Image: A 3D view of the brain ventricles of a study participant. Credit: Millward et. Al. , MDC
A team of researchers from the Max Delbrϋck Centre for Molecular Medicine in the Helmholtz Association (MDC) and Charité - Universitätsmedizin Berlin, including a former academic of the University of Malta, have discovered that Multiple Sclerosis (MS), where the immune system attacks the body's own protective layer around axons (nerve fibers) in the brain and spinal cord, triggers inflammation, which ultimately leads to the destruction of neurons.
Usually, the brain’s ventricle volume remains fairly constant, but the team of researchers observed that the ventricle volume changed over the course of the disease.
When they used an antigen to trigger encephalitis (inflammation of the brain) in mice, MRI scans clearly showed that the ventricles expanded. "Everyone thought it was a sign of brain atrophy," Dr Susan Waiczies recalls.
Enlarged brain ventricles in people with MS is commonly thought to be a sign of brain atrophy. A reduction in ventricle size had never been reported in patients. So what does this observation mean for MS patients? And can the finding even be transferred from mice to humans?
The current study saw the researchers test this with the help of extensive MRI data sets of MS patients. From 2003 to 2008, they had participated in a clinical trial at the Charité to test the effects of a new MS drug. "I was involved in the immunological planning and evaluation of this study, and I knew that the generated MRI data was extensive and robust," says Waiczies.
A diagnosis of multiple sclerosis is made from MR images and by analysing cerebrospinal fluid obtained by puncturing the spinal cord. Regular scans allow a better prognosis of disease progression. In this study, participants had received a monthly MRI scan. Countless images now had to be viewed and statistically evaluated.
Lead author Dr Jason Millward, neuroimmunologist at the MDC and Charité and statistics enthusiast, set to work on the new study.
"The key factor was the number of measurements taken over time, which provided us with a unique opportunity to see if the patients exhibited similar trends," explains Millward. That was indeed the case: "The majority of patients with relapsing-remitting MS exhibited fluctuations in ventricle volume - just as we observed with the mice." Interestingly, Millward also found that the patients with changes in ventricle volume seemed to be in an earlier stage of the disease.
The researchers now want to understand how the ebb and flow of brain ventricles occurs at the molecular level.
More info about this research can be found online.