New imaging test for multiple sclerosis developed at Case could help speed up new treatments & Discoveries

By Brie Zeltner, The Plain Dealer on September 24, 2013

CLEVELAND, Ohio– Multiple sclerosis, an immune-related disease of the brain and spinal cord that causes muscle spasms, numbness and difficulty walking, has no cure. Several treatments can stabilize the disease early in its course or slow it down once it has advanced, but many of them have serious side effects.

One of the impediments to advancing research on new treatments for MS is that there is no imaging test that can track or show the exact state of damage to the myelin, which is the fatty protective insulation to the nerves that is broken down during the disease.

Now, researchers at Case Western Reserve University think they have found a way to do just that, using positron emission tomography, or PET imaging and a molecular marker called MeDAS. By injecting MeDAS into the spinal cords of mice and rats that have an animal model of the disease, they were able to show, and quantify, the damage done to the animals’ myelin.

“This is a highly desired technique in the medical community,” said Yanming Wang, senior author of the paper describing their findings published Monday in the journal Annals of Neurology, and associate professor of radiology at Case. “[Drug companies] have myelin-repairing drugs in development but no way to measure their effectiveness in a quantitative way. This imaging technique could allow them to do that.”

About 400,000 people in the United States and more than 2 million people worldwide have multiple sclerosis, according to the National MS Society. The disease is two to three times more common in women.

Wang said the technique may also be of use in other diseases that involve nervous system damage, such as Alzheimer’s disease, spinal cord injury and stroke.

Wang’s group, at Case’s Center for Imaging Research, has been working on the problem for a decade, he said. It’s been difficult to find a molecule that could penetrate into the brain and attach itself to the myelin in the spinal cord and nowhere else in the body. MeDAS was able to do that.

The traditional imaging test for diagnosing MS is magnetic resonance imaging, or MRI. This technique can show inflammation and is pretty reliable at helping diagnose the disease in its early stages, but cannot accurately track the disease’s progression. PET imaging uses a different method to take pictures of the brain and spinal cord that reveals how well these tissues are functioning at any given time.

PET can, for example, tell doctors if a patient’s nerves are still working in the spinal cord or if there has been additional loss of myelin over time, Wang said. It is therefore potentially much more valuable as a tool to track the progress of the disease or to see if a treatment is working, he said.

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