Quantitative magnetic resonance measurement of brain changes in multiple sclerosis

• Grant number: 07/00082-6
• Support Opportunities: Regular Research Grants
• Duration: June 01, 2007 - May 31, 2009
• Field of knowledge: Health Sciences - Medicine - Medical Radiology
• Principal Investigator: Antonio Carlos dos Santos
• Grantee: Antonio Carlos dos Santos
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Multiple sclerosis (MS) is an inflammatory demyelinating disease with unknown cause, with strong influence of both genetic and environment. Multiple plaques of demyelization with few millimeters characterize the histology of MS, but it can reach many centimeters. In addition, microscopic lesions are diffuse in the normal appearing with matter (NAWM) on gross pathology and conventional magnetic resonance imaging (MRI). Clinically the disease is characterized by attacks followed by remissions on a very variable pattern with many sub clinic attacks what makes the MRI extremely valuable due its high sensitivity to MS lesions, even those not clinically apparent. Thus, MRI has been confirmed as a very important tool for diagnose and follow-up. However, beside the high sensitivity, MRI has a low specificity to discriminate demyelization from edema, gliosis and axonal lesion. In addition MRI has a very low sensitivity to the microscopic lesion on the NAWM. To cope those limitations quantitative magnetic resonance techniques (qMR) have been used. Between the qMR options some are currently used on MS patients and have biologic substrate well defined, like the T2 and T1 lesion volume as a marker of the burden disease, the number of enhancement lesions as a marker of inflammation, the brain atrophy as a parameter of tissue loss, the magnetization transfer ratio as a indicator of myelin destruction, and the MR spectroscopy with NAA quantification to measure the axon metabolic dysfunction. The objective of this project is to follow clinically defined MS patients, including subgroups in the relapsing-remitting and the secondarily progressive phase, subgroups under different treatment approach (using only corticosteroid in the attach, using interferon, or after autologous bone marrow transplant) in order to add new evidences to the MS pathophysiology and the process of brain tissue destruction and repair. (AU)