Tomassini, V, Robertson, N, Wise, R, Jones, DK ( 2014 - 2017) Predicting the individual's potential for functional recovery in Multiple Sclerosis: a novel clinical and neuroimaging strategy. MS Society. £263,362.
Development of recoveryoriented interventions is a major goal in the management of Multiple Sclerosis (MS). While the range of available interventions is expanding to include new disease modifying therapies with neuroprotective and reparative effects, novel interventions exploiting the brain’s own plasticity require efficient testing in optimised trials for translation to clinical settings. Therefore, early prediction of response to recovery interventions is a clinical and research necessity that relies on the identification of the individual’s potential for recovery as distinct from the disease prognosis. Recent advances in neuroimaging suggest that combining measures of brain damage and functional reorganization would allow us to identify this individual potential for functional recovery objectively and reliably. Combining neuroimaging with measures of initial disability we propose to develop a flexible predictive model of motor performance improvements with a 4week home training programme. From this model we derive a recovery index that expresses the individual’s reserve exploitable by recovery strategies. This model could be used for early identification of responders to therapeutic strategies promoting repair and recovery. It would also accelerate trials of new interventions by optimising designs and stratifying patients for such interventions in the clinic.