학술논문

Imaging outcome measures of neuroprotection and repair in MS: A consensus statement from NAIMS.
Document Type
article
Source
Neurology. 92(11)
Subject
Brain Disorders
Neurodegenerative
Clinical Research
Biomedical Imaging
Multiple Sclerosis
Clinical Trials and Supportive Activities
Autoimmune Disease
Neurosciences
Neurological
Brain
Diffusion Tensor Imaging
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Multimodal Imaging
Nerve Regeneration
Neuroprotection
Outcome Assessment
Health Care
Positron-Emission Tomography
Spinal Cord
North American Imaging in Multiple Sclerosis Cooperative
Clinical Sciences
Cognitive Sciences
Neurology & Neurosurgery
Language
Abstract
ObjectiveTo summarize current and emerging imaging techniques that can be used to assess neuroprotection and repair in multiple sclerosis (MS), and to provide a consensus opinion on the potential utility of each technique in clinical trial settings.MethodsClinicians and scientists with expertise in the use of MRI in MS convened in Toronto, Canada, in November 2016 at a North American Imaging in Multiple Sclerosis (NAIMS) Cooperative workshop meeting. The discussion was compiled into a manuscript and circulated to all NAIMS members in attendance. Edits and feedback were incorporated until all authors were in agreement.ResultsA wide spectrum of imaging techniques and analysis methods in the context of specific study designs were discussed, with a focus on the utility and limitations of applying each technique to assess neuroprotection and repair. Techniques were discussed under specific themes, and included conventional imaging, magnetization transfer ratio, diffusion tensor imaging, susceptibility-weighted imaging, imaging cortical lesions, magnetic resonance spectroscopy, PET, advanced diffusion imaging, sodium imaging, multimodal techniques, imaging of special regions, statistical considerations, and study design.ConclusionsImaging biomarkers of neuroprotection and repair are an unmet need in MS. There are a number of promising techniques with different strengths and limitations, and selection of a specific technique will depend on a number of factors, notably the question the trial seeks to answer. Ongoing collaborative efforts will enable further refinement and improved methods to image the effect of novel therapeutic agents that exert benefit in MS predominately through neuroprotective and reparative mechanisms.