They are less effective in stopping progression of the disease. Routine imaging provides information about the anatomical structures of the brain and is able to document the consequence of progression: severe brain atrophy. It is, unfortunately though, not able to detect the metabolic mechanisms that preceed this irreversible outcome. This project aims to highlight the importance of proton magnetic resonance spectroscopy. Until now this method has been limited to one voxel (2x2x2cm3) and therefore provided only information about one specific region of the brain. We will now extend it to 4x8x8 voxels to cover the majority of the brain by using magnetic resonance spectroscopic imaging (MRSI). As this will lengthen the acquisition time to unrealistic time frames especially in people with disability, we will apply fast echo-planar spectroscopic imaging (EPSI) and spiral MRSI techniques to accelaerate data collection rate and shorten time patients spends in scanner. We will develop methods to analyse this large amount of data and then correlate it with clinical data of our well characterised patient cohort.
We will recruit 20 relapsing remitting MS patients from the John Hunter Hospital MS clinic and age and gender match them with healthy controls. Patients must be between 20-55 y old and be on the same disease modifying treatment for at least 6 months. Participants will sign an informed consent form and undergo scanning at the 3.0 Tesla MRI unit at the Hunter Medical Research Institute (HMRI). Clinical parameters like annualised relapse rate (ARR), expanded disability status scale (EDSS), MS severity score (MSSS), fatigue score and cognitive scores, measured by symbol digit modality test (SDMT) and audiorecorded cognitive screen (ARCS), will be recorded at the same time.
- To develop volumetric MRSI that can identify metabolic changes in most parts of brain in MS patients compared to healthy control.
- To develop a fast acquisition technique that allows this method to be used in clinical practice.
- To correlate these metabolic changes with clinical signs of disability.