Despite available treatments for slowing the progression of multiple sclerosis, many patients still experience worsening symptoms. A new brain imaging technique may help.
Researchers at Brigham and Women’s Hospital in Boston have developed a way, using positron emission tomography (PET) scans, to detect “smoldering inflammation,” which could drive MS progression but is invisible on standard magnetic resonance imaging (MRI) tests—the preferred imaging method for MS.
PET Approach Could Explain Paradoxical MS Worsening
“One of the perplexing challenges for clinicians treating patients with MS is after a certain amount of time, patients continue to get worse while their MRIs don’t change,” Dr. Singhal said.Over the past eight years, Dr. Singhal and his team have worked on developing a new way to scan for inflammation. Their solution involved imaging immune cells in the brain called microglia, which are believed to play a role in the progression of multiple sclerosis but cannot be seen on routine MRI scans.
Putting the Test to the Test
The research team tested the PET imaging on 22 people with MS, plus an additional eight healthy individuals. In the PET scans, the team examined what they described as the level of “smoldering inflammation” from the microglia in the MS patients, then compared it to the healthy participants.They also compared the levels of smoldering inflammation to each patient’s disability and level of fatigue, and found a correlation. For example, the more “smoldering inflammation” in the microglia cells the team found, the more likely a patient was to report fatigue and difficulty managing their MS.
Radiation Risks
Unlike MRIs, PET scans expose patients to some levels of radiation.That radiation exposure could potentially be reduced if a different tracer is used, according to Dr. Singhal.
Because the study was performed on such a small sample size, the technique needs more research before it can be used routinely in a clinical setting, Dr. Singhal said.
