Statistics show that fewer African Americans than Caucasians develop multiple sclerosis, but a study by neurology researchers has found their disease progresses more rapidly and they don’t respond as well to therapies.
Magnetic resonance images (MRI) of a cohort of 567 consecutive multiple sclerosis patients showed that blacks with multiple sclerosis had more damage to brain tissue and had less normal white and grey matter compared to whites with the disease.
“Black patients showed more brain tissue damage and accumulated brain lesions faster than whites, along with rapid clinical deterioration,” confirms first author on the study Bianca Weinstock-Guttman. “The results provide further support that black patients experience a more severe disease, calling for individualized therapeutic interventions for this group of multiple sclerosis patients.”
“White matter” refers to the parts of the brain that contain nerve fibers sheathed in a white fatty insulating protein called myelin. The white matter is responsible for communication between the various grey matter regions, where nerve cells are concentrated and where cognitive processing occurs.
Image: Neurons or nerve cells found in white matter.
“Initially, multiple sclerosis was considered primary a white-matter disease,” says Weinstock-Guttman, “but today we know that the gray matter may be more affected than white matter.”
In general, black multiple sclerosis patients tend to have more severe and more frequent attacks, followed by an incomplete recovery even after the first episode. Studies on signs and symptoms of multiple sclerosis among populations have shown that blacks experience gait problems sooner after their diagnosis, show faster cognitive decline than whites with multiple sclerosis, and become dependent on a wheelchair sooner, she notes.
Seventy-nine black patients and 488 white patients were entered in the study. Participants were older than 18 and had been scanned within 90 days of their most recent clinical visit. Black participants were significantly younger, and their disease was more severe than white patients, despite having multiple sclerosis for a shorter amount of time.
“Results of the MRI scans showed that the aggressive disease process in blacks appears to be associated with increased macroscopic and microscopic tissue damage, as measured by specific MRI parameters,” says Weinstock-Guttman.
“Based on our MRI findings, a plausible hypothesis that would explain the more aggressive disease in blacks compared to whites with multiple sclerosis may be that blacks have a reduced capacity for remyelination, the brain’s ability to repair the protective myelin sheath. However, to confirm this hypothesis, we will need to conduct more longitudinal studies.”
References:
1. Bianca Weinstock-Guttman, et al. Increased tissue damage and lesion volumes in African Americans with multiple sclerosis. Neurology 2010, doi:10.1212/WNL.0b013e3181cff6fb
Why do you have to always compare people against each other? How would now this to be true and by what measure? Even if it were true what can be done about it?
Nothing