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New biomarker could be a game changer for multiple sclerosis research, study

by Loren Bonner, DOTmed News Online Editor | April 24, 2013
Dr. Robert Zivadinov
A new study could give multiple sclerosis researchers more insight into the disease and potentially offer clinicians a better way to treat patients with MS.

Most doctors evaluate MS by examining MRI scans of new gadolinium-enhanced lesions on patients after an initial attack. But over the past few years, MS research has focused on an area deep within the brain called the thalamus. As more studies surface, MRI measurements of thalamic atrophy are being viewed as an improvement over the current evaluation method.

This new study is one of them. Published online in the journal Radiology, the study is the first to examine thalamic volume in patients longitudinally. It looked at both the appearance of new lesions and the loss of thalamic volume over a two year period. Decreases in thalamic volume and an increase in lateral ventricle volumes were the only MRI measures independently associated with the development of clinically definite MS, according to the study.
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"We found that the deterioration of the thalamus was actually more predictive for the second clinical attack than the appearance of gadolinium-enhanced lesions," Dr. Robert Zivadinov from the Buffalo Neuroimaging Analysis Center of the University at Buffalo in Buffalo, N.Y, told DOTmed News. "This is an important finding because it's telling you that actually we should be open to looking at other markers of the disease."

Zivadinov said translating his results for the clinical space is still one big hurdle since radiologists can't volumetrically measure thalamus on a scan. However, one answer might come in looking at the enlargement of the third ventricle — an indirect sign of thalamic atrophy.

MS develops as the body's immune system attacks and damages myelin, the protective layer of fatty tissue that surrounds nerve cells within the brain and spinal cord. Symptoms include visual disturbances, muscle weakness and trouble with coordination and balance.

Zivadinov considers his study a breakthrough for establishing a new MS biomarker, which can also influence the way new drugs are developed to treat MS. Thalamic atrophy, also an ideal MRI biomarker because it's detectable at a very early stage of the disease.

"I would say the value of this study in radiology is really using this as a biomarker. I think that all future trials that are investigating the effects of therapy should use thalamic atrophy as the principle neurodegenerative biomarker," said Zivadinov.

Currently, there is no cure for MS, but early diagnosis and treatment can slow development of the disease.

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