A new study rubs salt into head wounds, prompting experts to think again when treating multiple sclerosis (MS).
According to the research published in the online journal Radiology, an excess of sodium in the brain could cause the degeneration of nerve cells that most commonly affect patients with MS. The intent behind the experiment was to inspect the mechanisms of relapsing-remitting multiple sclerosis (RRMS), the most common mode of MS where internal blitzes that damage neurological function are then followed by brief epochs of recovery. Sodium MRIs were conducted on 26 MS patients — 14 subjects were characterized as early-stage RRMS (less than five years in duration); the remaining 12 participants fell into the advanced disease distinction (longer than five years). Fifteen control partakers, matched on the basis of age and sex, were incorporated into the study as well. Researchers discovered that those in the early stages of MS had sodium buildup in specific brain regions, while those suffering from the advanced stages of the disease displayed sodium accumulation throughout the entire brain.
Predictability is notoriously lacking in MS diagnoses. The nature of the disease propels a body’s immune system to essentially turn on itself, assailing the myelin sheaths cloaking nerve cells to the point of scarring. Once blemished, the neurons no longer conduct signals successfully, effectuating neurological and physical disability. As all bodies are different, it’s difficult for physicians and medical professionals to evaluate how any given person who develops MS will react to the disease and exactly how far the impairment will progress.
"A major challenge with multiple sclerosis is providing patients with a prognosis of disease progression," said Patrick Cozzone, PhD, director emeritus of the Center for Magnetic Resonance in Biology and Medicine, a joint unit of the National Center for Scientific Research (CNRS) and Aix-Marseille University in Marseille, France. "It's very hard to predict the course of the disease."
Nevertheless, Cozzone, with the aid of Wafaa Zaaraoui, PhD, research officer at CNRS, Jean-Philippe Ranjeva, PhD, professor in neuroscience at Aix-Marseille University and a European team of specialists hailing from several disciplines, ventured forth to uncoil MS procedures one mind at a time.
"We collaborated for two years with chemists and physicists to develop techniques to perform 3T [3 Tesla] sodium MRI on patients," Zaaraoui said. "To better understand this disease, we need to probe new molecules. The time has come for probing brain sodium concentrations."
Investigators implemented specialty hardware and software to gauge the sodium content of cells visible through the sodium MRI images. Early-stage RRMS patients had noticeably high volumes of sodium in the brain stem, cerebellum and temporal pole of the brain. Advanced-stage RRMS participants had tremendous volumes of sodium prevalent in all brain regions, even in what looked to be normal brain tissue.
"In RRMS patients, the amount of sodium accumulation in gray matter associated with the motor system was directly correlated to the degree of patient disability," Zaaraoui added.
Sodium possesses the dichotomy of a nuclear weapon — at once a totem warding off assault, it can simultaneously signify the imminent destruction of its beholder if erroneously handled. In the case for MS treatment, the prevalence of sodium accumulation can be used as a biomarker of neuron degeneration instead of strictly a biohazard. This knowledge could abet pharmaceutical companies in developing potential remedies with longer-lasting relief than the current crop of treatments, which only have the ability to stall the progress of MS temporarily.
"Brain sodium MR imaging can help us to better understand the disease and to monitor the occurrence of neuronal injury in MS patients and possibly in patients with other brain disorders," Ranjeva concluded.