Reply. A persons MRI can appear fairly normal and they can be in terrible pain or even have weakness and/ or numbness. Certain infections, or other autoimmune diseases such as lupus or sarcoidosis, are associated with increased lesions in the brain. Learn more. This area highlights the junction between the intervertebral discs, bones, ligaments and nerves of the spine. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Weve helped a number of patients with their back pain, and we can do the same for you. As far as we know there are no activities that specifically cause MS or make it worse. Various types of MRI scans can monitor MS activity in the brain. In a 2018 study, researchers observed the patterns of lesions in the central nervous systems of people with either progressive or relapsing-remitting MS. MRI scans cause a small amount of the bodys water protons to line up with their powerful magnetic field. It is difficult to answer this without seeing the MRI or at least knowing more about the MRI. A range of medications can help slow the progression of the disease, but there is no cure for MS yet. What is the latest research on the form of cancer Jimmy Carter has? To learn more, please visit our. Regular exercise actually improves fatigue symptoms. Two Basic MRI of the Lumbar Spine Images (T1 AND T2 Images), Basic Anatomy of How to Read an MRI Lumbar Spine, How to Read an MRI Lumbar Spine in 8 Steps, 1. If you've had a brain magnetic resonance imaging (MRI), you may be alarmed to hear that it shows small white spots. The following is a very simple guide to help you understand the nomenclature of your MRI. The L3 nerve to the front of the thigh. Matt Jennings Former Youth Basketball Coach Updated 6 mo Promoted What is the best way to keep energy levels high throughout the day? These are also known as hyperintense lesions. Learn how we can help 1.1k views Answered >2 years ago Thank 1 thank Multiple Sclerosis Association of America. A disc herniation can be either a protrusion or extrusion. Spasticity is an increased muscle tension and tightness that may interfere with useful movements. Disc herniations can be large and appear permanent. In its early stages, it can be easily mistaken for MS due to similarities in symptoms. There are medications that have been shown to be helpful in MS-related fatigue. Generally, the lesions remain bright for only 1-2 months. It is not feasible to comment on MRI images in absence of seeing the films themselves. If youve recently undergone an MRI of your spine, your doctor may mention that you have one or more high-intensity zones in your back. The spine specialist should review the actual images with you and answer any questions you have about your report. Females tend to get MS about three times as often as males, a rate similar to other immune diseases. Magnetic resonance imaging (MRI) is a noninvasive type of imaging test that healthcare professionals use to detect multiple sclerosis (MS) activity in the brain and spinal cord. MS varies from person to person so there is no 'standard' set of symptoms for MS. MRI is the best imaging tool available to both diagnose and monitor inflammation in the central nervous system. Making sure that night-time sleep is good is also useful. In a typical fatty myelin sheath, the areas hold more water. Contact our clinic today at (651) 430-3800. In an mri of the spinal cord, what can a dark spot surrounded by a white ring i indicate? These white spots may indicate a cause for concern, including strokes or multiple sclerosis (MS). A person undergoing a scan will receive earplugs or earphones to help muffle the noise. In MS, patients develop various areas in the brain and spinal cord where the myelin is stripped off of the nerves. doi:10.1212/NXG.0000000000000185, Mora F. Successful brain aging: plasticity, environmental enrichment, and lifestyle. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. White Matter Lesions in Adults a Differential Diagnostic Approach. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Recent studies have shown that it cannot be predicted early in the disease and so the term can only really be used retrospectively, after people have done very well with MS for many years. An MRI scan is a noninvasive imaging test that healthcare professionals use to produce images of the bodys soft tissue and organs. done many echos and mri. The posterior annular fibers are structurally weaker compared to the anterior annular fibers, thereby predisposing them to disruption 1 . Infusion medications include Tysabri, Ocrevus, and Lemtrada. Secondary progressive multiple sclerosis (SPMS) is a later stage of multiple sclerosis. Auditory evoked responses are stimulated with a clicking noise in the ears, recording the brain's response. This pain comes in a variety of forms, including trigeminal neuralgia, a syndrome involving sharp, stabbing pain in the side of the face or the jaw. If you think you may have a medical emergency or a major medical problem, call your doctor or 911 immediately. You could discuss this with the local radiologist, or if you w "bright spots" on an MRI have various causes. If surgery eventually is required, surgery is intended to only fix the issues causing the symptoms and not to make your spine or MRI look perfect. The way we accurately treat patients is by correlating their symptoms to specific changes in their MRI. However, if the vertebral bodies look triangular, it indicates a fracture (inset). X-RAY of the Lumbar Spine-end plate entophytes are present at multiple levels in the Lumbar and lower Thoracic Spine. The magnetic resonance imaging (MRI) may show areas of abnormality that suggest MS, though the MRI in and of itself does not make the diagnosis. To avoid misdiagnosis, a persons doctor will need to follow clinical guidelines to diagnose MS. Join our weekly newsletter and get our best articles about body, mind, soul. of their symptoms and the treatment options. The body almost completely clears gadolinium from the central nervous system after 48 hours. In the middle of my spine one thoracic vertebrae shows a bright white spot in the bone of the vertebra itself that last for three or four cross sections of the scan. When this happens, the nerves cannot conduct electricity as well as they should, causing various symptoms. MS is more common in Caucasians, but can occur in other populations. The Central Canal in the MRI Lumbar Spine. Dialogues Clin Neurosci. An MRI can show where MS has damaged the myelin sheath because the fat is stripped away in those areas. These lesions require treatment as early as possible. People with MS and bladder problems are at a higher risk of urinary tract infections. In people with MS, there may be an increase in white blood cells and antibody formation in the spinal fluid. As we age, the facets can become larger and may, or may not, press into the nerves. Clinically isolated syndrome (CIS). Any gadolinium deposits that healthcare professionals find on an MRI scan suggest that there is disease activity in the brain. These actions help to strengthen our spine and prevent us from overloading certain spinal segments. While fatigue in MS can be due to a lack of sleep or poor sleep, it is often just one of the symptoms of MS. This article will look at common causes of white spots on a brain MRI, along with risk factors and treatment options. Multiple sclerosis is often difficult to diagnose because there is no single test or finding on an exam that makes the diagnosis and because the disorder varies from person to person. Not everyone needs a lumbar puncture, but it can be very useful. it was a sag stir image done without contrast. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Magnetic resonance imaging has become the single most useful test for the diagnosis of MS; MRI is sensitive to brain changes which are seen in MS. Classically, the MRI shows lesions in the white matter deep in the brain near the fluid spaces of the brain (the ventricles). 1 views . sharp pain in buttocks 3" to the right. As they shrink, the discs begin to bulge into the central spinal canal. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. It is imperative that the patient understands possible causes of their symptoms and the treatment options. The ligamentum flavum may enlarge (hypertrophy). Mri showed white spots, suspected ms, but spinal tap normal. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. With the ease of internet access, self-diagnosis is very common. An annular fissure describes one or more layers of the annulus being disturbed. I did. Inflammation from a new MS brain lesion breaks down the blood-brain barrier, allowing the gadolinium to leak into the brain. The central canal where the nerves reside within the spine can become smaller, causing central stenosis. What is Anterior Cervical Discectomy and Fusion (ACDF). However, the longer a person goes without developing a lesion, the more important it is for a doctor to rule out other conditions. Signs of vision loss or other symptoms that may be the result of neuromyelitis optica include: Lesions on the spine and brain indicate damage to the myelin that protects nerve cells. Cleveland Clinic is a non-profit academic medical center. While we try to limit ordering MRIs for everyone with low back or leg pain until the symptoms are persistent for weeks to months, conservative options such as physical therapy have failed or weakness/ numbness develops, many people have MRIs. In either case, this condition may or may not be symptomatic. If you have white spots, or white matter hyperintensities, on your brain MRI, your healthcare provider will determine the cause based on your medical history and doing an exam. MRI cannot pinpoint the exact cause of pain. Secondary progressive MS (SPMS) is a form of MS that can occur in people who have had RRMS, and it features a general worsening of symptoms over time. Some people with MS have a stable condition, others experience symptoms that worsen rapidly, while some have symptoms that resolve spontaneously. Learn more about what MS looks like on an MRI scan here. A persons symptoms depend on where MS lesions develop. These changes happen when the brain cells are inflamed or damaged. We avoid using tertiary references. MS is a neurological disease. In fact, large bone spurs/ osteophytes may stabilize the spine and autofuse a spinal level. It's easier to see this if you're looking at a T 2 image, in which the spinal canal will be a bright white compared to the rest of the image. It is used when people have had MS for many years without developing significant measurable disability. Discs have a great deal of fluid within them which allow them to act as shock absorbers. Abnormalities in white matter, known as lesions, are most often seen as bright areas or spots on MRI scans of the brain. The symptoms of CIS will last for at least 24 hours. After the age of 60 years old, about 90% of people have at least a "degenerative disc." Low back pain is one of the most common diseases in the United States. It is not clear how useful repeated MRIs are for following MS. Over time, certain areas of your spinal discs can be overstressed, and this can lead to tearing of some of the fibers of the outer layer. That being said, more than 20 percent of patients in the no back pain group were found to have at least one high-intensity zone during the imaging exam, so being pain free doesnt necessarily mean you are also high-intensity zone free. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. It is possible that a person diagnosed with MS may have lesions on their brain but not on their spine. How Are White Spots on the Brain Treated? Lesions occur on both the gray and white matter or on just the gray matter. On the other hand, a person can be asymptomatic with an MRI showing awful, nerve compression from a disc herniation, hypertrophy or spondylolisthesis. While a persons symptoms become more severe, MRI scans will not tend to show an increase or growth in inflammation. Can poor sleep impact your weight loss goals? There does not appear to be a link to trauma. Somatosensory evoked responses are recorded after stimulation of the nerves usually in the arms or legs and are a measure of the nerve activity coming up the nerves and into the spinal cord. The axial images or sliced bread views provide a clearer picture of a specific intervertebral disc and the adjacent nerves. The radiologist makes this report often without any consideration of the patients symptoms. Permanently damaged areas of the brain appear as dark spots. The vertebral bodies are usually labeled 1 through 5, and the discs are named by the bones above and below. The annulus of the disc may bulge, protrude or herniate. Similar to lesions found on the brain, they can appear as areas of bright or dark spots on the spinal cord. You can learn more about how we ensure our content is accurate and current by reading our. A doctor will look at all areas of the brain because the lesions can appear on either white or gray matter. On the other hand, a person can be asymptomatic with an MRI showing awful nerve compression from a disc herniation, hypertrophy or spondylolisthesis. Heart failure: Could a low sodium diet sometimes do more harm than good? These discs have a tough outer ring that surrounds a softer, gelatinous core. In fact, large bone spurs/ osteophytes may stabilize the spine and autofuse a spinal level. In general, the medications do not 'make you feel better,' but do reduce MS activity. According to the National Multiple Sclerosis Society, symptoms of MS include: Less common symptoms include difficulties speaking, swallowing, and breathing. Small strokes are often caused by blockages of small blood vessels due to high blood pressure or diabetes. Oral treatments include teriflunomide, fingolimod, and siponimod. You can't always prevent white spots on the brain but there are some steps you can take to protect your brain. In summary, the MRI findings do not determine whether or not symptoms are occurring. These spots (lesions) are easier to see on T2 weighted imagesa medical term that refers to the frequency (speed) of the radio impulses that are used during the scan. Doctors use various techniques to diagnose MS, including MRI scans and neurological exams. These terms are variations of the same concept. These areas are called plaques or sometimes lesions. With a fracture of the end plate, degenerative disc disease occurs as the fluid within the disc leaks out. Is it normal for a mri to show white spots on spine not the spinal cord but by the discs in between them. MRI scans use strong magnetic fields, radio waves, and computers to create detailed images of the bodys organs and soft tissues. There are two basic types of MRI images that differ by the timing of the radiofrequency pulses, named T1-weighted images and T2-weighted images. MS activity appears on an MRI scan as either bright or dark spots. There are now 16 FDA-approved medications to control the course of MS, all for the treatment of relapsing-remitting MS. (n.d.). Once the technician turns the radio waves off, the protons fall back to their original order. neuro says white spots benign, but what exactly causes them? Learn more about the, Multiple sclerosis (MS) is a progressive condition that affects the central nervous system and the brain. Some people develop back or neck pain, similar to the pain that many other people get. Small strokes are the most common cause of white spots on a brain MRI. I think Alzheimer's causes plaques, which I think are spots, but you are probably much too young for that. The discs tend to lose their water content (desiccate). 5 Look at the space available for your nerves. Anything that interrupts the smooth linear border of the central canal may be a potential problem. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Understanding multiple sclerosis, its symptoms, and how it can progress helps people to assess themselves for this condition. It is imperative that the patient understands. However, the immune system breaks down the disc material slowly over time. While patients with spasticity may be weak, the two are not the same, and strength may be preserved in someone with spasticity. It is not contagious, nor is it infectious. This is a sign of MS. One function of myelin is to help the nerves send impulses. Facet joints or associated synovial cysts posteriorly in the foramenal canal compress the nerve roots. The opposite is also true. To use this dye, they inject it into a persons vein just before the scan starts. I assume your doctor has sat down with you to discuss the results of your mri? In the past, physicians thought that MS did not cause pain. 2013;15(1):45-52. doi:10.31887/DCNS.2013.15.1/fmora, Marek M, Horyniecki M, Frczek M, Kluczewska E. Leukoaraiosis new concepts and modern imaging. Bulges rarely cause any pain or symptoms. Again, many patients may have even large herniations, without nerve inflammation, and therefore no symptoms. Indeed, age spo Any imaging test, especially an MRI, can have spots in them that are not a real abnormality, called motion artifact. The ligamentum flavum is a tissue just behind the nerve sac. If a little material squeezes out it can result in a mild disc herniation. A normal image is noted below on the left compared with the figure on the right which demonstrates severe spinal stenosis. The MRI is very useful in ruling out many other disorders that could be confused with MS, and the blood tests and spinal fluid may also be helpful in diagnosing other diseases. Studies have shown that about 30% of completely pain-free (asymptomatic) people undergoing a lumbar MRI have abnormalities detected. A person living with MS may have lesions in parts of the brain, spinal cord, or optic nerve. Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to email a link to a friend (Opens in new window), Two Level Cervical Disc Replacement (Mobi-C). Spasticity is a common symptom of multiple sclerosis. However, recent studies have shown that up to one-third of people with MS will have pain related to their MS at some time during the course of their disease. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. People with MS may not tolerate heat as well as they used to and may need to avoid particularly hot or humid situations. T2/FLAIR As we age, the ligaments holding the bones in place can loosen and allow the bones to slip. The researchers also observed impaired repair mechanisms and recurrent demyelination in the spinal lesions. Read our. A small disc herniation (figure C) may not produce symptoms. MS lesions can appear in both the brains white and gray matter. The resulting nerve compression can cause progressive pain, weakness and numbness. Disc Bulge/ Annular fissures Disc Herniation/ etc . A normal disc (figure A) provides ample room for the nerves to pass through. The L5 nerve to the top of the foot and big toe. We no longer use the term annular tear as trauma or external injury has not been associated with them. A STIR sequence is to evaluate edema or fluid. Powered by, Minimally Invasive Surgery Lumbar Spine, Anterior Cervical Discectomy and Fusion (ACDF), Minimally Invasive Surgery Cervical Spine, Vagal Nerve Stimulation and Seizure Epilepsy Surgery, About 60% of a persons range of motion is at L4-5 and L5-S1. Even when all the tests are done, some people cannot be diagnosed for years after the beginning of symptoms. The facets are the joints in the back that help the spine move. This article reviews the link between multiple sclerosis and spinal lesions. l3 l4. Other risk factors for white spots include getting older, race/ethnicity, genetics, obesity, diabetes, hypertension, and high cholesterol. We avoid using tertiary references. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://jamanetwork.com/journals/jamaneurology/fullarticle/2747565, https://pubs.rsna.org/doi/full/10.1148/radiol.2018171829, https://pubmed.ncbi.nlm.nih.gov/27349475/, https://www.nationalmssociety.org/What-is-MS/Types-of-MS/Clinically-Isolated-Syndrome-(CIS), https://www.nationalmssociety.org/What-is-MS/Types-of-MS/Relapsing-remitting-MS/Diagnosis, https://www.nationalmssociety.org/What-is-MS/Types-of-MS/Secondary-progressive-MS/Diagnosing-Secondary-Progressive-MS, https://www.ncbi.nlm.nih.gov/pubmed/29856910, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932576/, https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-Tools/MRI, https://www.nibib.nih.gov/science-education/science-topics/magnetic-resonance-imaging-mri, https://www.nationalmssociety.org/What-is-MS/Types-of-MS/Primary-progressive-MS, https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awab088/6164965, https://www.mssociety.org.uk/research/latest-research/latest-research-news-and-blogs/mri-and-ms-7-things-you-need-to-know, https://www.nature.com/articles/nrneurol.2015.157, https://www.sciencedirect.com/science/article/pii/S2211034819304407. Doctors refer to damaged areas on the spine or brain as lesions or MS lesions. C.T of the Lumbar Spine. A 23-year-old female asked: Is it normal for a mri to show white spots on spine not the spinal cord but by the discs in between them Dr. Daniel Clayton answered Specializes in Neurosurgery It can be: It is difficult to answer this without seeing the MRI or at least knowing more about the MRI. can put finger on sore spot? These changes may narrow the canal where the nerves reside in the spine (central stenosis). 2023 Rocky Mountain Brain & Spine Institute. They can also get worse if your risk factors for strokes aren't treated,leading to more lesions on the brain. My mri & mra scan of brain w/contrast show several areas have very small,round, bright, lighter spots? On this site, Dr. Sinicropi periodically provides assessments and commentary on specific procedures that individuals have undergone. Peter Pressman, MD, is a board-certified neurologist developing new ways to diagnose and care for people with neurocognitive disorders. 2017;3(5):e185. Receiving treatment early on could slow the progression of MS. People experiencing mild flare-ups may not require medical attention as the symptoms could go away without treatment. As we age, this ligament can get bigger or hypertrophy. Individuals should always consult a licensed and qualified health care provider for evaluation, diagnosis and treatment recommendations regarding their specific spine or other medical problems. Radio waves then pulse through the body, causing the protons to spin out of order. Although we are still unsure exactly why this is. However all, none or some of these findings may explain your symptoms. A 23-year-old female asked: Is it normal for a mri to show white spots on spine not the spinal cord but by the discs in between them Dr. Daniel Clayton answered Specializes in Neurosurgery It can be: It is difficult to answer this without seeing the MRI or at least knowing more about the MRI. Similarly, some patients may develop transient symptoms lasting only seconds such as twitching in an arm or a leg. 2018;83:76-81. doi: 10.5114/pjr.2018.74344, Wiggins ME, Tanner J, Schwab N, et al. Regardless of the cause, the vast majority of people get better with just rest, time and over-the-counter medicines. We know that it is more common further north and south of the equator. The following are answers to some commonly asked questions. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. According to some researchers, chronic active lesions are very damaging to the brain. MS is an autoimmune disorder that affects the central nervous system. If you have an MRI showing changes, it is recommended you meet with a spine specialist to see if these changes can explain your symptoms. For resources, research, and news for people living with MS, visit our dedicated MS hub. Last Updated on February 17, 2023 by Andre Panagos M.D. What's the Link Between Diabetes and Stroke? MS causes the immune system to attack the myelin sheath that surrounds the brain and spinal cord. The axial view is a cross-section. Listed are some commonly occurring changes, which may be described in a lumbar MRI report. 2020;192(12):1154-1173. doi:10.1055/a-1207-1006, Boehme AK, Esenwa C, Elkind MS. Stroke risk factors, genetics, and prevention. Read More Created for people with ongoing healthcare needs but benefits everyone. MS lesions may appear as either areas of gray, white, or black spots on an MRI, depending on whether they are new or old. Most people think that MS is a rapidly disabling disorder. Dr. Gollogly completed his undergraduate education in biology at Reed College in Portland, Ore. This can also occur from a fracture, either congenitally or from trauma. This article provides an overview of the condition, including. We do not know the cause of MS, but do know that it is an inflammatory disorder of the central nervous system that occurs in people with a tendency to such a problem. Policy. It should NOT be regarded as diagnostic, treatment or any other type of specific medical advice to anyone. The way we accurately treat patients is by correlating their symptoms to specific changes in their MRI. Typical MS lesions tend to be oval or frame shaped. Over time, a lumbar disc degenerates by first developing a disc bulge or bulging disc and/or an annular tear. A person with MS may expect to have routine monitoring of their condition every 312 months. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. The symptoms may vary over time depending on how extensive the demyelination is and on factors such as fatigue and heat. New or expanding lesions captured by a T-1 scan might indicate that a persons MS is worsening. Typically a bulge just means the disc tissue extends towards the nerves, and this can be a normal variant. Sometimes, white spots are caused by silent strokessmall strokes that don't cause symptoms. What are the white spots on my MRI? This article will explain how MS appears on an MRI scan and how often a person with MS should undergo MRI scans. The body may never fully repair the damage, which can lead to scarring. For example, we now know that even with early MS, the nerve fibers themselves (the axons) are affected more than we knew before. Radiology, and specifically MRI scans, can be useful in diagnosing multiple sclerosis (MS), a long-term condition that often worsens over time. Doctors typically provide answers within 24 hours. I finally saw an orthopedic dr. that ordered the MRI. The spots (called lesions) on the scan are areas of active inflammation. Can diet help improve depression symptoms? MS is an inflammatory disorder in which infection-fighting white blood cells enter the nervous system and cause injury. Your spine is comprised of vertebrae that are separated by spinal discs, which help to aid in movement and flexibility. T-1 scans can involve the use of gadolinium, which is a contrast dye, to look for new or growing lesions. About 60% of a persons range of motion is at L4-5 and L5-S1. What causes bright spots in 1 year old brain mri? A healthcare professional places a padded covering partially over the persons head to help keep it from moving during the scan. Anomalies remain bright, while normal brain fluid looks dark. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You can learn more about how we ensure our content is accurate and current by reading our. The result of these changes may narrow the place where the nerve exits the spine (foraminal stenosis). Below, we take a closer look at what high-intensity zones in your back are, and what they mean for the future or your spine health. This slows down the nerves impulses, causing symptoms that may either worsen steadily (known as progressive) or come and go (known as relapsing-remitting). thank you. Spinal fus 1 yr ago. is this normal and what causes this? There are various ways a person can manage spasticity. Roberts, K. (2017). So are age spots. Identify the middle of the central canal where the spinal cord and nerves float in the protective cerebral spinal fluid (CSF). There is evidence that having infections makes having an exacerbation of MS more likely. The bony edges that attach to the discs can enlarge as the discs bulge and may or may not compress the nerves. The normal central canal is usually quite big (figure A) and houses and protects the descending nerves. Spinal fluid testing may show that the immune system is active in and around the brain and spinal cord, supporting the diagnosis. Attacks are one marker of disease activity. The first MRI scan helps serve as a comparison scan, especially in evaluating CIS. Disc desiccation is a nonspecific term which describes natural aging of the discs. Initial symptoms could involve unexplained weakness and sensory changes. Before we explain what a high-intensity zone is, we first need to talk about the formation of your spine. Fluid-attenuated inversion recovery imaging reduces interference from the spinal fluid to help view the effects of MS. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more.
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