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 points, not fewer.

❓ "Is this MS, or is it something else?" If you've ever had a new symptom appear and spent three weeks trying to figure out whether it's a relapse, an old symptom flaring in the heat, stress, perimenopause, or a virus… you know how exhausting that guessing game is. An objective disease activity score gives your neurologist one more piece of information to weigh alongside your history and your exam. It isn't a yes or no answer by itself, and it can't tell you what a symptom is caused by. But it can help your team sort signal from noise.

🗣️ How to bring this up with your neurologist. Jennifer walks through what that conversation can sound like, what to ask, and why it's completely reasonable to bring a testing option to your provider rather than waiting for them to bring it to you. You are allowed to ask questions about your own monitoring plan.

💵 The practical stuff: coverage, cost, and timing. We talk through how the test is typically ordered, what to expect around insurance coverage, and how often testing tends to be repeated. Coverage and cost vary quite a bit depending on your plan and where you live, so this is a "confirm with your own provider and insurer" situation rather than a one-size-fits-all answer.

This episode is for you if:

✅ You've had an MRI come back "stable" but you don't feel stable
✅ You're not sure whether a new symptom is a relapse or something else entirely
✅ You're on a disease-modifying therapy and you want to know if it's working
✅ You want more information about your MS than a scan every 12 months can give you
✅ You like understanding the science behind a recommendation, not just being handed one

About Jennifer Chester

Jennifer Chester is a nurse practitioner with over a decade of experience in MS care who now works at Octave Bioscience, helping bring a brand-new blood test to people with MS, and it's one that can actually measure disease activity in real time. (One important note, this text is only available in the US).

Where to reach Jennifer & Octave Bioscience:

YouTube: https://youtube.com/@eventsoctave?si=vHCktRGw5NBq8q_g

Facebook: https://www.facebook.com/OctaveBioscience?mibextid=wwXIfrhttps://www.linkedin.com/company/octave-bio/

Website: https://www.octavebio.com/

Resources mentioned in this episode:

Conversation guide for your doctor: https://www.octavebio.com/patients

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected]

Website: www.MSingLink.com

Social:

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen