2014
DOI: 10.1136/jnnp-2014-307650
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Imaging outcomes for trials of remyelination in multiple sclerosis

Abstract: Trials of potential neuroreparative agents are becoming more important in the spectrum of multiple sclerosis research. Appropriate imaging outcomes are required that are feasible from a time and practicality point of view, as well as being sensitive and specific to myelin, while also being reproducible and clinically meaningful. Conventional MRI sequences have limited specificity for myelination. We evaluate the imaging modalities which are potentially more specific to myelin content in vivo, such as magnetisa… Show more

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Cited by 102 publications
(84 citation statements)
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“…[26][27][28][29] This imaging finding may hold promise for predicting disability progression and monitoring remyelination, and represents a possible new outcome marker for MS therapies. 30,31 Global brain volume changes The pathological hallmark of MS is the presence of multi ple focal demyelinating lesions in the cerebral white and grey matter, but substantial brain atrophy can also occur. 32 Over the past few years, several studies have used MRI derived methods to assess brain volume changes, revealing that atrophy can be present even in the early stages of MS, and that it advances over the disease course (Figure 2).…”
Section: Focal Lesionsmentioning
confidence: 99%
See 1 more Smart Citation
“…[26][27][28][29] This imaging finding may hold promise for predicting disability progression and monitoring remyelination, and represents a possible new outcome marker for MS therapies. 30,31 Global brain volume changes The pathological hallmark of MS is the presence of multi ple focal demyelinating lesions in the cerebral white and grey matter, but substantial brain atrophy can also occur. 32 Over the past few years, several studies have used MRI derived methods to assess brain volume changes, revealing that atrophy can be present even in the early stages of MS, and that it advances over the disease course (Figure 2).…”
Section: Focal Lesionsmentioning
confidence: 99%
“…Treatment options and strategies for patients with MS are dynam ically moving towards an individualized approach that includes conventional targets-immune modulation and immune suppression-and new targets such as neuro protection and remyelination. 26,31,120 Therefore, we will need new MRI biomarkers that focus on additional and alternative aspects of MS pathology.…”
Section: Future Perspectivesmentioning
confidence: 99%
“…Clinical trials of potential neuroreparative therapies are becoming more important in the spectrum of MS research. Imaging techniques used in modern MS clinical trials are required to be feasible from a time and practicality point of view, sensitive and specific for detection of demyelination and axonal loss, reproducible, and clinically meaningful 23. Although the use of non‐conventional MRI techniques, such as magnetization transfer, diffusion tensor, and position emission tomography imaging, have great potential to identify specific pathological substrate changes over time, their use in clinical MS trials has been limited in the past 24…”
Section: Discussionmentioning
confidence: 99%
“…In addition, there is a crucial need for the standardization of reading and interpretation of MS pathology on conventional MRI such as cortical grey matter lesions as well as for atrophy measurements. In addition, there is an unmet need for knowledge and guidance regarding the investigation in phase 1 and 2 clinical trials [43,44]. Among these substances, remyelinating agents are of particular interest and clinical relevance in MS.…”
Section: Resultsmentioning
confidence: 99%