During the initial funding period, our group developed a novel Diffusion Basis Spectrum Imaging (DBSI) method to simultaneously detect and quantitate inflammation, demyelination and axon injury in vivo using diffusion imaging (Wang et al. 2011). DBSI has substantially improved the accuracy and specificity of our prior diffusion tensor imaging (DTI) approach, by overcoming the main inadequacies of DTI. We hypothesize that DBSI can quantitate the proportions of axon injury, demyelination, and inflammation in CNS of MS patients. We previously showed using a mouse model that DBSI detects and quantitates axonal and myelin injuries that had escaped detection by standard imaging, and by DTI. Our preliminary data now include validation of DBSI using autopsied and biopsied human specimens, with favorable correlations with human histology. We also now have longitudinal data spanning 1.5 yrs, and comparisons of DBSI with magnetization transfer imaging (MTI). In Project 3, we will apply DBSI to humans with MS, comparing it to standard MRI, DTI and MTI. Project 3 will classify MS lesion subtypes by measures of axon injury, demyelination, and inflammation (cellularity and increased free water due to edema or tissue loss), and follow the patients over 4 years to identify predictors and correlates of clinical deterioration. We expect to achieve this using DBSI by differentiating prominent axonal injury vs. axon preservation, and demyelination vs. myelin preservation/ remyelination. We will examine established persistent black holes (PBHs) (new sub-aim), and perform longitudinal assessments of gadolinium-enhancing (Gd+) MS lesions to determine if DBSI will predict PBH formation, representing severe axon loss. With its ability to profile lesions and normal-appearing CNS, DBSI could help non-invasively elucidate the substrate of MS lesion formation and detect inflammation behind an intact blood-CNS-barrier (not detected by Gd+). DBSI has potential to aid development and testing of new therapies for progressive MS where loss of axons and tissue integrity are believed to play a large role.
Multiple Sclerosis affects about 2 million people worldwide, yet we do not even understand what causes it. The pathogenesis of progressive MS, for which no effective disease modifying treatments have yet been developed, is particularly unclear. One reason the field has been slow to fully understand MS is that CNS tissue sampling is rare (due to potential to cause harm), and the disease changes with time. We developed a new imaging method for use in MS to detect and measure loss of myelin and nerve fibers, as well as inflammation. Using a clinical MRI scanner, this is a non-invasive and safe way to see the underlying pathology in brains of people with MS. Upon validation, this method will lead to better understanding of the underlying MS disease process, and should also improve our ability to test new treatments.
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|Lin, Tsen-Hsuan; Chiang, Chia-Wen; Perez-Torres, Carlos J et al. (2017) Diffusion MRI quantifies early axonal loss in the presence of nerve swelling. J Neuroinflammation 14:78|
|Klein, Robyn S; Hunter, Christopher A (2017) Protective and Pathological Immunity during Central Nervous System Infections. Immunity 46:891-909|
|Adusumilli, Gautam; Trinkaus, Kathryn; Sun, Peng et al. (2017) Intensity ratio to improve black hole assessment in multiple sclerosis. Mult Scler Relat Disord 19:140-147|
|Hou, Jianghui; Baker, Lane A; Zhou, Lushan et al. (2016) Viral interactions with the blood-brain barrier: old dog, new tricks. Tissue Barriers 4:e1142492|
|Salimi, Hamid; Cain, Matthew D; Klein, Robyn S (2016) Encephalitic Arboviruses: Emergence, Clinical Presentation, and Neuropathogenesis. Neurotherapeutics 13:514-34|
|Kim, Joong Hee; Song, Sheng-Kwei; Haldar, Justin P (2016) Signal-to-noise ratio-enhancing joint reconstruction for improved diffusion imaging of mouse spinal cord white matter injury. Magn Reson Med 75:852-8|
|Yue, Xuyi; Jin, Hongjun; Liu, Hui et al. (2015) A potent and selective C-11 labeled PET tracer for imaging sphingosine-1-phosphate receptor 2 in the CNS demonstrates sexually dimorphic expression. Org Biomol Chem 13:7928-39|
|Daniels, Brian P; Klein, Robyn S (2015) Knocking on Closed Doors: Host Interferons Dynamically Regulate Blood-Brain Barrier Function during Viral Infections of the Central Nervous System. PLoS Pathog 11:e1005096|
|Wang, Yong; Sun, Peng; Wang, Qing et al. (2015) Differentiation and quantification of inflammation, demyelination and axon injury or loss in multiple sclerosis. Brain 138:1223-38|
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