Transcript
Announcer:
Welcome to NeuroFrontiers on ReachMD. On this episode, we’ll hear from Dr. Ethan Meltzer, Assistant Professor in the Department of Neurology and the Program Director of the Neurology Residency at the University of Texas at Austin. He’ll be discussing how advanced imaging and biomarkers could improve multiple sclerosis diagnosis and prognosis. Here’s Dr. Meltzer now.
Dr. Meltzer:
This notion of newer, more advanced imaging findings—and so this could be something like the central vein sign of a paramagnetic rim lesion, and these allude to the biological perivenular demyelination or activated macrophages laden with iron at the periphery of these smoldering chronic inflammatory lesions—these are much more specific to MS than other diseases. So it can help us to improve the specificity of our imaging and increase our certainty about a diagnosis, and they also correlate very well with some biological markers. And so I think that there is a role of these specific imaging findings, for example, in diagnosis, as well as measuring biological activity.
I think that these advanced imaging findings as well as some of these newer biological markers, whether they be serum or spinal fluid-based, also can potentially have a role in prognostication. For all of us who see these patients in the clinic, we all know how challenging it can be when we see someone and they are first diagnosed. They can look very similar to the other 10 individuals you saw. The optic neuritis is common, or transverse myelitis is common, and yet they can have these widely divergent prognoses over the next 10 or 15 years or as long as you may follow them. And so what we're sorely lacking is the ability to, once we make the diagnosis, prognosticate at a very individual level. How likely are you to respond to a certain type of disease-modifying therapy? How warranted is it to be aggressive here? When can we back off? What might things like, look like in 20 or 30 years? These are exceptionally practical, challenging questions that we get asked every day, and that's where some of these markers can really start to play a role in the clinic.
Announcer:
That was Dr. Ethan Meltzer discussing how biomarkers and imaging findings could be used to improve multiple sclerosis care. To access this and other episodes in our series, visit NeuroFrontiers on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
