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1 results

  • 20 - The challenge of demonstrating long-term benefit of disease-modifying therapies in multiple sclerosis

  • from Section II - Clinical trial methodology
  • Edited by Jeffrey A. Cohen, Richard A. Rudick
  • Book:
    Multiple Sclerosis Therapeutics
    Published online:
    05 December 2011
    Print publication:
    20 October 2011, pp 244-252

  • Summary

    The inflammatory response itself is probably partially responsible for some of the acute conduction block in multiple sclerosis (MS). Proton magnetic resonance spectroscopy (1H-MRS(I)) studies of neuroaxonal NA levels have emphasized that axonal disturbance in the brains of patients with MS can be substantial and widespread, encompassing both the lesional and normal appearing white matter and gray matter. The ability to observe axonal disturbance in vivo allows for correlations across time to be made between measures of axonal pathology and measures of clinical disability. The role of glutamate in mediating neuronal, axonal and oligodendrocyte damage in MS is a promising area of investigation enabled by 1H-MRS(I). 1HMRS(I) has an important role to play in the assessment of new treatments for MS that are directed towards either limiting the damage to the neuro-axonal central nervous system (CNS) or to enhancing its recovery after inflammatory damage.