Potential New Method for Early Diagnosis of MS

People with multiple sclerosis (MS) can have a variety of symptoms. Each person’s experience is unique, which can make diagnosis challenging.1

Currently, there is no 1 specific test to diagnose MS. Instead, doctors rely on combinations of findings, such as lab and imaging tests. Because of this, a person can have MS for months or even years before being diagnosed. And delays in diagnosis lead to delays in treatment.1

A potential new diagnosis tool

Experts have been working hard to find new ways to diagnose and treat MS as early as possible. One option that shows a lot of potential is swept-source optical coherence tomography (SS-OCT) analyzed with convolutional neural networks (CNNs).1

OCT is a type of imaging test. It uses beams of light to create an image of the retina of the eye. An SS-OCT test uses a specific type of laser that is able to create very clear, 3-dimensional images of the retina. CNNs are a type of computer system. Experts teach CNNs to look at these images for minor changes in the retina, which can be early signs of MS.1-3

Read on for a more detailed explanation.

What is swept-source optical coherence tomography (SS-OCT)?

OCT takes images of the body, like x-rays and magnetic resonance imaging (MRI) do. But unlike other types of imaging, OCT focuses on the retina. Light from the world around us is filtered and processed in the retina.2,4

OCT uses beams of light to create an image. The entire process takes only a few minutes and is not painful. During an OCT test, a person sits in front of a machine and rests their head on a support. OCT can help diagnose eye conditions, including:2

SS-OCT uses a specific type of laser during the imaging process. This laser makes very clear, high-quality images, even clearer than many other types of OCT. SS-OCT creates a 3-dimensional picture of the retina that doctors and computers can analyze.3

Retinal changes in MS

Some experts think OCT could be used to detect MS early. In MS, the body mistakenly attacks its healthy nerve cells. This is called demyelination.1,5

Demyelination can occur in the retina’s nerves before a person with MS shows any symptoms. MS can also cause inflammation in the retina and other parts of the eye. OCT may help doctors detect demyelination and inflammation in the retina. Then they could diagnose MS earlier than ever before.1,5

What are convolutional neural networks (CNNs)?

CNNs are a type of deep learning or machine learning. Deep learning is used in many different fields of study. It involves teaching machines to understand things in a similar way to how the human brain does. In medicine, CNNs can be helpful in reading images and making diagnoses.1

CNNs can be taught to look at images and detect patterns or make measurements. CNNs and other deep learning techniques can be trained to look for or perform certain tasks with high accuracy. In the case of MS, CNNs can be used to look at OCT images of the retina and detect minor changes.1

Using SS-OCT and CNNs to diagnose MS

One study used SS-OCT with CNNs to try to diagnose early-stage relapsing-remitting MS (RRMS). SS-OCT images from 48 people with MS and 48 people without MS were analyzed with the help of CNNs. Overall, the trained CNNs could correctly identify 100 percent of all cases of MS based on the images alone. Specifically, the CNNs detected changes in the thickness of the retina and some of its nerve cells, allowing for accurate diagnosis.1

Importance of this new option

More research is needed. But the study’s results suggest that SS-OCT images analyzed with CNNs could be helpful in diagnosing MS early. The approach may even be able to detect MS before symptoms begin. Being able to diagnose MS quickly can lead to an earlier start to treatment. And, an earlier diagnosis paired with the use of newer MS drugs may help to greatly improve life with MS.1

This new method is also exciting because it is quick, easy to access, and noninvasive. The test can be done in nearly any health center and does not need expensive equipment or specialists. This is especially valuable because other tests for MS, like lumbar punctures, can be costly, risky, and painful. It is very important to have a reliable, simple diagnostic test for MS. SS-OCT images analyzed with CNNs may be a step in the right direction.1

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