Multiple Sclerosis Centers of Excellence
Advances in MRI tools to assess cognitive impairment in MS
Some of the advances in the use of MRIs are simply additional. By injecting gadolinium, a contrast agent, we're able to detect whether those t2 lesions hyperintensities are relatively new, or whether they represent an older lesion. New lesions tend to see a break-down in the blood-brain barrier so gadolinium is absorbed into the brain and detected in fresh lesions.
Functional MRI has been around for about 20 years. It's a technique where we can place someone in the scanner, have them perform a cognitive motor sensory task and we can map which areas of the brain demonstrate increased neural activity. What we found is that the amount of activation in the brain was directly proportional to the amount of lesion load. So more lesion load, the more activation. And what that is saying is that the brain is working harder to be able to maintain normal test performance on this verbal memory task. And we think that fMRI may be one of those imaging techniques that will allow us to actually detect cognitive deterioration even before it is observed on neuropsychological testing.
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