Differences found between PPMS and SPMS

A new study has found differences in inflammatory activity and nerve damage between patients with primary progressive multiple sclerosis (PPMS) compared with those with secondary progressive MS (SPMS).

PPMS patients were found to have more severe inflammatory activity and nerve damage earlier on in their condition. They were also found to have larger amounts of copper, a heavy metal, around their brain, and less vitamin C.

The study was conducted on 22 people with SPMS, 18 with PPMS and 13 healthy people who served as controls. Blood samples from the participants were taken, as well as samples of cerebrospinal fluid (CSF).

Levels of a variety of molecules were abnormal in MS patients when compared with controls, with the differences generally bigger in the CSF than blood, which researchers expected as MS affects mainly the brain and spinal cord.

There were substantially fewer differences between the PPMS and SPMS blood or CSF analyses, with an overlap between the two types of MS in most of the molecules examined.

Researchers said, “The evidence… buttresses the idea that both PPMS and SPMS are different presentations of the same disease with similar metabolic alterations.

Overall, the scientists stated that their “observations suggest that while [secondary progressive] MS is a metabolically active disease that progresses gradually over a longer period of time, the pathological [disease-causing] insults induced in [primary progressive] MS are rather more intense at the beginning, causing severe disability within a relatively short period.”

Researchers also speculated that as vitamin C is an antioxidant, the lower levels seen in this study might make the nervous system more susceptible to damage in PPMS.

Vitamin C is an antioxidant, and the researchers speculated that lower levels may make the nervous system more vulnerable to damage in PPMS. “The efficiency and efficacy of… vitamin C supplementation on MS may need to be investigated,” they wrote.