One of the aspects of my multiple sclerosis that I try hard not to think about is the physical damage the disease has done to my brain.
My brain had always been my best feature. I have not been blessed with great beauty or athletic prowess; I’m not musically gifted or good with my hands. But I could always rely on my brain: I’m smart, I’m funny and I can write a decent sentence when I have to.
So my first glimpse of the MRI that helped diagnose my MS was a real eye-opener. It was shocking to see the bright white spots where my own immune-system cells had attacked tissue in my brain, causing what was likely irreversible damage. I hated the term “white-matter lesions” referring to scars on the nerve fibers where immune cells had destroyed the protective myelin coating.
As I sat in my neurologist’s office viewing the MRI film on his lightbox, it was all there in black and white: MS had assaulted my favorite organ. And there was no telling how much farther it would go.
Neither I nor, I believe, my neurologist knew then to look for signs of damage on the thalamus, a gland that plays a key role in communication between various areas of the brain. Based on previous research, scientists already believed the thalamus (part of the brain’s grey matter, not the white matter) to be among the spots that MS targets heavily. But new research, if confirmed, adds evidence that shrinkage of the thalamus gland may indicate that MS is in play.
A study published April 23 in the journal Radiology tracked for two years 216 people with MS who’d been diagnosed with clinically isolated syndrome (a single neurological episode that often turns out to be the first symptom of MS). Decreases in the size of the thalamus, detected with MRI techniques, were found to be quite common among the 92 patients who eventually were diagnosed with MS. Moreover, shrinkage of the thalamus was a better predictor of which patients would develop MS than the presence of new lesions or the number of lesions detected by MRI.
The relationship between shrinkage of the thalamus and MS is not yet understood, and this study’s results need to be replicated in future studies, the authors note. But if the findings are confirmed, doctors may have another marker besides changes to the spinal fluid detected through lumbar puncture and white-matter lesions detected through MRI in their diagnostic arsenal. The involvement of the thalamus in the way MS develops might open new areas of research and perhaps lead to new treatments.
I’ll be honest: I wouldn’t be any happier learning that my thalamus had shrunk than I was to see those bright white spots on MRI that first time, or any time since. But I know that every new bit of knowledge science can amass about this perplexing disease marks a step toward better therapies and, one of these days, a cure. I am so grateful for these scientists’ hard work on our behalf.