An MRI may identify the early warning signs of multiple sclerosis, a new study suggests, even in those who do not show signs of the disease.
Researchers found brain abnormalities similar to those that occur with MS in study subjects who were undergoing brain scans for other reasons, such as migraine or a head injury.
After an average of 5.4 years of follow up, 30 per cent of the 44 study participants developed MS symptoms, while another 29 per cent showed further brain abnormalities but did not have symptoms of the disease.
The findings are published in the online edition of the journal Neurology.
The researchers were able to rule out other causes for the abnormalities, which appeared on the MRI as tiny white spots on the brain.
"The big question is what do we do if the finding comes up - it puts a lot of pressure on us as neurologists how to deal with this fact," Dr. Peter Rieckmann, a professor of neurology and research chair at the Multiple Sclerosis Society of Canada, told Â鶹´«Ã½.
The findings lead to a conundrum for doctors; if they find evidence of MS but the patient does not exhibit symptoms, should they formally diagnose it? And if so, should they give patients medication to slow the progression of the disease?
Multiple sclerosis is a disease that attacks the central nervous system and can cause a range of symptoms, from blurred vision and extreme fatigue to speech difficulties and partial paralysis.
It affects between 55,000 and 75,000 Canadians, according to the Multiple Sclerosis Society of Canada.
There is no definite cause and although there are some medications that can slow the progression of the disease, it has no cure.
The disease is diagnosed after symptoms appear.
However, the new findings could one day allow doctors to identify and treat MS patients early on, especially those who are at higher risk for developing the disease.
Doctors caution that the findings need to be replicated in further study, and it is still unclear if all patients with these brain abnormalities go on to develop MS, Rieckmann said.
Therefore, researchers warn that doctors should refrain from giving MS medication to patients who do not exhibit signs of the disease.
And they do not advocate using MRI scans to look for signs of MS in patients without symptoms.
In an editorial accompanying the study, Dr. Dennis Bourdette of Oregon Health & Science University in Portland and a fellow of the American Academy of Neurology, stated that for now, patients must exhibit symptoms in order to receive a diagnosis.
"This study sets the stage for establishing a process for evaluating these patients and following them to help determine the risk of developing MS," Bourdette wrote. "Until then, we should not tell them that they have MS or treat them with disease-modifying therapies. For now, it's best to remember the wise advice that we 'treat the patient, not the MRI scan.'"
With a report from CTV medical specialist and producer Elizabeth St. Philip
