Book contents
- Multiple Sclerosis Therapeutics
- Multiple Sclerosis Therapeutics
- Copyright page
- Contents
- Contributors
- Abbreviations list
- Foreword
- Preface
- Section I Introduction
- Section II Clinical trial methodology
- 6 Measures of neurological impairment and disability in multiple sclerosis
- 7 Assessment of neuropsychological function in multiple sclerosis
- 8 Health-related quality of life assessment in multiple sclerosis
- 9 Measures of acute and chronic lesions visualized by conventional magnetic resonance imaging
- 10 Measures of magnetization transfer
- 11 Measurement of CNS atrophy
- 12 Axonal pathology in patients with multiple sclerosis
- 13 Imaging of gray matter lesions in multiple sclerosis
- 14 Functional imaging in multiple sclerosis
- 15 Diffusion imaging in multiple sclerosis
- 16 The use of MRI in multiple sclerosis clinical trials
- 17 Optical coherence tomography to monitor axonal and neuronal integrity in multiple sclerosis
- 18 The process of drug development and approval in the United States, the European Union, and Asia
- 19 Selection, interpretation, and development of end-points for multiple sclerosis clinical trials
- 20 The challenge of demonstrating long-term benefit of disease-modifying therapies in multiple sclerosis
- 21 The growing need for alternative clinical trial designs for multiple sclerosis
- 22 Ethical considerations in multiple sclerosis clinical trials
- 23 Pharmacogenomics and related discovery-driven approaches in multiple sclerosis
- 24 Neutralizing antibodies directed against biologic agents to treat multiple sclerosis
- Section III Clinical trials of multiple sclerosis therapies
- Section IV Therapy in clinical practice
- Index
- Plate Section
12 - Axonal pathology in patients with multiple sclerosis
Evidence from in vivo proton magnetic resonance spectroscopy
from Section II - Clinical trial methodology
Published online by Cambridge University Press: 05 December 2011
Book contents
- Multiple Sclerosis Therapeutics
- Multiple Sclerosis Therapeutics
- Copyright page
- Contents
- Contributors
- Abbreviations list
- Foreword
- Preface
- Section I Introduction
- Section II Clinical trial methodology
- 6 Measures of neurological impairment and disability in multiple sclerosis
- 7 Assessment of neuropsychological function in multiple sclerosis
- 8 Health-related quality of life assessment in multiple sclerosis
- 9 Measures of acute and chronic lesions visualized by conventional magnetic resonance imaging
- 10 Measures of magnetization transfer
- 11 Measurement of CNS atrophy
- 12 Axonal pathology in patients with multiple sclerosis
- 13 Imaging of gray matter lesions in multiple sclerosis
- 14 Functional imaging in multiple sclerosis
- 15 Diffusion imaging in multiple sclerosis
- 16 The use of MRI in multiple sclerosis clinical trials
- 17 Optical coherence tomography to monitor axonal and neuronal integrity in multiple sclerosis
- 18 The process of drug development and approval in the United States, the European Union, and Asia
- 19 Selection, interpretation, and development of end-points for multiple sclerosis clinical trials
- 20 The challenge of demonstrating long-term benefit of disease-modifying therapies in multiple sclerosis
- 21 The growing need for alternative clinical trial designs for multiple sclerosis
- 22 Ethical considerations in multiple sclerosis clinical trials
- 23 Pharmacogenomics and related discovery-driven approaches in multiple sclerosis
- 24 Neutralizing antibodies directed against biologic agents to treat multiple sclerosis
- Section III Clinical trials of multiple sclerosis therapies
- Section IV Therapy in clinical practice
- Index
- Plate Section
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.
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- Multiple Sclerosis Therapeutics , pp. 150 - 164Publisher: Cambridge University PressPrint publication year: 2011
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