Gray matter atrophy is related to long-term disability in MS
Submitted by art on Fri, 2008-07-11 07:17.
MS has largely been termed a white matter (WM) disease with a focus on lesions and myelin breakdown. More and more evidence is being produced to indicate that gray matter (GM) plays a significant role.
This study looked at WM and GM in people with long-duration MS. They conclude that in MS patients with a relatively long and homogeneous disease duration, GM atrophy is more marked than WM atrophy, and reflects disease subtype and disability to a greater extent than WM atrophy or lesions.
It's a pity that this sort
It's a pity that this sort of research can't be focused on getting answers rather than just recording observations. So many questions: which comes first - grey matter or white matter damage; does white matter damage lead to grey matter damage; are there different disease processes at work; how can the grey matter loss be slowed / stopped; is re-myeliantion going to have any impact if its primarily a grey matter disease.
A good analogy is a rusting car door. Is it the damage to the paintwork on the outside that leads to the rusting door or is the door rusting from the inside and then causing damage to the paintwork on the outside? Until the so called experts can start to answer the really basic questions we are still some way off from a cure.
I love your analogy and I
I love your analogy and I will be stealing it.
As an engineer, this is the biggest complaint I have about so much of the "science" that gets done. It is just recording observations - no real analysis or synthesis gets done. The point should be to answer a question that matters in the clinic. If you can't tie what you are working on to something clinically relevant (even if it takes many steps), then don't call it "MS research" - just call it "research".
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Art Mellor, Accelerated Cure Project for MS, art-msnews -at- acceleratedcure.com
You're welcome to steal it.
You're welcome to steal it. It was my own (my dad was a car mechnanic and used to do quite a bit of bodywork - which may have been behind my thinking). My neuro said it was a good analogy but then added "we just don't know".
Maybe there will be some breakthroughs announced at the ACTRIMS / ECTRIMS / LACTRIMS conference in September! No Greek restaurants and sandy beaches for you and Hollie this year!
Do you have any ideas how
Do you have any ideas how one would structure a study to find the cause? It seems like some of these things require very small steps to even know what questions to ask.
You contradict yourself. You
You contradict yourself.
You make a valid point that a cure can't be sought without knowing the underlying cause then bemoan the fact that this research is being done.
I didn't complain that this
I didn't complain that this research is being done. I complained about research that was solely descriptive. We need *understanding*, not just description. We need to link descriptions to theories and models that allow us to predict future behavior so that we can change it to alleviate the disease.
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Art Mellor, Accelerated Cure Project for MS, art-msnews -at- acceleratedcure.com
gray matter atrophy seems to
gray matter atrophy seems to accompany a lot of neurological and psychological conditions (which makes me think it is a secondary response like a muscle shrinking from neglect.) There has been evidence of reversing the damage in bipolar patients taking lithium.
Engineering can't be equated
Engineering can't be equated to biology. That's stupid. People aren't erector sets, or microwave ovens, etc. Without research, there can't be any understanding. Without understanding, then where do you start to apply concepts to get answers? The rusting door analogy is stupid as well. Metal doesn't rust from the inside out. When the paint is scraped away, and the integrity of the metal underneath is compromised, then rust is caused by oxidation of the unprotected metal. This would make a better analogy for inflammatory response. Let me ask this question: why have a website filled with these articles if all they do is annoy you, and you think they mostly lead nowhere? That's kind of ridiculous.
I don't think criticizing
I don't think criticizing the direction of research is the same as dismissing it entirely.
Also needs to be said that people here at AC do much more then complain, they continue to work to change things.
Um, let's stay civil here,
Um, let's stay civil here, please. If your only argument is "that's stupid" you're not going to convince anyone.
Humans *are* erector sets - at a chemical level. No scientist currently believes that biology has a special domain with magical properties that can't be understood by the fundamentals of physics, chemistry, and mechanics.
Here's a good paper where a biologist makes the same argument I do. In fact, most of the top biology schools (including Harvard and MIT) have created bio-engineering and systems biology programs to address this very problem. So if you know something that they don't, I'd love to know about it.
As for rust, if the metal is painted when there is already some rust starting or with moisture trapped inside, it can rust underneath the paint. This would be analogous to there being an internal cause of neurodegeneration like a virus (for example) that would eat away at the axon and cause the myelin to degrade - rather than the other way around.
If you have anything to contribute to support your claims other than ad hominem attacks, I'm very interested to hear them (no sarcasm). Perhaps you can tell us about what you are doing that is getting us closer to a cure as it sounds like you have some experience with research.
And if you're going to call names, at least have the decency to provide yours (even if it's a pseudonym) and not post anonymously.
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Art Mellor, Accelerated Cure Project for MS, art-msnews -at- acceleratedcure.com
I'm going to address your
I'm going to address your last question separately:
>why have a website filled with these articles if all they do is annoy you, and you
>think they mostly lead nowhere?
Your assumption that "all they do is annoy [me]" is where you go wrong. This site provides a collection (and database) of the research done on MS. It is part of a much larger context that is the mission of our organization (you can read about that here). Part of that mission is to identify what has been done and what needs to be done.
If we don't know what is being done wrong, we can't fix it. I use this forum to present what has been done and to give praise and criticism where it is due. We allow comments so that people who disagree can weigh in with their opinions. We prefer opinions that actually have some content to them and not just "that's ridiculous." I can't do much with that opinion if you are, in fact, correct.
I've spent the last seven years of my life developing an approach to curing MS, raising money, building a team, and creating one of the largest repositories of MS blood samples and data in the world. Researchers around the globe are starting to use these samples to do studies on a scale they couldn't do otherwise. We do significant due diligence on each step we take to make sure that top researchers have guided our direction. We always want to know when we are doing something wrong - so if you have something useful to contribute in the way of criticism, we are very open to hearing it. This isn't about ego - it's about curing the disease that plagues me and others.
I, and many others, have found MSNews a useful resource - that's why we do it. As to our criticism of most of the research - that's because most of it is rather useless. The almost ubiquitous conclusion "larger studies are needed," which are then never followed up with larger studies, indicates a significant problem in the research infrastructure. We are working to fix that.
So please, take some time to expand on your "stupid" and "ridiculous" comments with some substance rather than opinion - that's how science is done.
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Art Mellor, Accelerated Cure Project for MS, art-msnews -at- acceleratedcure.com
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