title: Imaging as an Outcome Measure in Multiple Sclerosis.
abstract: Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Magnetic resonance imaging (MRI) is sensitive to lesion formation both in the brain and spinal cord. Imaging plays a prominent role in the diagnosis and monitoring of MS. Over a dozen anti-inflammatory therapies are approved for MS and the development of many of these medications was made possible through the use of contrast-enhancing lesions on MRI as a phase II outcome. A similar phase II outcome method for the neurodegeneration that underlies progressive courses of the disease is still unavailable. Although magnetic resonance is an invaluable tool for the diagnosis and monitoring of treatment effects in MS, several imaging barriers still exist. In general, MRI is less sensitive to gray matter lesions, lacks pathological specificity, and does not provide quantitative data easily. Several advanced imaging methods including diffusion tensor imaging, magnetization transfer, functional MRI, myelin water fraction imaging, ultra-high field MRI, positron emission tomography, and optical coherence tomography of the retina study promising ways of overcoming the difficulties in MS imaging.
authors.affiliation: Mellen Center for Multiple Sclerosis, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA. ontaned@ccf.org.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ontaneda
authors.affiliation: Mellen Center for Multiple Sclerosis, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Fox
mesh_terms: D001284:Atrophy / Q000000981:diagnostic imaging; D015415:Biomarkers; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D002986:Clinical Trials as Topic; D018450:Disease Progression; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging* / Q000473:pathology; D009186:Myelin Sheath / Q000473:pathology; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000000981:diagnostic imaging* / Q000473:pathology; D041623:Tomography, Optical Coherence
chemical_list: D015415:Biomarkers
keywords: MRI; Multiple sclerosis; atrophy; biomarker; lesions; optical coherence tomography