MS Center Research

Clinicoradiological paradox:
MS is more than counting lesions. The lesions on the brain don't always correlate with what is happening to the patient. Sometimes there are NO lesions related to a severe symptom.

Optical coherence tomography (OCT):
This is a way to assess retinal damage. It turns out that MS causes not only optic neuritis (inflammation of the optic nerve, which kills nerve cells--I have this on the left side) but retinal thinning. And retinal thinning is related not only to vision changes but to brain atrophy.

I learned on another website that brain atrophy in MS happens when a bunch of dead areas occur in the brain, and then the brain sort of collapses down on them. Sometimes there is no evidence of brain damage (no lesions) for years, and then suddenly brain atrophy shows up on an MRI. At this clinic, they are using OCT to predict who will have brain atrophy... and prevent it.

Project RESTORE:
REcover, STop, and REgenerate. Recover function, from acute attacks, and from illness. Stop progression of disease and progression of disability. Regenerate nerve cells and myelin. This all sounds great--hopefully they can do at least some of what they aspire. I saw that my doctor is involved with this project.

Clinical trials:
They are trialing three new drugs. One is combining oral estrogen with a common injected disease-modifying drug (DMD). Pregnancy puts MS into remission, so this one sounds promising.

Another trial is to make a common DMD last longer, so that it doesn't have to be injected as often. This is great, but I suspect the main reason they're researching this slightly modified drug is because the patent on that DMD will expire in a few years.

The third trial is of a completely new DMD--one for primary progressive MS. The rest of the DMDs are for relapsing-remitting MS.

Imaging:
They are experimenting with 7 Tesla MRI. Current "high" strength MRI is 3 Tesla, and most are 1.5 or less. I think my brain images were on a 1.0 Tesla machine. It is known that 25% more lesions show up using 3T compared with 1.5T. I wonder how many more would show up using 7T.

They are also experimenting with some imaging techniques I am not familiar with: diffusion tensor imaging, magnetization transfer imaging, and magnetic resonance spectroscopy.

Psychiatric and neurological:
One doctor is interested in the immune-mediated mechanisms of depression and cognitive impairment in MS and several other autoimmune neurological disorders. He is a psychiatrist.

Sensory neuropathy:
One doctor developed a technique to use superficial nerves to study sensory neuropathies associated with immune-mediated neurological disorders: MS and a bunch of others.

Inflammation:
They are researching how to protect nerves from damage due to inflammation. Also trying to understand how new neurons are produced.


This is all going on at the MS Center where I'll see a neurologist on November 23. My guy is mostly focused on treatment--he's still an assistant professor and probably is still establishing his own lines of research.

I'm on the cancellation list, of course, and I certainly hope I can get in sooner!