Week 1 -- Safaa Mouline

I have the pleasure of working with Dr. Gauthier in Neurology this summer. The first thing I noticed this week was how the world of clinical research in a medical setting uses a completely different language than the world of academic scientific research. While this is perhaps quite an obvious observation, it was interesting to see how different lab meetings are here; in my Ithaca lab, we typically use MRIs that have already been collected, so talk of coordinating data collection and patient scanning was completely new to me. Beyond logistics discussions, through the lab meeting I also learned more about a specific MS lesion called a paramagnetic rim lesion as there were discussions to try to classify different lesions for a dataset the clinic has collected. 

I also had the opportunity to sit in on a meeting in which all the different MS doctors at the clinic go over different cases they would like input on. All the cases were discussed with some imaging projected (T1, T2 FLAIR, QSM, etc.) on the TV, and almost all cases were about new patients who may or may not have MS. For example, one patient had cerebral amyloid angiopathy resulting in microhemorrhages and there was a question as to whether they also had MS based on their MRI. Apparently, the diagnostic criteria for MS changed recently to make MS easier to diagnose. It used to be that diagnoses required dissemination in space and in time, meaning that lesions had to be in different locations and developed at different times, respectively. However, recently this changed so that dissemination in time is no longer needed. 


Perhaps the most interesting part of my week was shadowing Dr. Gauthier through her patient appointments. On the medical side of things, I got to witness Dr. Gauthier determine Expanded Disability Status Scale (EDSS) scores for each patient. This involved observing walking, testing reflexes, identifying whether a patient can feel the buzzing from a tuning fork, and more. Beyond the medical tests, I really enjoyed observing patient-doctor interactions. Because MS is a chronic disease, some patients have been coming to the clinic for decades. Thus, my clinician knows her patients on a personal level, and through their interactions, I got to learn more about patients’ lives, families, travels, and goals. 


Project-wise, I am working with a dataset of around 890 patients with MS. Specifically, the dataset includes different imaging modalities, lesion masks, and EDSS scores. However, since everyone's brain anatomy differs slightly and scans were acquired on different scanners, the imaging first needs to be registered to MNI space, a standardized brain template that allows for meaningful comparisons across subjects. When I was not shadowing or in meetings, I spent my time working on this co-registration. 


I’m looking forward to meeting more shadowing next week! 

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