Analysis of neurodegenerative processes in demyelinating central nervous system disease

We are evaluating brain atrophy, memory disorder, attention disorder, etc in Japanese patients with multiple sclerosis and neuromyelitis optica and analyzing the relevance of those factors.

We are conducting joint research with other institutes, and analyze risk factors of cerebral atrophy by measuring brain MRI methods which can visualize brain cell degeneration and also cerebrospinal fluid and blood biomarkers. We are also analyzing the prevention effect of cerebral atrophy by disease modifying therapy (DMT) widely used in patients with multiple sclerosis.

Recently, concept of no evidence of disease activity (NEDA) -3 has emerged as a therapeutic goal of MS. Although at first this seems to be considered as ultimate goal of treatment, studies have revealed that some patients with NEDA-3 still have brain volume loss. We showed that more than 60% of Japanese MS patients with NEDA-3 also had significant brain volume loss during 32 months follow-up period (Yokote et al, 2018).

Serum neurofilament light has been demonstrated to be a good biomarker to predict brain volume loss. However, it is nonspecific and increases in patients with various neurological diseases. We found significant correlation between serum retinol levels and rate of brain volume loss (Yokote et al, 2017) and consider serum retinol to be a candidate biomarker to predict brain volume loss in MS.

We also collaborating with other institutions to analyze the risk factors of brain atrophy of patients with multiple sclerosis by measuring brain MR images that can evaluate neuronal degeneration, and biomarkers in the cerebrospinal fluid or blood. In addition, we cooperate with them in the validation of Japanese version of Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), a simplified assessment of cognitive function in patients with multiple sclerosis (Niino et al. 2017).