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Fatigue and depression are prevalent and significant symptoms of MS, often contributing substantially to reduced quality of life for people living with MS. Fatigue affects up to 80% of people living with MS and often presents early in the disease course.
The AusLong study, a large and long-term Australian research study tracking over 400 individuals for more than 15 years, found that five years after a first clinical demyelinating event, 41% of people with early MS experienced fatigue, and 19% developed clinical depression. Despite its huge impact, one of the unfulfilled needs in MS is an effective treatment option to combat fatigue.
Treatments that improve the function of mitochondria (parts of a cell which produce energy) might slow the neurological damage and have a protective effect, whilst also reducing fatigue. While some individual drugs and agents that support mitochondrial function have shown promise in reducing fatigue, depression and reduction in brain volume, a combination therapy using multiple mitochondrial support agents has yet to be tested in MS.
This project is part of a larger clinical trial that has been funded by the Federal Government’s Medical Research Future Fund (MRFF).  The project tested whether magnetic resonance imaging (MRI) techniques can be used to assess the effectiveness of a combined dietary supplement that aims to boost mitochondrial function and reduce fatigue and depression in relapsing remitting MS.
As part of a larger clinical trial that has been funded by the Federal Government’s Medical Research Future Fund, this project is testing whether magnetic resonance imaging (MRI) techniques can be used to assess the effectiveness of a combined dietary supplement that aims to boost mitochondrial function and can help combat fatigue and depression in a relapsing remitting MS.
Dr Ramadan’s team has finalised ethics approvals across 6 study sites and established the protocols and analysis platforms for MRI imaging. They started recruitment of study participants in early 2020 but due to delays as a result of extended lockdowns, it is expected recruitment and data collection will be finalised by the end of 2022.
Despite the delays, Dr Ramadan and his team have presented at international conferences. Their work highlights the novel techniques they are using to analyse MRIs. These techniques may help monitor brain inflammation non-invasively and potentially provide insight into the pathophysiology of MS.
It is hoped that this work will show that MRI will prove to be a powerful tool to detect markers associated with fatigue and depression in MS.
Updated: 31 March 2022
Dr Ramadan and his team successfully recruited 38 participants into the clinical trial, equally dividing them into the treatment group and placebo (mock treatment) group. Clinical assessment and magnetic resonance scans took place at the start of the trial before treatment started and 16 weeks after the start of treatment, which is when treatment finished.
One of the goals of the study was to use magnetic resonance scans to assess the biochemical changes occurring in the brain as a result of the treatment. Initial results indicate promising shifts in metabolite concentrations in the brain, suggesting the treatment’s potential in improving fatigue and depression.
The team have used advanced imaging techniques to assess study changes in the brain of people living with relapsing remitting MS. Although data analysis is ongoing, the team found:
Initial results also revealed a link between baseline levels of disability, fatigue and metabolism in the brain. Additionally, they revealed that participants receiving the mitochondrial dietary supplement had improvements in fatigue scores and corresponding changes in imaging markers. A detailed analysis between clinical and imaging data will provide insights into the disease process in relapsing remitting MS as well as the therapeutic potential of the treatment.
The innovative use of imaging techniques in this study could help monitor brain inflammation non-invasively and enhance our understanding of mitochondrial function in MS. This may lead to the development of more targeted therapies for fatigue and depression in people living with relapsing remitting MS.
Dr Ramadan and his team have collaborated closely with the Hunter Medical Research Institute. The team is actively working on enhancing data sharing and further analyses. This will ensure that the data from this project will be accessible for future research and clinical applications.
The team plans to present the results of this study at various conferences and prepare publications that highlight the novel use of imaging in this context.
Updated 31 July 2024
Dr Saadallah Ramadan
$25,000
2019
3 years
Past project
