Last month, we came across a study that associated the link between retinal disease and diabetes to race. An individual’s race, it appears could also play a part in multiple sclerosis (MS). Experts at the University of Buffalo claim that blacks with MS seem to have more severe symptoms and could decline faster than whites.
According to the new study, though fewer African Americans than Caucasians may develop MS, statistics suggest that their disease to progress more rapidly. Besides the neurology experts also indicate that they may not respond as well to therapies. This seems to have come forth after analysis of the MRIs of a cohort of 567 consecutive MS patients. It suggested that blacks with MS probably had more damage to brain tissue and also apparently less normal white and gray matter as 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,” affirmed Bianca Weinstock-Guttman, MD, UB associate professor of neurology in the UB School of Medicine and Biomedical Sciences, first author on the study. “The results provide further support that black patients experience a more severe disease, calling for individualized therapeutic interventions for this group of MS patients.”
Parts of the brain that comprise of nerve fibers sheathed in a white fatty insulating protein called myelin are referred to as ‘white matter’. It could be responsible for communication between the various gray matter regions that have a concentration of nerve cells and also where cognitive processing occurs.
“Initially, multiple sclerosis was considered primary a white-matter disease,” mentions Weinstock-Guttman, “but today we know that the gray matter may be more affected than white matter.”
Black MS patients, the study showed in general probably had more severe and frequent symptoms. Even after the first episode, this was seemingly followed by an incomplete recovery. Analysis on the signs and symptoms of MS among popuations appears to have demonstrated blacks to experience gait problems much sooner after their diagnosis. They apparently exhibit faster cognitive decline as compared to whites with MS and may also become dependent on a wheelchair sooner as per Weinstock-Guttman.
MRI scans conducted at the Buffalo Neuroimaging Analysis Center (BNAC), included around seventy-nine black patients and 488 white patients as part of the study. Besides being scanned within 90 days of their most recent clinical visit, the participants were also reportedly above 18 years of age. Despite having MS for a shorter amount of time and being significantly younger, the severity of the disease was more severe than white patients.
“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,” explained Weinstock-Guttman. “Based on our MRI findings, a plausible hypothesis that would explain the more aggressive disease in blacks compared to whites with MS 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.”
These results were published ahead of print on Jan. 20 at Neurology.org and appear in the Feb. 16 issue of the journal Neurology.