A new way of looking at the brains of multiple sclerosis (MS) patients could greatly enhance doctors’ ability to select the best therapy for each person.
Researchers from The University of Texas at Dallas’ Center for BrainHealth have joined colleagues at UT Southwestern Medical Center to study 3D images of MS lesions in the brain, with the aim of learning to differentiate between injuries that are likely to heal and those that are not.
In a study published online May 30 in the Journal of Neuroimaging, the researchers examined 109 brain lesions from 23 MS patients using a patent-pending technique employing 3 Tesla MRI.
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“Studying a lesion and the tissue surrounding it in three dimensions is a novel approach,” said Dr. Dinesh Sivakolundu, the lead author of the study and a PhD student in the Department of Biological Sciences at UT Dallas. “This has allowed us to compile a list of defining characteristics of MS lesions, including cerebral blood flow, metabolic rate of oxygen, and their shape and texture.”
Understanding the significance of each detail and having reliable images of the area will improve the prospects of choosing the appropriate therapy for individual patients, Sivakolundu said.
This illustration shows an isolated MS lesion in 3D.
“Right now, the state of the art for assessing MS lesions is getting multiple two-dimensional cross sections,” said Sivakolundu, who holds a medical degree from Government Kilpauk Medical College in Chennai, India. “This leaves out data on the severity of the underlying injury, the harm done to the tissue surrounding those lesions and an estimate of how long the lesion has existed. There is very little data for determining if a lesion can heal or not.”
Established pharmaceutical therapies for MS focus on using immunosuppressive medication to limit further neurological damage. However, new drugs are expected to be available soon that enhance the capacity of an existing lesion to heal if it is able. This occurs through a process called remyelination — restoring the damaged myelin coverings of nerve cells to reestablish their ability to conduct the electrical signals that make the brain work.
Dr. Darin T. Okuda, senior author of the study, is a professor in the Department of Neurology and Neurotherapeutics at UT Southwestern and director of the Neuroinnovation Program. Members of his laboratory performed the 3D phenotyping of brain lesions in collaboration with Dr. Xiaohu Guo, a professor of computer science in UT Dallas’ Erik Jonsson School of Engineering and Computer Science.
