Chronic inflammation in multiple sclerosis — seeing what was always there

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Title: Chronic inflammation in multiple sclerosis — seeing what was always there
Authors: Matthews, P
Item 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.
Issue Date: 16-Aug-2019
Date of Acceptance: 24-Jul-2019
ISSN: 1759-4758
Publisher: Nature Research (part of Springer Nature)
Journal / Book Title: Nature Reviews Neurology
Sponsor/Funder: Medical Research Council (MRC)
National Institute for Health Research
Funder's Grant Number: MR/N026934/1
Publication Status: Accepted
Embargo Date: 2020-02-16
Appears in Collections:Faculty of Medicine

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