Researchers have found a way to identify previously undetectable brain lesions in a breakthrough that could transform the fight against multiple sclerosis.
Commonly known as MS, multiple sclerosis is a debilitating disease in which the immune system mistakenly attacks the body’s nervous system. It affects around 150,000 people in the UK.
While it can trigger a wide range of symptoms, including fatigue, vision problems, muscle spasms, memory difficulties and balance issues, one of the hallmarks of MS is the lesions and scarring it leaves on the brain and spinal cord.
But a significant part of understanding brain lesions has remained out of reach for scientists for years.
They have long known that damage to the brain’s grey matter – responsible for processing information, movement, memory and emotion – is a major driver of disease progression.
However, up until now, the magnetic resonance imaging (MRI) scans which are used to monitor MS patients have only been able to detect lesions in the brain’s white matter.
As a result, researchers have had little way of monitoring hidden damage in the brain’s grey matter, even though they knew it was likely occurring. Many MS drugs developed in recent years have, therefore, focused on treating white matter lesions only.
Now, scientists at the University at Buffalo say they have found a way to reveal grey matter lesions, and this could be a significant breakthrough for MS treatment.
Researchers have found a way to identify previously undetectable brain lesions in a breakthrough that could transform the fight against multiple sclerosis
Robert Zivadinov, the study’s senior author on the paper and a professor of neurology at the University of Buffalo, said: ‘Detecting previously invisible cortical lesions on conventional legacy MRI scans has major implications for MS research and clinical care.
‘The ability to see for the first time these previously hidden indicators of MS disease progression, including cognitive impairment and disability, is an important advance.’
The researchers used artificial intelligence (AI) to compare several different types of MRI images of the same brain at once.
They tested the technique on scans from more than 700 MS patients and uncovered more than 11,000 previously undetectable grey matter lesions.
While each scan on its own showed little or no sign of damage in the brain’s grey matter, the AI was able to spot tiny differences between the images that humans cannot see.
The researchers said the technology could also identify where the brain tissue was not behaving like healthy tissue.
Michael G. Dwyer, the study’s first author and associate professor of neurology and biomedical informatics in the Jacobs School, said: ‘We have all been very frustrated, knowing that these cortical lesions were there but not being able to see them.
‘There’s a lot of ongoing damage that continues to happen in MS that you won’t see with conventional MRI, but that histopathologists have been clearly demonstrating for decades on postmortem tissue.
‘What this collaboration has been able to accomplish is a real success story for applying AI in the medical arena.
‘We now have access to these incredibly useful data on MRI scans that were there but you couldn’t see them without using AI to pull them out. The computational methods are finally at the point where we can do this.’
MS lesions are thought to trigger many of the disease’s debilitating symptoms, including weakness, numbness, vision problems and difficulty with balance.
They interfere with the brain’s communication network by slowing down or blocking nerve signals.
Professor Zivadinov added: ‘This work, which has revealed that there is so much invisible pathology in the brain, will have tremendous impact for reviewing data from past clinical trials and also for those going forward.’
The number of people living with MS in Britain is up by around 20,000 since 2019.
Symptoms usually first appear between the ages of 20 and 40, and it is thought to occur when the immune system mistakenly attacks the myelin sheath – the protective coating around nerve fibres. This causes inflammation and damage to the central nervous system.
MS is not usually fatal, but advanced disease can weaken the muscles used for breathing and swallowing and increase the risk of serious infections.
There is no cure, but treatments can slow the progression of the disease.
