NeuroRX

, Volume 2, Issue 2, pp 277–303 | Cite as

Imaging of multiple sclerosis: Role in neurotherapeutics

  • Rohit Bakshi
  • Alireza Minagar
  • Zeenat Jaisani
  • Jerry S. Wolinsky
Article

Summary

Magnetic resonance imaging (MRI) plays an ever-expanding role in the evaluation of multiple sclerosis (MS). This includes its sensitivity for the diagnosis of the disease and its role in identifying patients at high risk for conversion to MS after a first presentation with selected clinically isolated syndromes. In addition, MRI is a key tool in providing primary therapeutic outcome measures for phase I/II trials and secondary outcome measures in phase III trials. The utility of MRI stems from its sensitivity to longitudinal changes including those in overt lesions and, with advanced MRI techniques, in areas affected by diffuse occult disease (the so-called normal-appearing brain tissue). However, all current MRI methodology suffers from limited specificity for the underlying histopathology. Conventional MRI techniques, including lesion detection and measurement of atrophy from T1- or T2-weighted images, have been the mainstay for monitoring disease activity in clinical trials, in which the use of gadolinium with T1-weighted images adds additional sensitivity and specificity for areas of acute inflammation. Advanced imaging methods including magnetization transfer, fluid attenuated inversion recovery, diffusion, magnetic resonance spectroscopy, functional MRI, and nuclear imaging techniques have added to our understanding of the pathogenesis of MS and may provide methods to monitor therapies more sensitively in the future. However, these advanced methods are limited by their cost, availability, complexity, and lack of validation. In this article, we review the role of conventional and advanced imaging techniques with an emphasis on neurotherapeutics.

Key Words

Multiple sclerosis magnetic resonance imaging brain atrophy diffusion imaging magnetization transfer spectroscopy functional imaging 

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Copyright information

© The American Society for Experimental NeuroTherapeutics, Inc 2005

Authors and Affiliations

  • Rohit Bakshi
    • 1
    • 4
  • Alireza Minagar
    • 2
  • Zeenat Jaisani
    • 1
  • Jerry S. Wolinsky
    • 3
  1. 1.Departments of Neurology and Radiology, Partners MS Center, Center for Neurological ImagingBrigham and Women’s Hospital, Harvard Medical SchoolBoston
  2. 2.Department of NeurologyLouisiana State University Health Sciences CenterShreveport
  3. 3.Department of NeurologyUniversity of Texas Health Science Center at HoustonHouston
  4. 4.FAAN Brigham & Women’s Hospital Harvard Medical SchoolBoston

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