302. Is Your MRI Telling the Full Story? A New Way to Measure MS Disease Activity

If you've ever walked out of an MRI appointment still wondering what's actually happening inside your body right now… this episode is for you.

In this episode, I'm joined by Jennifer Chester, a neurology nurse practitioner who works with Octave Bioscience, to talk about a blood test (available in the US) built specifically for multiple sclerosis (MS). Not a diagnostic test, and not a replacement for your MRI. It's a way to measure MS disease activity between scans, using proteins in your blood.

We get into what biomarkers actually are, how the test works, what the number means, and how to bring it up with your neurologist without feeling like you're overstepping.

Here's what we cover 🔑:

🔬 What a biomarker actually is. A biomarker is anything measurable in your body that tells you something about what's going on inside it. Cholesterol is a biomarker. Blood sugar is a biomarker. In MS, researchers have identified specific proteins that show up in the blood when there's inflammation, myelin breakdown, or nerve fiber damage happening. Measuring those proteins gives your care team information they can't get from asking how you feel.

🩸 How an MS-specific blood test works. The Octave MSDA (Multiple Sclerosis Disease Activity) Test measures 18 different proteins in a standard blood draw, then factors in your age and sex to generate a disease activity score. Why 18 and not one? Because MS isn't one process. It's immune activity, inflammation in the nervous system, myelin biology, and nerve fiber damage happening at different rates in different people. A single protein only tells you about one of those. A panel gives a fuller picture.

📊 What the number actually means. The test produces a score from 1 to 10, along with subscores tied to those four biological pathways. On its own, one score is a snapshot. Tracked over time, it becomes a trend line, and the trend is where the useful information lives. Your neurologist is looking at whether your number is holding steady, climbing, or dropping while you're on a particular treatment.

🧠 Blood test versus MRI (they're not competing). This is the part I want you to hear clearly. An MRI shows lesions, which is damage that has already occurred. A blood-based biomarker test is designed to reflect biological activity that's happening now, at a level that may not have shown up on a scan yet. Jennifer explains why the test is intended to complement imaging and your clinical exam, not replace either one. More data point