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An investigation of magnetization transfer ratio and T1 hypointense lesion volume in secondary progressive multiple sclerosis.

Hayton, T; (2012) An investigation of magnetization transfer ratio and T1 hypointense lesion volume in secondary progressive multiple sclerosis. Doctoral thesis , UCL (University College London). Green open access

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Abstract

The data presented in this thesis were collected as part of a trial of neuroprotection with lamotrigine in secondary progressive multiple sclerosis (MS) and comprise clinical assessment and quantitative magnetic resonance imaging (MRI), specifically focussing on T1 hypointense lesion volume (T1LV) and magnetization transfer ratio (MTR). The aim of the study was to evaluate the usefulness of these MRI techniques for monitoring neuropathology in MS by examining the correlation of MRI measures with clinical measures both cross-sectionally and longitudinally and the responsiveness to change of these measures. The potential neuroprotective effect of lamotrigine was assessed by comparing clinical and MRI data in placebo and verum arms of the trial. The introduction briefly summarises: the clinical features of secondary progressive MS; some of the aspects of MS pathology and pathophysiology that may be ameliorated by lamotrigine treatment; some of the techniques for assessing clinical status in MS, including the impact of MS on quality of life (QoL); and the role of quantitative MRI in monitoring putative neurodegeneration in MS. The methods chapter details: the structure and conduct of the trial, including recruitment of subjects, acquisition of clinical and MRI data; and the post-acquisition analysis of the MRI data. The results chapter addresses four issues: the cross-sectional correlation of MRI with clinical measures; the responsiveness to change and longitudinal correlation of MTR measures with clinical measures; the responsiveness to change and longitudinal correlation of T1LV with clinical measures; and the cross-sectional and longitudinal correlation of a large number of MRI and clinical measures with the Multiple Sclerosis Impact Scale (MSIS-29), a measure of the impact of MS on QoL. The conclusions chapter summarises some of the more notable results presented, some of the limitations of the study and proposes some further work that could be done to clarify any areas of uncertainty.

Type: Thesis (Doctoral)
Title: An investigation of magnetization transfer ratio and T1 hypointense lesion volume in secondary progressive multiple sclerosis.
Open access status: An open access version is available from UCL Discovery
Language: English
Keywords: Multiple sclerosis, secondary progressive, Magnetic resonance imaging, Magnetization transfer ratio, Expanded Disability Status Scale, Quality of life, Neuroprotection, Clinical trial
UCL classification: 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
URI: http://discovery.ucl.ac.uk/id/eprint/1362888
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