Your Donations in Action: Colin D. McKnight, MD

In multiple sclerosis (MS), the immune system attacks myelin, causing inflammation and damage to the myelin sheath. For patients with MS, several changes occur in the cerebrospinal fluid (CSF) that may reflect the underlying processes that characterize the disease.

Developing noninvasive methods for detecting pathological CSF changes would aid MS diagnosis and offer insight into the pathophysiology and mechanisms of neurological impairment in MS.

For his 2021 RSNA Research Scholar Grant project, “Magnetization Transfer Imaging of the Human Spinal Cord and Cerebrospinal Fluid to Characterize Myelin Metabolism in Multiple Sclerosis,” Colin D. McKnight, MD, associate professor and vice chair of clinical operations in the Department of Radiology and Radiological Sciences at the Vanderbilt University Medical Center in Nashville, TN, and colleagues investigated the use of magnetization transfer (MT) MRI as a tool to detect macromolecular changes in spinal CSF.

The researchers studied 27 individuals diagnosed with relapsing-remitting MS (RRMS) and 38 age- and sex-matched healthy controls. Using MTMRI and quantitative MT (qMT) imaging, they collected data from the spinal cord and CSF of each group, measuring the MT ratio (MTR) and quantifying B1, B0 and R1 corrected qMT-derived pool size ratio (PSR).

Both CSF MTR and CSF qMT-derived PSR were significantly increased in individuals with RRMS compared to healthy controls. In patients with RRMS, CSF PSR was correlated to Expanded Disability Status Scale Scores, which assess the degree of disability in individuals with MS.

“Elevated MT MRI signal has previously been noted to be related to macromolecular content, specifically that of myelin in the setting of MS. As we have tied increased CSF MT MRI signal in MS to decreased MT MRI signal in the cord, this highlights the possibility that demyelination products are cleared through the CSF,” Dr. McKnight said. “This elevated CSF MT MRI signal is correlated with measures of MS clinical disability, highlighting a new potential noninvasive imaging biomarker of disease.”

Dr. McKnight credits the RSNA Research Scholar Grant award with providing protected research time, enabling him to collaborate with other imaging scientists, basic scientists and clinicians.

“These interactions helped generate multiple ideas that have proven central to subsequent NIH funding,” Dr. McKnight said. “Continued RSNA funding is critical to our field as the RSNA grant allows for radiologists to play a central role in formulating innovative research.”

For More Information

Learn more about R&E Foundation funding opportunities.

Read our previous Your Donations in Action story.