Multiple sclerosis patients often present at Brigham and Women’s Hospital, saying they feel worse, but image tests appear stable. Wanting to fill that information gap, researchers at the Harvard teaching hospital are harnessing a powerful 7 Tesla MRI machine to spot overlooked signs of the disease’s progression, and improve treatment.
They’ve found that one MRI marker of brain inflammation in MS patients may be more common than previously thought, and a possible sign of gray matter injury, they reported in a study published Tuesday, Nov. 12, in the Multiple Sclerosis Journal.
"The 7T MRI scanner affords us new ways of viewing areas of damage in neurologic diseases such as MS that were not well seen using 3T MRI; it's capturing nuances that we would otherwise miss," study co-author Jonathan Zurawski, MD, a neurologist at Brigham, said in a statement. "The 7T scanner reveals markers or signatures that were poorly characterized or overlooked and may allow us to better understand the disease process and ultimately better treat MS patients.”
To reach their early conclusions, Zurawski and colleagues enrolled 30 participants in their study with the earliest form of the central nervous system disease, called relapsing remitting MS. Along with 15 more healthy subjects, they underwent detailed 7T MRI scans as scientists sought signs of inflammation at the meninges—a thin tissue covering the brain and spinal cord—and gray matter lesions.
Meningeal inflammation could be a key clue to understand how MS progresses from its early form, Brigham researchers noted.
They found that two-thirds of MS subjects had leptomeningeal enhancement (LME), compared to just one of the healthy participants; previous studies using 3T MRI found rates of LME as low as 20%. MS participants also displayed a four- to five-fold increase in cortical and thalamic lesions, which researchers noted is a telltale sign of gray matter injury.
The study was limited by its small sample size, and Zurawski and colleagues were not yet able to address how LME might affect the disease’s progression. But they plan to continue following participants to gauge how LME and gray matter lesions change over time, and will also look to add additional subjects.
"Gray matter injury is an important part of MS, which may be a key factor leading to disease progression," Zurawski said in a statement. "Our hope is that by finding new markers of this progression, it opens up the opportunity for developing treatments that can prevent progression before lesions become widespread."
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.