Multiple Sclerosis (MS)

Multiple sclerosis is a chronic disease associated with progressive loss of myelin, the natural insulator of nerves.

Overview

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system, characterised by demyelination and axonal damage. Patients may present with a wide range of symptoms, such as vision problems, muscle spasms, mobility impairment, cognitive dysfunctioning and fatigue. The age of onset of symptoms generally lies between 20 to 40 years. MS may present with an immediate progressive disease course – primary progressive MS – or with a relapsing-remitting disease course that usually results in a progressive course – secondary progressive MS - at later stages.

Together with the Anne Rowling Clinic at the University of Edinburgh we study patients with relapsing-remitting MS and primary progressive MS. The aim is to aid patient treatment by means of better early disease stratification for treatment with existing and new therapies. Patients included in these studies receive an extensive range of assessments, including brain and retinal imaging, and cognitive, inflammatory markers and genetic tests, that will help map the disease from multiple perspectives. Using quantitative brain imaging, we aim to develop biomarkers that aid prediction of clinical disability over time, or that act as reliable measures of disease status. Additionally, they are used to test drug effectiveness and may aid explanation of some biological processes underlying MS. In addition to quantifying MS lesions and brain volume using standard structural MRI we are also using diffusion tensor imaging (DTI) and magnetisation transfer (MT) imaging. These techniques are able to detect subtle brain abnormalities that we cannot detect using conventional imaging techniques; in particular the integrity of myelin, which is critical for nerve function and a hallmark of damage in MS.