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MS-QMRI: Advanced MRI to investigate progression in MS
The pathophysiology of multiple sclerosis (MS) disease progression still remains unclear. Not knowing when the progression will start and why is a major concern for people with MS and their carers, including their consultant neurologists. In MS, brain and spinal cord abnormalities may be observed using conventional Magnetic Resonance Imaging (MRI) techniques, but these are qualitative in nature and not specific to the mechanisms underlying pathology, such as demyelination, remyelination, inflammation and axonal loss. To overcome this limitation, we have developed novel fast quantitative brain and spinal cord acquisition protocols including quantitative magnetization transfer (qMT) to calculate parameters such as the ‘restricted’ proton fraction, which measures protons bound to macromolecules, especially myelin, and multi-shell diffusion-weighted imaging to obtain indices of neurite density and neural diffusivity, related to axonal integrity. The proposed multi-modal protocols will now be evaluated in a longitudinal study (with data acquired at two time points, 18 months apart) in early secondary progressive MS subjects, in order to assess clinical progression, and healthy volunteers. Fast and robust acquisition methods for brain and spinal cord myelin and axonal damage markers of clinical progression in MS are essential for assessing and monitoring the effects of upcoming neuroprotective and reparative treatments.
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