Multiple Sclerosis Pathology
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- čas přidán 20. 05. 2024
- We can see multiple sclerosis lesions on MRI scans, but what are they? What is inside of them? This video explains the histopathology of MS from biopsy and autopsy studies and discusses possible treatment implications based on the types of inflammatory cells which are present.
Selected Sources:
Pathology of multiple sclerosis: where do we stand? pubmed.ncbi.nlm.nih.gov/23917... Sclerosis: www.nejm.org/doi/full/10.1056...
The Pathologic Foundations of Multiple Sclerosis: Current Considerations: www.ajmc.com/view/the-patholo...
Pathology of Multiple Sclerosis: www.sciencedirect.com/topics/....
Pathological heterogeneity of idiopathic central nervous system inflammatory demyelinating disorders: pubmed.ncbi.nlm.nih.gov/18219...
Grey matter pathology in multiple sclerosis: www.thelancet.com/journals/la...
Pathology of Multiple Sclerosis: www.researchgate.net/publicat...
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Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
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he video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information. - Věda a technologie
![How Bad is Multiple Sclerosis? [Average Prognosis from MS EPIC UCSF Study]](http://i.ytimg.com/vi/DGAgCARu4fo/mqdefault.jpg)
Thank you, Dr. Beaber, for raising awareness about such a sensitive topic. I was recently diagnosed, and my neurologist recommended ofatumumab injections for me. Just to give you some background, I'm 27 years old from Italy and had no symptoms until last December when I experienced paresthesia on the left side of my face. About three weeks later, weakness appeared in my right hand and lower leg. I was prescribed high doses of steroids for five days, which quickly alleviated the weakness. In February, I was hospitalized briefly to expedite the diagnostic process and undergo necessary tests. While I have multiple lesions, including some in the cervical spine, they are not particularly large, and some showed gadolinium enhancement. Currently, I have no active lesions, likely due to the steroids. I still have slight paresthesia on the right side of my face, but it's minimal. I'm feeling very optimistic and hopeful that Kesimpta won't cause any major side effects. Thanks again, Dr. Beaber, for your informative videos; they've helped me overcome my fear of this illness.
Wow awesome information! I wish I had you to go with me for my disability hearing tomorrow 😊..... Thank you
Good luck tomorrow
Going to school with Dr. Beaber on Wednesdays! Thanks so much for the lesson. I love gaining a better understanding what is happening. Because there are 4 different patterns of lesions, is it possible that there are different diseases?
Edit: Yes! I would be willing to donate my brain. I will discuss it with my neurologist at my next appointment!
I think for type IV, this may be a separate disease mimicking MS. Otherwise, I think there is relatively good evidence MS is a single disease. Of course, I could be wrong about this.
@@DrBrandonBeaber thanks so much!
Wow! Very interesting video! Thank you! After 10 yrs and asking several times my wife’s neurologist finally showed me a MRI scan. She didn’t say much beyond that it was typical of MS. Do you ever share MRI specifics with a patient’s physical therapist? Seems like it would be helpful to the therapist to know what parts of the brain have been effected. Generally my wife’s therapist get a referral that simply says lower limb spasticity.
Why didn’t your medical school teach you that MS is an autoimmune disease (or did they?) I suspect that the marching orders, if you will, for the lymphocytes, immune cells, etc, come from the gut (specifically small intestine via the vagus nerve). This would certainly create a wide range of treatments! What do you think of this article title from last year: “Engineered probiotic found to ease symptoms in mouse model of MS” (Lindsey Shapiro August 2023). Perhaps the future of MS treatment may include gastrointestinal doctors, or more functional medicine. Kinda like if you have chronic sinusitis you could keep on going to an ear, nose, and throat doctor, but the allergist would be the most helpful?
Did any slides or data in this video refer to spinal chord lesions, and are there just as many variations of those??
As usual I have more questions than before, rest assured I will keep watching and learning! Thank you - concerned MS caregiver.
P.S. - I can imagine this conversation: “ I went to the doctor today to discuss my recent MRI. They told me I have a perivenular disease, poly antigenic disease, and an autoimmune disease!” Friend responds, “Oh my, what are they called”. Patient responds, “MS”.
P.S.S. - I am correct in understanding that perivenular inflammation precedes lesions in most cases? And, if so, finding ways to halt or slow that inflammation would be the most helpful?
Thank you
Thank you. Have filled out the paperwork for letting science have at my brain when I am gone. TBH it's a less creepy thought for me than the usual exit routes!
Thank you for your contribution to our understanding of MS (hopefully many decades from now).
I would never let my CSF be monkeyed with again, my Spinal tap was very uncomfortable. I am 53 years old in May a woman I’ve had multiple sclerosis for 35 years. I’m still able to drive and walk although I did just have a really bad relapse in November but I’m coming back from it almost 100% now. So whatever you do, don’t give up.
Grand rising Dr. This is so amazing and helpful. I received this diagnosis back in 2011 and honestly nobody explained anything to me other than saying it's a lifelong disease that will eventually get worse and kill me. I'm literally just now getting the actual documentation of my MRI and everything else. I was never given anything, the only thing I was given was a suggestion for me to enter a trial that the neurologist was involved with. And so I never even took any medicine so I surely wasn't going to do that. So fast forward a decade thank God I didn't take the medicine but anywho I fell leaving the pool and it brought everything to the forefront so I'm going to quit talking my message in and now and just listen to the rest of what you got to say but brother you are so appreciated! I hope you have a magnificent day
Yeah I might consider donating my brain however I am a conspiracy scientist so no one but I know about the world now that kind of makes me a little leery cuz maybe y'all would come try to collect it
Cuz I never took any of their drugs from day one. Haven't taken anybody's drugs honestly oh well but I did have the period of pot smoking. And I wouldn't be going crazy look I was born an asthmatic. Whole life asthma allergy bronchitis hay fever anything wrong related but that was like the only illness that that I've had.
@@MelissaFortune In order to get a viable specimen, specific actions to preserve the brain have to be taken very shortly after someone passes away, so this must be arranged in advance.
@@DrBrandonBeaber i know, I was clowning. Im a registered as a doner. I do recognize the difference between the two
Hi from Israel very interesting video no one brings such information like you thanks God bless you
Thanks for your videos.l I wish you were in NY!
I don't know if you saw it but I responded in a tweet on X with a clinical study on a emerging stem cell treatment (phase1). If you did see it I would love for you to do an overview on it. It seemed like a prety extreme intervention that I had many questions about, such as is the cranial hole is permament or do they seal it after the injection.
Just recently diagnosed with RRMS and I've just begun ocrevus infusions! I really appreciate a doctor taking their time to explain things about MS, definitely subscribing 🙏
Be careful, there’s a risk of cancer/malignancies with Ocrevus. I’m currently getting of it. Just saying.
Thank you very much for making this video, or any video for that matter as I usually feel more informed and "in the loop" if that makes sense. My MS Neuro team is amazing and they take and make time to properly listen to me and treat me. However, your videos help me to get another perspective and food for thought. In this case, donating my brain. I'm certainly open to it if this is permitted in my faith which I will check.
I would donate my brain.
I wont need it anymore, so why waste a perfectly damaged brain?! 😅
I dont even know where to start that whole process.
I loved this video. Sooo fascinating to me. Those slides are incredible- seeing the cells eating the myelin.
Thank you! Have a good day
I believe they accept brain and spinal cord donations at the Cleveland Clinic. More information here: my.clevelandclinic.org/research/neurological/multiple-sclerosis/ms-tissue-acquisition-pathology
@DrBrandonBeaber great! I have it on my to do list now
Me too😅
Thanks Doc.
I am in the KP system/SD chapter w/ Dr. Matich so only 2 hrs away.
Very heavy burden of Lesions but I guess I am operating fairly well at this time.
Dr. Brandon how would you treat chronic central vertigo and why does contrast really matter if lesions r clear. How do we know if LP results change is it a one time test can bands mean other diseases
Awesome video!
Thanks
What do very late stages of Secondary Progressive MS look like in a female 55 yo? How do you know if the brain is deteriorating to a point where additional treatment or exam is needed?
This is a controversial topic. There is some evidence disease modifying therapies could be less effective in older people with progressive MS. We don't have great evidence in older people with MS as they have historically been excluded form clinical trials.
Well maybe the the entire age spectrum needs to be taken into consideration when assessing stats and progression now that bases it on new technologies and modern observations. Thanks for the reply.@@DrBrandonBeaber
Would you do a video on neural reserve/neural redundancy and how best to implement it, please?
This was a VERY interesting video. I remember the brain bank for MS donations- of brains 🧠- it’s nice to see what they’ve come up with all the research they’ve done.
I found it interesting that even the “ normal “ brain 🧠 tissue had a few cells as well.
❤
#Sharingiscaring
I believe plan to receive brain and spinal cord donations is ongoing at the Cleveland Clinic. Dr. Daniel Ontaneda may know about this. More information here: my.clevelandclinic.org/research/neurological/multiple-sclerosis/ms-tissue-acquisition-pathology
Dr. Brandon may i ask how does low ferritin affect MS and what do u think of iv iron infusions r they risky meaning allergic reactions? Why do i feel central vertigo and unbearable fatigue could it be from my low ferritin
Thank you Dr., I love your videos, I always learn something.
Thanks
Hi Dr. Brandon,
I learn a lot from your videos. I wish if I could book an appointment with you. In Sweden we should choose our medication ourselves and i am lost!
Regards.
Dr. Brandon do do MRIs show how many attacks have happened say within 3 6 months to a year? Drs always ask how many attacks weve had but its confusing sometimes symptoms from MS itself or infections mimic an attack. What relapses do u feel need steroids? If i have frequent vertigo what should i do everytime i take steroids for dizziness i worsen.
Fascinating video Dr. BB. Thank you. I am a medically retired engineer; cheers MS.
So a lot of this extremely biological content isn't my bag. But!
It shows the extent of #MS research and a lot of the possible 'hows'; engineer 😅.
Brilliant.
I'm 46, with RMS since maybe '97, now with Ocrevus.
Hello, as I said in previous comments.. You are doing really good job with these videos, keep it up. As a medical student, may I ask you for uploading videos at least in 720p quality? Or does YT have some problems now with video uploading?
I am simply using a camera which comes with my laptop. I will have to look into a different camera.
What about a video on Functional Overlay?
How do you donate your body/brain?
I think a study of individuals who have had re-mylenation naturally occur would be useful. Especially their genetics, biology etc. if any die, their brains biopsy would be useful too. Could help us learn what exactly is different about them. I have seen several ocrevus users whose lesions went away. I haven’t had that even though I have had MS since I was 13 and would probably have a higher chance of repair due to my age.
This would be an interesting study indeed.
I posted a comment earlier today. Where did it go? Was it too long? What about spinal chord lesions? Are there just as many variations? Do you also consider MS an autoimmune disease? Thank you
Me too!!
Thank-you for another informative video Dr Brandon, I would definitely consider donating my brain to science fiction haha just kidding doctor but if it would help our doctors learn a little bit more about the disease I'm all for it.
Hello Dr my son age 13 yr has suffered from viral encephalitis 13 th oct 2023 sir 26th dec report mri thete is asyemmetircal changes in white matter involving basal ganglia and anterior commesur sir can you help us in management will be very thankful to you
What about mast cells??!!
What causes perivenular inflammation?
You mean what is the root cause of MS? The proximate cause is immune cells extravasating from the periphery into the central nervous system.
Thank you. I’m going to try to find out what causes that to happen.
16:51 melatonin?
Have you seen a spike in new MS cases since Covid19 vaccines? I was dx 6 months after the first mRNA injection. I I feel like it came out of nowhere.😔
Per observational studies, the risk of MS is about the same with or with covid-19 infection and with or without covid-19 vaccination. One study explained in this video: czcams.com/video/AW-Uq5elig8/video.html
If the medical community was much better at MS, conditions similar to MS like Sheehan's, I'd be more than happy to donate my brain. However I believe doctors just want a specimen to poke around with. Doctors walk a thin line between an ethical human being and a mad scientist. They'd probably prefer to watch a person decline hoping they'll get a front row seat to the show. They get to PRACTICE on the patient, drug the patient, etc.
Look. I showed this video to several neurologist and my primary care physician. They didn’t even understand it. I somewhat understand it because I spent two years studying MS. This video is way too complicated for anybody to watch.