Moccia, M;
de Stefano, N;
Barkhof, F;
(2017)
Imaging outcome measures for progressive multiple sclerosis trials.
Multiple Sclerosis Journal
, 23
(12)
pp. 1614-1626.
10.1177/1352458517729456.
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Abstract
Imaging markers that are reliable, reproducible and sensitive to neurodegenerative changes in progressive multiple sclerosis (MS) can enhance the development of new medications with a neuroprotective mode-of-action. Accordingly, in recent years, a considerable number of imaging biomarkers have been included in phase 2 and 3 clinical trials in primary and secondary progressive MS. Brain lesion count and volume are markers of inflammation and demyelination and are important outcomes even in progressive MS trials. Brain and, more recently, spinal cord atrophy are gaining relevance, considering their strong association with disability accrual; ongoing improvements in analysis methods will enhance their applicability in clinical trials, especially for cord atrophy. Advanced magnetic resonance imaging (MRI) techniques (e.g. magnetization transfer ratio (MTR), diffusion tensor imaging (DTI), spectroscopy) have been included in few trials so far and hold promise for the future, as they can reflect specific pathological changes targeted by neuroprotective treatments. Position emission tomography (PET) and optical coherence tomography have yet to be included. Applications, limitations and future perspectives of these techniques in clinical trials in progressive MS are discussed, with emphasis on measurement sensitivity, reliability and sample size calculation.
| Type: | Article |
|---|---|
| Title: | Imaging outcome measures for progressive multiple sclerosis trials |
| Location: | Rome, ITALY |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/1352458517729456 |
| Publisher version: | http://dx.doi.org/10.1177/1352458517729456 |
| Language: | English |
| Additional information: | This article is publisher under Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) licence. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Neurosciences, Neurosciences & Neurology, Multiple sclerosis, progressive, imaging, outcome, trial, PLACEBO-CONTROLLED TRIAL, RANDOMIZED CONTROLLED-TRIAL, NERVE-FIBER LAYER, CLINICALLY ISOLATED SYNDROMES, POSITRON-EMISSION-TOMOGRAPHY, MAGNETIZATION-TRANSFER RATIO, BRAIN PARENCHYMAL FRACTION, LONG-TERM DISABILITY, SPINAL-CORD ATROPHY, DOUBLE-BLIND |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10033939 |
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