Purpose of review: To summarize recent developments using non-conventional MRI techniques to measure neuroprotection, repair and plasticity in multiple sclerosis.
Recent findings: Recent advances in our understanding of the pathogenesis of multiple sclerosis, particularly as it relates to the development of chronic disability, have led away from a 'lesion-centric' view of multiple sclerosis towards investigating neurodegeneration and pathology in normal appearing brain tissue. Advanced image processing techniques that measure atrophy globally and regionally also have provided insight into the putative mechanisms that contribute to neurodegeneration. In addition, novel quantitative imaging techniques that are more specific than conventional MRI for myelin and axonal pathology have been instrumental in revealing the dynamic nature of injury and repair of myelin and axons in lesions. Novel imaging techniques that are sensitive to the pathology of myelin and axons that happens in multiple sclerosis also provide a method by which we can measure neuroprotection and test the efficacy of putative therapeutic agents in multiple sclerosis.
Summary: Non-conventional MRI techniques have contributed to a greater understanding of the complex pathogenesis of neurodegenerative phenomena that occur in multiple sclerosis. The pathological specificity of these novel imaging methods enables the evaluation of the neuroprotective effects of novel therapeutic strategies.