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MRI in familial multiple sclerosis
S G Lynch1, J W Rose, W Smoker
1Department of Neurology, University of Utah Medical School, Salt Lake City.
Abstract:
We obtained cranial MRIs of 76 individuals from 13 MS multiplex families. Thirty-one MS patients and 45 normal family members participated in the study. Twenty-eight of the 31 individuals with definite or probable MS had multiple white matter lesions by MRI. Thirty-five normal family members had normal MRIs, and 10 had abnormal studies. Four normal individuals under age 40 had abnormal MRIs. Three had multiple white matter lesions. The 4th had a single small white matter lesion in the left centrum semiovale. Six normal individuals over age 50 had multiple white matter lesions. Although diffuse white matter lesions in individuals over age 50 should be interpreted with caution, these lesions in individuals under age 40 with no history of underlying medical illness are suggestive of demyelination. The results of the present study indicate that subclinical MS may be present in apparently normal members of multiplex families.
Insights
Subclinical multiple sclerosis (MS) may be present in seemingly healthy relatives of MS patients. Cranial MRIs revealed white matter lesions in some normal family members, suggesting early or undiagnosed MS.
Area of Science:
- Neurology
- Radiology
- Genetics
Background:
- Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Multiplex families, where MS occurs in multiple members, offer insights into genetic and environmental factors.
- Identifying subclinical disease is crucial for early intervention.
Purpose of the Study:
- To investigate the prevalence of brain abnormalities suggestive of demyelination in apparently normal family members of individuals with MS.
- To determine if subclinical MS lesions are detectable via cranial MRI in unaffected relatives.
Main Methods:
- Cranial magnetic resonance imaging (MRI) was performed on 76 individuals from 13 MS multiplex families.
- Participants included 31 individuals diagnosed with MS and 45 neurologically normal family members.
- MRI findings were analyzed for the presence and characteristics of white matter lesions.
Main Results:
- Twenty-eight of 31 MS patients exhibited multiple white matter lesions.
- Ten of 45 normal family members had abnormal MRIs, including white matter lesions.
- Abnormal MRIs in normal individuals under 40 were particularly suggestive of demyelination.
Conclusions:
- Subclinical multiple sclerosis (MS) may be present in asymptomatic members of MS multiplex families.
- Cranial MRI can detect white matter lesions indicative of demyelination in individuals without a clinical MS diagnosis.
- These findings highlight the potential for early detection and intervention in at-risk family members.