Stem cells as a resource for regenerative neurology.

Public and media interest in the potential applications of stem cells in regenerative neurology has led to growing hope and expectation. This interest is heightened by the current paucity of treatments available for neurodegenerative diseases and their generally poor prognosis. Patient discussions about stem cells are therefore a common occurrence in clinical practice, requiring neurologists to offer clear and accurate information. In the context of a complex and rapidly evolving field, this can be extremely challenging. Here we address issues around stem cell populations relevant to regenerative neurology, including the opportunities they offer for research and their potential application as direct therapies, concluding with a pragmatic assessment of the likely clinical benefits of stem cell research.

Development of a high-resolution fat and CSF-suppressed optic nerve DTI protocol at 3T: application in multiple sclerosis.

Clinical trials of neuroprotective interventions in multiple sclerosis require outcome measures that reflect the disease pathology. Measures of neuroaxonal integrity in the anterior visual pathways are of particular interest in this context, however imaging of the optic nerve is technically challenging. We therefore developed a 3T optic nerve diffusion tensor imaging protocol incorporating fat and cerebrospinal fluid suppression and without parallel imaging. The sequence used a scheme with six diffusion-weighted directions, b = 600 smm(-2) plus one b ≈ 0 (b(0)) and 40 repetitions, averaged offline, giving an overall scan time of 30 minutes. A coronal oblique orientation was used with voxel size 1.17 mm x 1.17 mm x 4 mm, We validated the sequence in 10 MS patients with a history of optic neuritis and 11 healthy controls: mean fractional anisotropy was reduced in the patients: 0.346(±0.159) versus 0.528(±0.123), p<0.001; radial diffusivity was increased: 0.940(±0.370)x10(-6) mm(2) s(-1) compared to 0.670(± 0.221)x10(-6) mm(2) s(-1) (p<0.01). No significant differences were seen for mean diffusivity or mean axial diffusivity.