Defining disease progression in MND from MRI ‘snapshots’

Although conventional brain magnetic resonance imaging (MRI) scans are often normal in people with MND, more sophisticated MRI techniques have shown changes in the structure of their brains as the disease progresses. A limitation of even the most recent MRI techniques is that they can only provide a snapshot of the brain at a single moment in the course of the illness.

Only a description of how these MRI changes evolve over time as the disease advances will tell us how the nerve cell damage due to MND is evolving, area by area, in relation to an individual’s symptoms. This could be obtained by collecting several MRI scans from the same person over time, but the nature of MND makes it challenging to get scans showing the course of disease over several years.

We are funding a three year PhD studentship that aims to use a new imaging method to define the progression of MND (our reference: 859-792). The researcher team, involving Profs Mara Cercignani and Nigel Leigh from the University of Sussex, will use MRI scans that have already been obtained from people with MND and healthy controls.

By applying new concepts in medical computing to clinical data, this project will identify how changes to the brain evolve in sequence, and how this relates to things we can see and measure in the rest of the body.

Each change, such as loss of brain volume in an area, constitutes an ‘event’ in their model. Putting together these events in a computer model can help to tell us the order in which the changes (or ‘events’) are more likely to happen.

You can think of each MRI scan as a freeze frame or still from a film, and having to put them in order (to create the event model) based on clues you can see within the frame, such as whether the main character is older or has changed their appearance.

Matt Gable PhD student at Sussex

Matt Gabel

So far PhD student Matt Gabel, together with colleagues, has identified a list of clinical and behavioural biomarkers to help inform and ‘test’ the model. Clinical biomarkers may be things like the ALS Functional Rating Scale (ALSFRS-r), which assesses various aspects of life with MND such as ability to move and carry out day-to-day activities.

Matt has tested his ‘event model’ using clinical data. From this he saw that language impairments are an early but continuing problem in people who have MND, and that difficulties in executive function (decision making) occur after the initial language impairment.

Matt is currently in his third year of his PhD research and is inputting actual imaging data (from MRI scans from both people with MND and healthy controls) into their ‘event model’ to help map changes that happen to the brain.

Throughout June 2016 MND Awareness Month will be highlighting the rapid progression of the disease in its powerful Shortened Stories campaign, sharing the experiences of people currently living with MND, or who have lost loved ones to the disease, through art, poetry and film.

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