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Headlines 5 “Neuroinflammation plays a fundamental role in neurodegenerative disease,” Miriam explains. “It is the brain’s early response system that if left unchecked, can lead to disease. In the last 10 years or so, we have become more aware that it is a key feature in nearly every major brain condition, from Alzheimer’s and Parkinson’s diseases to stroke, concussion, and multiple sclerosis.” However, Miriam adds, it is frequently only detectable later in the disease’s progression. For decades, scientists assumed inflammation was a reaction to damage. Now, they understand it is part of what causes the damage. “Initially, it’s a protective response - but if it goes on too long, it begins to cause damage itself.” Miriam is part of a team leading the development of some of the most advanced imaging tools in modern research. Her latest project, funded by the Neurological Foundation, is to advance ultra-high contrast (UHC) MRI to detect the earliest signs of neuroinflammation in the human brain – potentially years before clinical symptoms arise. With Dr Helen Murray at the CBR, Miriam is demonstrating at the cellular level that the changes we see on imaging are indeed due to inflammation “This UHC MRI technique increases the sensitivity of neuroinflammation imaging by about 10-fold. We’re seeing unprecedented detail, particularly in the brain’s white matter, where subtle damage occurs,” Miriam explains. UHC imaging is already making a difference. Miriam’s project involves collaboration with the Mātai Medical Research Institute in Gisborne – a cutting-edge imaging facility known for its work in brain, concussion, and mental health research. At the CBR, researchers analyse brain tissue donated to the Neurological Foundation Human Brain Bank. At Mātai, the focus is on scanning living patients, giving researchers a rare opportunity to study inflammation in real time using UHC. People with traumatic brain injury, multiple sclerosis, Parkinson’s disease, and even methamphetamine use - are being scanned using the new techniques, and the results are helping paint a fuller picture of what early inflammation looks like in these diseases. “Until recently, we did not have a way to identify early neuroinflammation in living people. If we can detect it sooner, we may be able to intervene – and minimise the damage before symptoms take hold,” Miriam says. She gives the example of visiting a hospital following a minor head injury. “For most people, a head scan is unlikely to detect any abnormality following an acute, mild or repeated head injury. But using this technique, we are able to see damage that would otherwise be invisible in the white matter (the nerve fibres). “The team at Mātai has also seen this in patients with multiple sclerosis, brain tumours, Parkinson’s disease, and even people who have had chemotherapy. And the changes are apparent without the use of contrast agents. “This is a rapidly developing technology. While we have focused on white matter, the team is developing the technique for grey matter (cell bodies) which will further enhance our view of what is happening inside the brain.” Miriam’s Neurological Foundation grant will enable her team to take the next vital step in validating the patterns the UHC MRI is picking up in the brain. “We want to confirm that what we see on the MRI reflects real changes in the brain tissue. That’s what this grant is helping us do.” By comparing MRI results with biological samples and clinical data, the team hopes to prove that these imaging patterns correspond to the very earliest stages of disease. “Research shouldn’t end once a new technology is developed in a lab,” Miriam says. “It needs government investment to make it more widely available. This technology will be able to detect brain disease much earlier, before it becomes harder and more expensive to treat, which will benefit thousands of New Zealanders.” One of NewZealand’s leading imaging experts, Associate Professor MiriamScadeng at the Centre for Brain Research, says advances in imaging technology are set to revolutionise howwe detect and treat brain disease. THOUSANDWORDS “From brain injury to cancer, from Parkinson’s to dementia, the ability to actually see what’s happening inside an individual’s brain then take a personalised approach to treatment is going to make a huge difference.” Associate Professor Miriam Scadeng