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Imaging to evaluate remyelination and neuroprotection

The treatment goals of remyelination and neuroprotection in multiple sclerosis (MS) present new challenges to treatments, and also in finding ways to evaluate these outcome measures. Dr Benedetta Bodini (Sorbonne University, France) discussed the potential of MRI and PET techniques in evaluating myelin repair and neuroprotection in clinical treatment trials [1].

MRI offers very high sensitivity to tissue microstructural damage and generally has a high resolution; PET has the highest possible specificity for single cellular, myelin, or neuronal targets, but at the expense of resolution, which is generally very low.

Dr Bodini gave an overview of MRI techniques that are sensitive to myelin content changes. Magnetisation transfer ratio (MTR) is very sensitive to myelin and has very reasonable acquisition times. However, the signal is affected by oedema and axonal density, as well as by microglia. MTR captures changes in myelin content in single lesions....

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