Neuropathy Problems Archives

MS -- Important new screening test

Blood test can predict MS flareups, study shows
Procedure is 95% accurate, researchers say
Disorder difficult to diagnose in its early stages

FROM ASSOCIATED PRESS, REUTERS

BOSTON—Scientists have developed a blood test that appears to be the first reliable way to predict whether patients with neurological problems such as tingling or blurred vision will soon develop the debilitating disease multiple sclerosis.

Austrian researchers studying patients with possible MS symptoms found those with two kinds of protein antibodies in their blood early on were 76 times more likely to develop the tough-to-diagnose disorder than those with neither antibody.

An estimated 50,000 Canadians have MS. Prevalence rates range from one case per 500 people to one in 1,000 across the country. Canada is a high-risk area for MS, which occurs more often in countries farther from the equator. Nearly three more people a day in Canada are diagnosed with MS, according to the Multiple Sclerosis Society of Canada Web site.

Some 400,000 Americans, mostly women, have multiple sclerosis.

Early symptoms of MS can have numerous other causes, such as a stroke or a brain tumour. One-third of patients with these initial symptoms recovers and never develops MS. Others go for years before a flare-up shows they have MS.

Up to now, "nobody was able to predict for an individual patient what will be in the future," said lead researcher Dr. Thomas Berger of the University of Innsbruck neurology department.

MS is incurable. It inflames the brain and spinal cord, but lets the brain work as it robs the body of abilities. Symptoms include weakness, tremors, difficulty walking, blindness, incontinence, extreme fatigue and emotional problems. It can lie dormant for months or years, then worsen steadily or cause repeated flare-ups.

MS disables some. Others lead fairly normal lives. Sometimes fatal, it usually appears between age 20 and 50.

Traditionally, before doctors can make a definitive diagnosis, patients must develop nerve-related problems in two different areas of the body, and those appearances must be separated by at least six months.

Berger said the blood test could help doctors decide whether to offer a patient early treatment with drugs recently proven to reduce flare-ups and to slow MS for some.

The best current diagnostic test, an MRI scan for lesions on nerves in the brain and spinal cord, can only predict the chances of developing multiple sclerosis over the next decade, and its accuracy ranges from 80 per cent down to 11 per cent, Berger said.

The blood test is 95 per cent accurate in predicting which people will have a flare-up within several months, he added.

"These antibodies seem to predict the next attack and therefore a diagnosis of MS," said Dr. Stuart Cook, a neurologist and president of the University of Medicine and Dentistry of New Jersey.

MS is poorly understood but involves damage to nerve fibres and their protective myelin sheath in the brain, spinal cord and eyes.

In the Austrian study, reported in today's New England Journal of Medicine, doctors tested 103 patients with possible early symptoms for two blood proteins — anti-MOG and anti-MBP. Then MRI scans determined how many nerve lesions they had.

After some four years of testing, the doctors found 23 per cent of patients with neither antibody relapsed after 3 3/4 years on average.

Among those with both antibodies, 95 per cent had a disease-defining relapse, within just 7 1/2 months on average. The results must be confirmed, among more patients and with a longer follow-up, Cook said.

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