Grant: Project Grant

At least 50% of people living with multiple sclerosis (MS) have a progressive form of the disease, meaning that disability increases steadily. This can include physical progression, e.g. difficulty walking, and cognitive progression, meaning that people experience problems with memory, attention and problem solving. Cognitive impairment has a negative impact on quality of life, making it difficult to perform everyday tasks, and is the leading cause of unemployment for people with MS. It is difficult to determine if treatments for MS will help slow or reverse progression because symptoms worsen gradually, so clinical trials require a large number of participants and take many years. If we can understand the cause of progression in MS, we can find better ways to figure out if a treatment is working. Our goal is to show that we can use new magnetic resonance imaging (MRI) techniques to predict progression. MS damages myelin, a fatty substance that covers and protects nerve fibers in the brain and spinal cord. We have developed an advanced MRI technique that can measure the amount of myelin present. We looked at the relationship between the amount of myelin and how well people performed on physical and cognitive tests. We found that myelin and test scores are closely linked, which tells us myelin damage plays a role in progression. In this study, we will ask our previous volunteers with MS to return 4 years after their original visit so we can collect additional physical, cognitive and myelin MRI data. We will explore whether the amount of myelin at the beginning of the study can predict changes in disability. We will also use new MRI tools to determine what other biological changes, in addition to myelin damage, are linked to progression. Understanding the link between biological changes (in particular myelin) and physical and cognitive changes will allow these more specific imaging methods to be used in clinical trials trying to slow myelin damage and progression.