Rebuilding in The Brain

Photo: Brain

Patients who suffer from MS
typically present with centers of
inflammation in the brain and
spinal cord;©
Sebastian Kaulitzki

Patients who suffer from multiple sclerosis (MS) typically present with centers of inflammation in the brain and spinal cord, which cause symptoms that range in severity depending on site and size. For example, sufferers feel a tingling sensation in their extremities, they stumble more or they have difficulties seeing. In extreme cases, they become incapable of moving around on their own and are confined to a wheelchair.

The brain, however, often manages to minimize the functional damage caused by such centers, i.e. the damage that is noticeable to the patient. It has various “tools” at its disposal for this purpose: firstly, processes that are based on a rapid reinforcement or reduction of nerve cell contacts; secondly, the transfer (usually with a delay) of certain tasks from the damaged region of the brain to a healthy one. “Plasticity” is the name science has given to this ability on the part of the brain to adapt to changed conditions.

The answer to the question as to which mechanisms actually underlie this compensation in MS patients is of great clinical value. If medicine were to manage to boost the compensation mechanisms in a suitable location with the help of drugs or physiotherapy, it might be possible to delay or even prevent the onset of disabilities that are caused by MS.

Now the scientists have managed to make some progress in the search for the processes responsible. Together with colleagues from Bamberg and Leipzig they have taken are closer look at a variant of the neuroplastic processes that begin rapidly: the so-called excitability-decreasing plasticity, which is significant in the focus on certain movements.

“We were able to show that an early form of neuroplasticity is fully retained in the locomotor system of patients slightly to moderately affected by MS despite pre-existing inflammatory damage,” concludes Doctor Daniel Zeller.

14 MS patients and a control group of 14 healthy participants were examined by the scientists as part of this study. With the help of Transcranial Magnetic Stimulation (TMS), they temporarily “paralyzed” an area of the brain that is responsible for hand movement and then examined whether “healthy brains” and “MS brains” differ in their response to this. “Studying this form of plasticity in multiple sclerosis is especially interesting,” says Zeller. After all, it directly targets those mechanisms that limit the excitability of neurons. This means that it might be possible to translate the results directly into treatment strategies.

So, what do these results reveal? “Together with the findings of an earlier study we conducted we can say that there is no evidence that the early stages of MS are accompanied by a disruption of the initial compensation steps in the brain,” says Zeller.

In terms of rehabilitation for sufferers this means that it would be better if corresponding approaches were aimed at boosting later forms of plasticity, such as the recruitment of other regions of the brain for the execution of a certain task.; Source: Würzburg University Hospital