What have we done so far?
Magnetic resonance research in Newcastle over the last few years has advanced understanding in many diseases. A few representative advances are described below.
A major project is developing a new approach to defining brain tissue structure, organisation and several aspects of how the brain works. To allow effective but kind study of people with early dementia we have developed very rapid scanning techniques. Several different but complementary tools have been developed. These allow measurement of the six major parameters in the same patient
Structural scan, T1 and T2 relaxation maps providing details on tissue microenvironment.
Tissue microsctructure revealed by mean water diffusion, diffusion anisotropy and cerebral blood flow.
Understanding the relationship between these measurements will shed new light on disease progression of Alzheimer’s disease and other forms of dementia. Understanding the processes affecting the ageing brain is central to unlocking the secrets of dementia.
Type 2 Diabetes
Magnetic resonance research has made a dramatic advance in understanding of this increasingly common condition. It has been a longstanding puzzle why there appeared to be two separate defects – failure to produce enough insulin and resistance to the body’s own insulin. We have been able to define how a single process causes the disease. Fat accumulation in the liver is the earliest defect. This prevents insulin acting normally. It also spills over from the liver to affect insulin production in the pancreas. Not only does this define the single process that is happening in an individual developing type 2 diabetes, but also it explains why the disease behaves in an epidemic fashion in populations. Further work will pin point how to capitalize upon what we can now describe as a window of reversibility in a disease previously thought to be permanent. Let’s cure type 2 diabetes properly.
Primary Biliary Cirrhosis
Tiredness may affect us all. However, in the common liver disease primary biliary cirrhosis, tiredness is severe and profoundly affects day to day life. This was thought to be related to biochemical changes in the brain. We have been able to show that the brain is normal. However, in muscles there is a specific defect in handling acid produced during any activity. Acid levels recover very slowly. This problem is potentially treatable and work on this is underway. As people with the condition frequently die from heart disease, we have developed direct methods for study of heart muscle using the non-invasive magnetic resonance techniques. Preliminary results show major defects in heart muscle energy levels.
High field magnetic studies on the heart are completely non-invasive and allow detailed assessment of structure and function. As the signals from blood differ depending on the speed of flow, all details of how blood is being pumped through the heart can be “seen”. Similarly, flow through blood vessels in the brain can be assessed and this technique is being applied in studies of dementia and high blood pressure. The microstructure of the brain is being studied to understand the nerve fibre connections within the brain (Figure). How the brain operates during thinking or looking at images can be also monitored. This is being applied in studies of depression and of normal brain function.
Children with muscular dystrophy are being studied over time in order to understand exactly how the muscles are affected. The successful execution of this work involved building a toy magnet, with sound effects, which the volunteers could play with beforehand in order to remove any fear of the unknown. Studies on adults with disorders of energy metabolism (mitochondrial disease) depend upon unique coils and sequences, and are working towards avoiding the need for diagnostic muscle biopsy. Investigation of the ageing process is defining how physical activity changes muscle function and body composition, and how this promotes “metabolic youth”.