School of Medicine

Wayne State University School of Medicine

Multiple Sclerosis

Multiple sclerosis (MS) is an inflammatory disease which damages the insulating covers of nerve cells in the brain and spinal cord, known as myelin. This damage results in a wide range of signs and symptoms including physical and cognitive. MS is usually of two types: with new symptoms either occurring in isolated attacks (relapsing form or RRMS) or slow progression of symptoms from the onset (progressive form or PPMS). However, there is no complete remission as permanent neurological problems may occur over time.

There is no known cure for multiple sclerosis. Treatments attempt to improve function after an attack and prevent new attacks. They may also slow disease from progression. There are 10 treatments approved by the FDA for the treatment of relapsing forms of MS but none for the progressive form. Several new trails are underway to test therapies for PPMS. As of 2008, between 2 and 2.5 million people are affected globally with rates varying widely in different regions of the world and among different populations. The disease usually begins between the ages of 20 and 40 and is three times as common in women as in men. It is widely believed that the earliest detailed description of MS was in 1868 by Jean-Martin Charcot. While the cause is not clear, the underlying mechanism is thought to be either destruction by the immune system or failure of the myelin-producing cells. Proposed causes include genetics and environmental factors such as infections or vitamin D deficiency. MS is usually diagnosed based on the presenting signs and symptoms and the investigations, of which brain MRI scan is the most useful.

Our Laboratory Investigates:

Quantification of tissue injury that includes lesion volume and morphology, brain volume, grey and white matter injury, corpus callosum volume, MTR, DTI, and voxel-wise MTR analysis to detect myelin signal in-vivo.

By using whole brain MTR, we can quantify the myelin content of the whole brain. Quantification of myelin loss at cellular level in a particular lesion over time is also performed by using one of the advanced techniques: Voxel-wised MTR. Microscopic movement of water in tissues is quantified by using DTI.

T1-W Image showing lesion in dark in ROIs

T2-W image showing lesion as hyper-intensity in ROIs (Red)

Voxel -wised analysis of the lesion. Green- remyelination: Blue- stable region; Red- demyelination
Whole brain tissue Magnetization Transfer Ratio (MTR) map
Spinal Cord volume measurement shown in
ROI (Red)

Axial FLAIR image used as reference image to estimate lesion volume