Chronic inflammation in multiple sclerosis — seeing what was always there
File(s)
Accepted version
Author(s)
Matthews, Paul
Type
Journal Article
Abstract
Activation of innate immune cells and other brain compartmentalized inflammatory cellsin the brains and spinal cords of people with relapsing–remitting multiple sclerosis (MS) and progressive MS have been well described histopathologically. However, conventional clinical MRI is largely insensitive to this inflammatory activity. The past two decades have seen the introduction of quantitative dynamic MRI scanning with contrast agents that are sensitive to the reduction in blood–brain barrier integrity associated with inflammation and to the trafficking of inflammatory myeloid cells. New MRI imaging sequences provide improved contrast for better detection of grey matter lesions. Quantitative lesion volume measures and magnetic resonance susceptibility imaging are sensitive to the activity of macrophages in the rims of white matter lesions. PET and magnetic resonance spectroscopy methods also can be used to detect contributions from innate immune activation in the brain and spinal cord. Some of these advanced research imaging methods for visualization of chronic inflammation are practical for relatively routine clinical applications. Observations using these techniques suggest ways of stratifying patients with MS to improve their care. The imaging methods also provide new tools to support the development of therapies for chronic inflammation in MS.
Date Issued
2019-08-16
Date Acceptance
2019-07-24
Citation
Nature Reviews Neurology, 2019, 15, pp.582-593
ISSN
1759-4758
Publisher
Nature Research (part of Springer Nature)
Start Page
582
End Page
593
Journal / Book Title
Nature Reviews Neurology
Volume
15
Copyright Statement
© 2019 Springer Nature Limited
Sponsor
Medical Research Council (MRC)
National Institute for Health Research
UK DRI Ltd
Grant Number
MR/N026934/1
RDA26
4050641385
Subjects
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Neurosciences & Neurology
CENTRAL-NERVOUS-SYSTEM
POSITRON-EMISSION-TOMOGRAPHY
SUPERPARAMAGNETIC IRON-OXIDE
BRAIN-BARRIER PERMEABILITY
APPEARING WHITE-MATTER
B-CELL FOLLICLES
CORTICAL-LESIONS
IN-VIVO
TRANSLOCATOR PROTEIN
CEREBROSPINAL-FLUID
Neurology & Neurosurgery
1103 Clinical Sciences
1109 Neurosciences
1113 Opthalmology and Optometry
Publication Status
Published