The diagnosis of multiple sclerosis strikes fear into the hearts of thousands of patients every year. Despite years of research in the medical community, the cause of the disease remains a mystery and the cure elusive. Multiple sclerosis, or MS, as it is commonly referred to, affects women more than men. It occurs most frequently between the ages of 20 and 40 but can occur at any age. In the past, diagnosis has been limited to a spinal tap and MRI’s that show lesions in the brain and/or spinal cord. Now there is hope in a new type of CAT scan called optical coherence tomography, or OCT.
MS is an autoimmune disease which means the body attacks its own cells. In the case of MS, the areas attacked are the brain, spinal cord, or optic nerve. The pathology of the disease involves the myelin sheath, which is a protective covering that surrounds the nerve cells that make up the central nervous system, or brain and spinal cord. This covering is missing in the optic nerve. The myelin sheath is damaged when the body’s cells attack the brain or spinal cord, causing inflammation. It is unknown what triggers this inflammation. Some researchers believe it is caused by a virus. Others believe it is genetic or environmental. (PubMed Health, Multiple Sclerosis, MS; demyelinating disease, Sept. 26, 2011).
MS produces many symptoms. This is because the inflammation along the myelin sheath can occur in different areas of the brain or spinal cord and may inflame different areas each time an attack occurs. These attacks can last days, weeks, or months. The attacks may be mild or severe. When an attack subsides, the disease is said to be in remission. Symptoms may include:
• muscle spasms
• loss of balance
• loss of coordination
• trimmer and/or weakness in arms or legs
• bowel and/or bladder incontinence
• double vision or vision loss
• memory loss
• loss of ability to reason
MS is broken down into three classifications. Most people have the relapsing type where the symptoms occur then go into remission. Once the disease has lasted for a decade or more, the symptoms tend to get worse. The periods of remission become infrequent, and the disease is said to be in the secondary progressive classification. In the third classification, the symptoms are serious from the beginning, and there are no periods of remission. This type is called the primary progressive type. (Ibid).
Optical Coherence Tomography
There are no cures for MS, but the available treatments do slow its progression. The problem comes in attempting to monitor the disease for the purpose of treatment. MRI’s of the brain or spinal cord can detect lesions that reveal scarring, but there is a need to determine when these changes begin and whether they depict ongoing damage or new attacks. Researchers have been looking for ways to track the progression of the disease in order to plan treatment. They believe they have found the answer in the optical coherence tomography, or OCT. The OCT measures the thickness of nerve fibers found in the retina at the back of the eye, which form the optic nerve.
As stated earlier, these nerve fibers differ from nerves found in the brain or spinal cord, because they do not possess the protective myelin sheath. Since they don’t have this protective sheath, researchers believe these nerves will be the first to show signs of MS damage. A study involving 164 patients, which occurred at Johns Hopkins, revealed that patients who had relapses of MS had faster thinning of the retina than those who had no relapses. The study also showed that those with increased disability showed increased thinning of the retina, and those with lesions on the MRI had increased thinning. Researchers involved in the study believe that the effectiveness of new treatments for MS may also be tested by this new OCT scan. In other words, the OCT not only promises to be a tool that will enable physicians to monitor disease progression but will provide a measure for the success of new treatments. OCT offers hope that the quality of life for patients afflicted with MS will improve. (“Eye Scan Reveals Multiple Sclerosis”, Charles Ayoub World Web, 2011).
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