“We’re studying how the three-dimensional structure and surface characteristics of lesions impact the surrounding brain tissue,” Okuda said. “Our findings are significant because they provide clarity on lesion age and the potential for myelin repair, which are not readily apparent with current MRI techniques. This new technique may serve as an ideal platform for the study of myelin repair treatments in the near future.”

Dr. Bart Rypma, also a senior author of the study, said the current treatment-prescribing method leaves open the potential for patients to be on a drug long term even though it might not help them. This becomes particularly risky with drugs that suppress the immune system.


“Our approach will give more information to doctors in the clinic who have to make judgments about which therapeutic course to try,” said Rypma, professor of psychology and the Meadows Foundation Chair in Behavioral and Brain Sciences at UT Dallas.

In the current study, researchers used 3 Tesla MRI to classify a lesion and its periphery in terms of several measurements. The results indicate that approximately one-third of MS lesions show signs of a high probability of repair.

“Our approach will give more information to doctors in the clinic who have to make judgments about which therapeutic course to try.”

Dr. Bart Rypma, professor of psychology and the Meadows Foundation Chair in Behavioral and Brain Sciences at UT Dallas

“If a lesion does not have the capacity to heal, remyelinating drugs aren’t going to help,” Sivakolundu said. “Our technique becomes a biomarker for targeted therapy because we can now decide if a lesion is likely to heal. From that, we can decide which drug regimen is worthwhile.”

The best indicator of lesion-healing potential is what the team calls BOLD slope, where BOLD stands for “blood oxygen level dependent.” It compares the amount of oxygen available at the injury site to that of its surroundings.

“When we compare a lesion to the tissue around it, we see either an increase or a decrease in the amount of oxygen present as you move outward from the center,” Sivakolundu said. “That’s the BOLD slope. If the amount of oxygen is higher in the peripheral area, that’s a lesion that can be repaired. The surrounding tissue can supply blood and oxygen to enable healing.”

Sivakolundu added that 3D imaging conveys crucial information about how smooth or round a lesion is.

“Lesions that have the capacity to heal are more spherical in shape, with fewer jagged boundaries,” he said. “They also have rougher surfaces, as opposed to smooth, because roughness indicates high metabolism in the surrounding cells.”

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