Summary: Medical Imaging

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Alternative Imaging for MRI in MS

MRI is a great tool for medical imaging and widely used for Multiple Sclerosis (MS), but it has some limitations in lacking specificity1. New emerging techniques such as transcranial magnetic stimulation (TMS) and optical coherence tomography (OCT) have the potential to address issues not resolved by current MRI techniques.

TMS is a non-invasive technique used for monitoring the central nervous system (CNS) activity and response in a pain-tolerated manner. It is a safe technique for patients; some patients only experience minor side effects like headaches after testing. TMS is a new method not widely used in MS research yet, but can be useful to detect and monitor the conditions affecting patients with MS.

TMS focuses on examining the motor neuron system of the CNS. (As defined by Simpson et al.) TMS works by attaching a wire coil to a scalp that transfers a high, but short, current to create a magnetic field at right angles relative to wire coil2. Action
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CMCT can be used as a diagnostic tool for MS patients. It has the reliability of 0.83 in prolonged CMCT and 0.75 in normal CMCT4. CMCT may also improve diagnostic certainty by detecting silent lesions2. A correlation to MS between TMS and disability has been noted through CMCT and function of leg. ?????? Another study showed correlation between abnormal MEP and disability EDSS.

A study showing the potential of TMS in drug treatment monitoring is using the drug 4-aminopyridine (4-AP) that aids in walking disability. TMS measures the effect of the drug in MEP of upper and lower limbs. Before 4-AP treatment patients demonstrated reduced MEP levels, and after treatment there was an increase in MEP5. The increase in MEP by 4-AP is due to an increase in conductivity by demyelinated nerve

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