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
Austrian researchers studying patients with possible MS symptoms found
that those with two kinds of antibodies in their blood early on were 76
times more likely to develop the tough-to-diagnose disorder than those with
Some of the potential early symptoms of MS can have numerous other
causes, such as a stroke or a brain tumor. Moreover, one-third of patients
with these initial symptoms recover and never develop MS. Others can go for
years before they have a second flare-up showing they have MS.
Up to now, "nobody was able to predict for an individual patient what
will be in the future," said lead researcher Thomas Berger of the department
of neurology at the University of Innsbruck.
MS is incurable. 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 slow the progression of the disease in some people.
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
percent to 11 percent, Berger said. The blood test is 95 percent accurate in
predicting which people will have a flare-up within several months, he said.
"These antibodies seem to predict the next attack and therefore a
diagnosis of MS," said Stuart Cook, a neurologist and president of the
University of Medicine and Dentistry of New Jersey. "I think it's an
About 400,000 Americans, mostly women, have multiple sclerosis, which
usually strikes between age 20 and 40.
MS is poorly understood but involves damage to nerve fibers and their
protective myelin sheath in the brain, spinal cord and eyes. The cause is
unknown, but doctors suspect a virus or other infection makes the immune
system attack the myelin and nerve fibers.
Symptoms include weakness, tremors, difficulty walking, blindness,
incontinence and emotional problems.
The disease can lie dormant for months or years, then worsen steadily or
cause repeated flare-ups. Some victims become disabled, but others lead
fairly normal lives.
Often, MS is not diagnosed until the second episode of symptoms. Many
doctors just monitor patients until then, rather than starting treatment,
because the initial symptoms often are not due to MS at all; because
medications do not work for some people and have serious side effects; and
because MRIs, even when combined with spinal fluid tests and patient
history, can be inaccurate.
In the Austrian study, reported in today's New England Journal of
Medicine, doctors tested 103 patients with possible early symptoms for their
levels of antibodies called anti-MOG and anti-MBP. MRI scans were used to
determine how many nerve lesions they had.
In an accompanying editorial, Jack P. Antel and Amit Bar-Or of the
Montreal Neurological Institute said the findings, once confirmed, could
identify subgroups of patients that particular drugs would help the most.
Choosing the right drug now is hit-or-miss.