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David Pitt, MD

Award Name CCTS Pilot 2009
Award Date 04/01/2009

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Detecting Cortical Demyelination with Ultra-Highfield MRI

David Pitt, PhD, Assistant Professor of Neurology, and his research team have been awarded a pilot grant from the Pilot and Collaborative Translational and Clinical Science Program, proposing a research project to focus on cortical demyelination in multiple sclerosis patients with ultra-high field MRI scanners.

Awarded by the Center for Clinical and Translational Science (CCTS), the grant provides funding for a new scientific approach to the observance of cortical matter lesions in the brain as multiple sclerosis progresses. Teaming up with Petra Schmalbrock of the Wright Center of Innovation, Pitt and his team are using novel ultra-highfield MRI technology to observe and categorize various types of lesions in MS brain.

"Multiple sclerosis is thought of as an autoimmune disease," said Pitt. “The patient’s own immune system destroys myelin, which is a fatty sheath around neurons. Without myelin, the nerves cannot function well. We have the means to detect these lesions in white matter, but we have not been able to detect these lesions in cortical gray matter in MS patients. This is a “hidden” pathology and it is very exciting to be able to now see these lesions.”

"There are two phases to multiple sclerosis," said Pitt. “in the first phase, patients develop intermittent neurological problems which go on to become chronic and irreversible in the second phase. It is suspected that cortical matter lesions occur in this second phase, but no current technology allows us to prove this in MS patients.”

Dr. Pitt, affiliated with the Department of Neuroscience, Department of Neurology, Division of Neuroimmunology and Multiple Sclerosis, has one critical goal for his research. He wants to find a new method of magnet resonance imaging in order to see and to determine the amount of cortical lesions in multiple sclerosis patients. “This project is currently done with brain tissue from deceased MS patients but we do this of course to eventually image alive patients with the aim to determine the impact of these lesions on the patient’s symptoms and disease course.”

Pitt and his team hope to determine if the cortical lesions correspond with inflammatory pathology, as with white matter lesions, or caused by a different process entirely. "In addition to seeing these lesions on MRI, we want to find out the reason why cortical lesions form, for example if they form because of inflammation or not," said Pitt. Pitt has considered what the future of his research could look like in a clinical setting: Once cortical lesions can be detected in multiple sclerosis patients, the efficacy of anti-inflammatory drugs can be tested to see if cortical lesions still develop. Based on this, better treatment decisions can be made and new treatments can be developed.

By Amy Hoover, Tuesday, June 2, 2009

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