Predicting and monitoring the long term effects of MS

Dr Ai-Lan Nguyen

The University of Melbourne, VIC

| Better treatments | Epidemiology | Scholarship | 2018 | Investigator Led Research |
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Summary

The course of MS in each individual is different. There are limited tools available to predict the severity of the disease in individuals.

During her PhD, Dr Ai-Lan Nguyen, plans to compare commercially available MRI programs to those available for research. She will investigate if these recently automated research programs can detect brain shrinkage more quickly and easily than the commercially available ones. These tests may be able to detect brain shrinkage before physical or mental symptoms are noticed.

Dr Nguyen will combine the results of the MRI scans with mental and physical tests to determine the best predictors for increased disability. As these tests can be quickly and easily performed it is hoped they could be incorporated into clinical practice. She will also investigate what effect certain therapeutics have on brain shrinkage, and if these therapies appear to alter the course of MS.

The second part of this project relates to Dr Nguyen’s interest in pregnancy in MS. Women with MS often experience less symptoms during pregnancy. During her PhD, she is investigating whether pregnancy can also delay the onset of a first clinical attack, known as clinically isolated syndrome (CIS) using a large dataset.

Progress to Date

Dr Nguyen project is focussing on differences seen in brain volume loss or shrinkage in people with MS. This brain volume loss value, measured as a percentage, relates to brain tissue that is lost over time. This is a process that occurs naturally as we age, but the process is accelerated in MS and may predict clinical outcomes. MRI scans can measure brain volume loss, but the changes are often very small, making it paramount that accurate measurements can be made across different scans and different visits to the clinic in people with MS.

Dr Nguyen is collaborating with a number of hospitals and MS clinics around Australia and Czech Republic to collect MRI scans from different MRI scanners and also the same scanner at different times to determine whether the automated calculations of brain volume loss are accurate in these different settings. So far, Dr Nguyen has collected 342 pairs of scans (taken from the same individual) from these clinics. Analysis is now underway, and ultimately this will lead to Dr Nguyen will determining the best method to accurately capture brain volume loss by MRI. The next stage of this research will look at mental and physical tests of MS to see if they correlate with MRI data. She received the MRI data in December 2019 and is currently analysing the results.

Dr Nguyen has investigated whether pregnancies delay the onset of CIS by analysing retrospective data from a very large cohort of women with MS, with the analysis now complete. The results of this work have been submitted as a manuscript to a scientific journal, which is currently under review. These findings may aid understanding into the impact of pregnancy on the first presentation of MS. This work will sit alongside other research undertaken by Dr Nguyen looking at the use of disease modifying therapies for MS in pregnancy.

In 2019, Dr Nguyen was awarded an MS Research Australia Travel Award to travel to the University of Genoa in Italy to work under Professor Maria Pia Sormani, an internationally acclaimed MS researcher, in order to explore how best to analyse the MRI results of this project. She has also presented this work at national and international conferences.

Publications

  • Nguyen A, Eastaugh A, van der Walt A, Jokubaitis V. Pregnancy and multiple sclerosis: clinical effects across the lifespan. Autoimmun Rev. (2019) 18:102360.
  • van der Walt A, Nguyen A, Jokubaitis V. Family planning in multiple sclerosis and its treatment: a review and update. Medical J Aust. (2019) 211(5):230-236
  • Nguyen A, Havrdova E, Horakova D,…Butzkueven H, Jokubaitis V. Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis. Mult Scler Relat Disord (2018) 28:235-243.

Updated: 11 June 2020

Updated: 03 January, 2018

Investigator

  • Dr Ai-Lan Nguyen, The University of Melbourne, VIC

Supervisor

Grant Awarded

  • Postgraduate Scholarship

Total Funding

  • $60,000

Duration

  • 4 years over 2018 – 2021

Funding Partner

  • Perpetual Foundation - Kevin Darrell Clarke Endowment
  • Baxter Charitable Foundation
  • Rotary Club of Moorabbin
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