GP thinks you could have MS, you should see a neurologist (a specialist in conditions of the nervous system) for a specialist assessment.
Tests for MS
Diagnosing MS is complicated because no single test can positively diagnose it. Other possible causes of your symptoms may need to be ruled out first.
It may also not be possible to confirm a diagnosis if you have had only one “attack” of MS-like symptoms. A diagnosis can only be made with confidence once there’s evidence of at least two separate attacks, although this may include signs of attacks on an MRI scan that you may not realise you have had.
Some of the tests you may need to confirm MS are outlined below.
Neurological examination
Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes.
These may show whether your nerves are damaged in a way that might suggest MS.
Magnetic resonance imaging (MRI) scan
A magnetic resonance imaging (MRI) scan is a painless scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.
It can show whether there’s any damage or scarring of the myelin sheath (the layer surrounding your nerves) in your brain and spinal cord. Finding this can help confirm a diagnosis in most people with MS.
A standard MRI scanner is like a large tube or tunnel. The machine is noisy and some people feel claustrophobic while the scan is done. Tell your neurologist if you’re worried about this.
Newer scanners are more open and work quicker than those used in the past, and most people have scans without any problems.
Evoked potential test
There are several types of evoked potential test.
The most common type assesses how well the eyes work. Light patterns are shown to the eyes while your brainwaves are monitored using small, sticky patches called electrodes placed on your head.
It’s a painless test and can show whether it takes your brain longer than normal to receive messages.
Lumbar puncture
A lumbar puncture is a procedure to remove a sample of your spinal fluid by inserting a needle into the lower back. Spinal fluid is the fluid that surrounds your brain and spinal cord, and changes in the fluid can suggest problems with the nervous system.
The procedure is done under local anaesthetic, which means you’ll be awake, but the area the needle goes in will be numbed. The sample is then tested for immune cells and antibodies, which is a sign that your immune system has been fighting a disease in your brain and spinal cord.
Lumbar punctures are very safe, but are often uncomfortable and can cause a headache that occasionally lasts for up to a few days.
A lumbar puncture will often be performed to provide extra information if your symptoms or scans are unusual.
Blood tests
Blood tests are usually performed to rule out other causes of your symptoms, such as vitamin deficiencies or a very rare, but potentially very similar, condition called neuromyelitis optica.
Determining the type of MS
Once a diagnosis of MS has been made, your neurologist may be able to identify which type of MS you have.
This will largely be based on:
the pattern of your symptoms – such as whether you experience periods when your symptoms get worse (relapses) then improve (remissions), or whether they get steadily worse (progress)
the results of an MRI scan – such as whether there’s evidence that lesions in your nervous system have developed at different times and at different places in your body
However, the type of MS you have often only becomes clear over time because the symptoms of MS are so varied and unpredictable. It can take a few years to make an accurate diagnosis of progressive MS, as the condition usually worsens slowly.
- Brain
- The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.
- Inflammation
- Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
- Lesions
- A lesion is an abnormal change in an organ or body tissue because of injury or disease.
- MRI
- MRI stands for magnetic resonance imaging. It is the use of magnets and radio waves to take detailed pictures of inside the body.
Why do young people with Type-2 Diabetes go on to develop heart damage?
Diabetes Awareness
The research team, led by Dr Gerry McCann, Consultant Cardiologist at Leicester’s Hospitals and NIHR Fellow and Professor Melanie Davies, Honorary Consultant at Leicester’s Hospitals, Director of the Diabetes Centre and Professor of Diabetes Medicine at the University of Leicester, are going to use MRI scanning to determine what causes early heart failure in 100 younger adults with diabetes.
The study will randomly allocate patients to different treatment arms. The first group will receive optimal blood sugar lowering treatment and lifestyle advice. The second, a very low calorie diet and the third, moderate intensity exercise training. The research team hope that conducting MRI scans throughout this period will indicate whether early heart damage can be completely reversed.
Dr McCann stated “Patients with diabetes are four times more likely to develop heart failure and other circulation problems. Younger diabetics have the greatest life-time risk of complications and death. It is essential that we develop tools to diagnose heart failure early and effective treatments to prevent this serious life threatening condition progressing. This NIHR award will see Leicester’s cardiovascular and diabetes research units working together to combat heart failure developing in patients with diabetes.”
It is hoped that by using the evidence produced by the MRI scans to compare the different treatment methods, it will lead to better treatments that prevent hospitalisation with heart failure and premature deaths.
Prof. Davies noted “We have seen a dramatic increase in the numbers of people developing Type-2 diabetes at a younger age. Our previous work has shown that younger people already have evidence of heart damage. We want to see if we can intervene and reverse these really worrying changes.
I am delighted that we have been awarded this prestigious award funding to allow us to carry out this important and innovative work in Leicester.”