Studying remyelination in nerves with electrophysiology
Research type
Research Study
Full title
Studying progressive remyelination in nerves by grading electrophysiological recovery
IRAS ID
284097
Contact name
Alasdair Coles
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge
Duration of Study in the UK
10 years, 0 months, 3 days
Research summary
The greatest unmet need in multiple sclerosis (MS) are treatments which delay, or reverse disability. Now, drugs are being discovered that can promote regeneration of the lining of nerves in MS. The problem is uncertainty in the optimum test to measure this effect in people, over the course of a clinical trial.
One technique that has proved increasingly useful in this respect is a simple and safe non-invasive test of the speed of conduction along the optical pathway: the visual evoked potential (VEP). The full-field VEP has previously been deployed in clinical trials, and now recent research has indicated that multi-focal VEP (MF-VEP) might be more sensitive and robust to detect remyelination. Similarly, another test, this time looking at eye movements, has also been advocated to be an effective method to study nerve repair and regeneration. This test of eye movements (called saccades) can be measured using a non-invasive portable saccadometer.
However, there is a knowledge gap in that it is not known exactly how these measures are affected by the natural course of multiple sclerosis, how they change with time following a relapse (MS flare) affecting the eyes (optic neuritis), and how durable changes that we observe can be. It is also not known how these changes compare with other illnesses that affect the visual pathway. This is essential as researchers will be increasingly relying on these tests to monitor the effects of novel therapies in the setting of clinical trials.
We will characterise abnormalities in the VEPs and saccades of MS patients compared with controls at different timepoints over the course of 1-2 years; a smaller subgroup will be invited to continue to 5 years. We will be able to use this information to better determine how to employ these tests in a robust, rigorous fashion, within clinical trials.
REC name
Wales REC 7
REC reference
20/WA/0294
Date of REC Opinion
12 Nov 2020
REC opinion
Further Information Favourable Opinion