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MS research provides hope

April 17, 2006|by JULIE E. GREENE

As a retiree, Washington County resident Rosalie Hollinger still had an active life.

She volunteered at her church, St. Joseph Catholic Church in Halfway, went duckpin bowling and gardened.

In 1979 she began having trouble walking and standing and spent a few days in the hospital, says her husband, Dale Hollinger.

Different diagnoses were made, and she was sent home when she got better.

A year later her health started declining again and around 1981 she began using a motorized scooter.

By the end of 1985 she was paralyzed from the neck down and remains so today, Dale Hollinger says.

Rosalie Hollinger has progressive multiple sclerosis.

She and her husband chat, and she directs housework, watches television and reads - with someone else turning the pages. He or another caregiver help her eat, bathe, and get in and out of bed.

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About 400,000 Americans acknowledge having MS and, of those, about 10 percent were diagnosed with progressive MS, says Amanda Culler, marketing director for the National Multiple Sclerosis Society's Maryland Chapter.

People with progressive MS experience a slow but almost continuous worsening of the disease. Most people with MS have relapsing-remitting MS, which is characterized by clearly defined flare-ups followed by partial or complete recovery periods, according to the society's Web site.

The Hollingers' hope MS researchers will find a way to regenerate the nerves the disease has damaged, Dale Hollinger says.

Last fall the National MS Society awarded $15.6 million in grants to four research teams trying to determine how to repair the damage caused by MS.

Of course, to do that, they also are looking at what causes MS, which is thought to be an autoimmune disease that affects the central nervous system.

One of those teams is a group of about 25 doctors and scientists at Johns Hopkins School of Medicine in Baltimore led by Dr. Peter Calabresi.

Among the projects his team is working on is a new way to take images of the brain and spinal cord so they can better measure changes in the progress of the disease and treatments.

Magnetic resonance imaging (MRI) has been used for about 20 years. The problem with using MRIs is they pick up the inflammation but not enough detail about the integrity of the myelin and axons, says Calabresi, an MS neurologist.

Axons are nerve fibers, and myelin is the protective coating around those nerve fibers. It's believed that MS occurs when the myelin becomes damaged, affecting the nerve fiber's ability to send messages from the brain to the spinal cord.

With MRIs, an MS patient might know his or her condition is declining, but the MRI doesn't show any changes, Calabresi says.

Imaging is important with MS because biopsies cannot be taken of the brain or spinal cord. Scientists rely on animal testing and investigating the brains of deceased people who had MS to see what is happening with MS.

Calabresi's team is working on diffusion tensor imaging, or DTI, which involves looking at how water molecules flow in different directions.

The scanning equipment notes the path of water - found naturally in the body - around nerve fibers. If the nerve is intact, the water flows along the nerve's pathway. If the nerve is cut, water molecules diffuse in a random pattern.

DTIs have been taken of 80 MS patients, providing information about how their nerve fibers are working, Calabresi says.

Calabresi's team hopes DTIs will speed up the process of clinical trials and getting drugs approved for MS treatment.

Often it takes hundreds of patients and many years to see if a treatment works, he says. Calabresi hopes DTIs could one day tell researchers whether a drug treatment is promising enough to continue exploring in a matter of six months rather than years, he says.

For Rosalie Hollinger, any discoveries about nerve regeneration might come too late, her husband says. She's 68, and it typically takes a long time to get new treatments approved.

"There is an awful lot of hope for others going through it, still in their 30s or 40s," he says.

Calabresi says he never wants to say never because that removes all hope.

Hope is important, but it has to be balanced with a dose of reality.

"It's difficult. You never know. We're hoping for a breakthrough. Do we have something right around the corner to save this poor man's wife? No, but I'm not giving up," Calabresi says.

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