Assessing Deep Gray Matter Loss in Cortical, Thalamic Regions to Understand MS Progression: Robert Zivadinov, MD, PhD

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The director of the Buffalo Neuroimaging Analysis Center discussed the need to further explain differences in cortical lesions and deep gray matter in patients with severely affected multiple sclerosis. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

"Now, based on these results, we are going to target much more sophisticated imaging protocols, including maybe 7-Tesla MRI, to detect better cortical lesions and spinal cord damage, as well as potentially PET to recognize microglia."

A collaboration between The Boston Home (TBH) and the University at Buffalo (UB), the CASA-MS study is an ongoing trial understanding severe multiple sclerosis (MS) through imaging, clinical, cognitive, and laboratory features. The analysis included 53 patients with MS from TBH who had Expanded Disability Status Scale (EDSS) scores between 8.0 and 9.5, and 53 individuals from UB who had EDSS between 3.0 and 6.5. Between the cohorts, more patients in TBH had non-relapsing progressive MS (71.7% vs 30.2%; P <.001).

Presented at the 2023 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, February 23-25, in San Diego, California, this was one of the first studies to assess severe forms of MS with multi-faceted quantitative MRI and serum biomarkers of axonal loss. Above all, those from TBH showed lower cortical brain volume (d = 1.164; P <.001), thalamus volume (d = 0.946; P <.001) medulla oblongata volume (d = 0.569; P = .01) and network efficiency (d = 0.460; P = .033). Additionally, this group demonstrated a significant relationship between lower TV and higher serum glial fibrillary acidic protein (r = –0.43; P = .013) and lower cortical volume and higher serum neurofilament light (r = –0.4; P = .014).

Lead investigator Robert Zivadinov, MD, PhD, sat down with NeurologyLive® at the Forum to discuss whether industry leaders and pharmaceutical companies should focus more on treating the cortical aspects of the disease. Zivadinov, director of the Buffalo Neuroimaging Analysis Center, provided insight on the next steps in furthering this research, including incorporating additional high-powered biomarker scans and taking a closer look at the lack of inflammation seen in progressed patients.

Click here for more 2023 ACTRIMS Forum content.

REFERENCE
1. Zivadinov R, Jakimovski D, Burnham A, et al. Comprehensive assessment of severely affected multiple sclerosis (CASA-MS) study. Presented at: 2023 ACTRIMS Forum; February 23-25. San Diego, CA. Abstract P430
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