Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system, in which nerve fibres in the brain and spinal cord are damaged, disrupting the flow of information in the brain and between the brain and body.
Over 23,000 people in Australia are affected by MS, which is most often diagnosed in early adulthood and can therefore dramatically impact the social and economic participation of people affected. This gives great urgency to understanding more about the cause, care and possible cure of the disease.
The Multiple Sclerosis Clinic at BMC is a tertiary referral, multidisciplinary bulk-billing clinic for patients with multiple sclerosis. A joint venture of the BMC and Royal Prince Alfred Hospital, the clinic provides comprehensive neurological service for people with MS in the one location. The clinic is staffed by seven Neurologists with subspecialty expertise in the diagnosis and management of multiple sclerosis, a MS Fellow and a Neurology Advanced Trainee from Royal Prince Alfred Hospital, two clinical nurse consultants in multiple sclerosis, continence advisors, and, by prior appointment, a MS physiotherapist. The clinic is closely affiliated with the MS Clinical Trials Unit at the BMC.
The Brain and Mind Centre hosts a dedicated Multiple Sclerosis Clinical Trials Unit, providing patients with access to treatment trials of the latest therapies for MS. The unit is directed by Professor Michael Barnett.
The MS Clinical Trials Unit conducts a variety of studies, ranging from observational clinical research through to Phase 2, 3 and 4 treatment trials. To express your interest in participating in MS clinical trials, please contact our manager, Dr Marinda Taha. It is important that you to discuss your potential participation in MS treatment trials with your treating neurologist first.
The Brain and Mind Centre MS Clinic is the largest multiple sclerosis clinic in New South Wales. We are a major contributor to MSBase, the world’s largest clinical registry that contains almost 70,000 patient datasets. MSBase has generated cutting edge clinical outcomes research that has been published in numerous top-tier neurology and research journals.
Our neuroimaging researchers are dedicated to improving the lives of patients with MS. We use the latest technologies to provide novel insights into MS pathogenesis and repair mechanisms and to develop non-invasive biomarkers of the disease. Together with the Sydney Neuroimaging Analysis Centre (SNAC), our work has been rapidly translated into MS clinical trials and clinical practice.
We share infrastructure and expertise with SNAC, an ultramodern facility located within the Brain and Mind Centre that uniquely integrates in-house neuro-imaging research with a dedicated, regulatory-compliant commercial image analysis facility for Phase 2, 3 and 4 clinical research trials.
The Brain and Mind Centre’s MS Clinic and Neuroimaging Research Group participates in a number of large collaborative research projects, involving the major MS centres in Australia. For example, we participate in the IMPROVE-MS study, the largest, prospective, longitudinal MS cohort study ever undertaken. Funded by Biogen, the study seeks to develop MRI biomarkers of subclinical disease progression in MS. The study is a collaborative research project spanning five national centres (Brain and Mind Centre, Royal Melbourne Hospital, Box Hill Hospital, Royal Newcastle Hospital, Royal Hobart Hospital). All (central) neuroimaging analysis will be performed in the Brain and Mind Centre’s Sydney Neuroimaging Analysis Centre imaging laboratories. Principal Investigators: M Barnett, H Butzkueven, T Kalincik, T Kilpatrick, J Lechner-Scott, Bruce Taylor.
Brain and Mind Centre researchers led the highly successful rollout of the University-wide imaging data service in 2017-18. We are now building the next generation, cloud-based data-sharing platform for MS researchers worldwide that will also host a number of integrated, automated analysis pipelines. Based on XNAT technology, this platform is integrated with MSBase and NVIDIA’s artificial intelligence learning platform, CLARA. Funded by a Nerve Research Foundation grant and more recently by the Australian Government Medical Research Future Fund, the platform will set a benchmark in diagnostic MS imaging; track subclinical progression of the disease; and help to direct therapeutic strategies for the condition.
Serum biomarker research
We are investigating novel serum biomarkers to diagnose and monitor MS. Exosomes are small packages released by many cells in the body, including brain cells. Their outer membrane provides a protective environment and exosomes are full of RNA and DNA. Large numbers of exosomes circulate in the blood, including exosomes from the brain.
We are isolating exosomes from patients’ blood and profiling their RNA using massively parallel sequencing to see if we can find signatures of disease from a simple blood test. Our promising results have been published in the prestigious journal Scientific Reports and show that blood exosome signatures can distinguish people who have MS from people who don’t and a specific RNA signature can reliably distinguish what sort of MS a person has. Encouraged by these results, we are now undertaking a much larger study of these potential MS biomarkers. We are monitoring patients over time to see if we can predict when their MS is active and how effective a certain treatment is.
Dr Mahtab Ghadiri has recently her doctoral work on T-cell and B-cell immunophenotyping in MS. Her research provides detailed insights into the immune system and its regulation in MS, as well as how the immune system responds to disease-modifying therapies.
Dr Ghadiri was the inaugural recipient of the Brain and Mind Centre McGill University Fellowship. Her work in this field under the supervision of Dr Jack Antel and Dr Amit Bar-Or in Canada as well as Associate Professors Michael Barnett and Stephen Reddel at the Brain and Mind Centre, has yielded new, clinical relevant biomarkers that predict response to MS treatments. Her work has been published in top tier journals, including Scientific Reports.
The MS Research Australia Brain Bank coordinates the collection, storage and use of human post-mortem tissue from people with MS to use in research across Australia and internationally. Based at the Brain and Mind Centre, the MS Research Australia Brain Bank is a collaborative undertaking of MS Research Australia, the Brain and Mind Centre and the Sydney Local Health District.
The MS Research Australia Brain Bank is co-directed by Professor Michael Barnett and Associate Professer Michael Buckland. More information can be found on the MS Research Australia Brain Bank website.