Week 4 - Safaa Mouline

Yay, the estimated structural connectivities of the MRI data finally (partially) completed this week (it was running on the background for a couple of weeks but it takes a lot of time per MRI). This meant that I was able to use this to also estimate functional connectivities of the subjects, as well creating some preliminary models with these modalities to predict EDSS (a disability metric in MS) scores. The dataset I'm using of MS MRIs collected at Weill was also previously processed to include some MRI measurements, such as cortical thickness, lesion volume, thalamic volume, and cerebral volume, which I added to the models. It was really useful to update the lab during a meeting to get feedback on where to take it from here. We're hoping we can add to the dataset so that it becomes longitudinal, including 5 year MRIs and EDSS scores as well. It would be interesting to see how accurate it is to predict EDSS at a later time point but another idea is to use the first time point to predict atrophy in the second time point MRI. The MRIs have already been collected, so hopefully some of this can be done in the remaining time of immersion! 

On the clinical side, I got to shadow Dr. Gauthier in clinic again this week. After seeing many patients under different treatments, I'm getting a better idea of what drugs are best suitable for which patients. For example, Tysabri is a drug that works well for many patients with relapsing MS. It prevents inflammatory cells from crossing into the brain rather than broadly suppressing the immune system, so compared to other MS drugs it doesn't make patients as prone to infections. However, if a patient is JC positive, they cannot be on Tysabri. JC is a virus that about 80% of the population has with no symptoms but can become dangerous under a weakened immune system. The JC virus antibody status is always checked before starting Tysabri since JC-positive patients carry a risk of a serious brain infection called PML.  One patient unfortunately had to switch medication for this reason because the patient became JC-positive. 

At this week's MS doctors' meeting, the main discussion surrounded a disease called MOGAD (Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease). Both MOGAD and MS cause episodes of neurological symptoms and show lesions on MRI, which is why they're sometimes confused early on, so the clinicians were going over the official updated MOGAD diagnoses criteria. 

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