Clinical MS Research Group
Remyelination (Cunniffe Group)
Our research mission focusses on preventing and reversing disability in people living with multiple sclerosis. We lead groundbreaking research in the field of remyelination, dedicated to repairing the nervous system and improving the lives of individuals affected by demyelinating disorders. We therefore conduct drug trials of remyelination-promoting drugs, and conduct clinical studies to better understand the reasons people with MS fail to repair the damage done by the disease.
Learn more about our trials here and related projects below.
A study assessing remyelination in adults and children with central nervous system demyelinating diseases
Nerves in the brain and spinal cord are normally surrounded by a protective layer of a substance called myelin (similar to the plastic insulation of an electric cable). In multiple sclerosis (MS), and in other demyelinating conditions of the central nervous system (CNS), the immune system attacks the myelin, leaving nerve fibres (similar to the metal wire in the cable) unprotected. This causes nerves to malfunction, which can result in symptoms such as changes to vision, sensation, movement and cognition. Over time, unprotected nerve fibres die, leading to progressive disability.
To avoid this happening, we are trying to understand remyelination – the process by which myelin is regenerated – as this could reduce disability and prevent progression. At present, the tests employed for the diagnosis and monitoring of MS and other demyelinating conditions of the CNS are not sensitive to detecting the damage or the repair of damage (particularly standard MRI brain scans). The ARMOUR-One study (IRAS: 313164) is designed to introduce measures of myelin and axonal health to routine clinical practice. It is our ambition to improve the monitoring of nerve health in multiple sclerosis and other demyelinating conditions, while additionally beginning to understand the factors that might impact nerve protection and repair.
The study is observational, does not change regular care, and there are no risks from these specialised assessments. Participants attend between 1 and 3 study visits over 12 months each lasting up to 3-4 hours. Remyelination is assessed by looking at the changes in eye tests and MRI brain scans between the initial and final visits.
The study is being conducted in Cambridge. Participants should have relapsing-remitting, primary progressive, or secondary progressive MS; myelin-oligodendroctye glycoprotein antibody associated disease (MOGAD); or neuromyelitis optica spectrum disease (NMO). We are also seeking to recruit healthy volunteers to help us interpret our findings. There are no age limitations to recruitment, but participants will need to be able to cooperate with the eye tests and other investigations.
The study is recruiting up to 180 participants including adults, children, and healthy volunteers. We are always pleased to hear from people who might want to participate in our research. If you would like to learn more then please email: cuh.ccmr-trials@nhs.net or one of the study investigators using the emails below.
DANIEL-MS [Demyelination Assessments of Nerves by Investigating Eye movement Latency in MS]
One of the central research aims of our group is to understand how best to measure remyelination in people living with multiple sclerosis. Eye movement abnormalities are common in people with MS and can be rapidly, precisely and non-invasively assessed using high-frequency infrared oculography (a technique where specialised cameras can track the eyes and measure the time taken for eye movements to occur in response to visual stimuli). A grant from Ferblanc has allowed us to purchase an Eyelink tracker (pictured), which allows us to study eye movements very accurately.
Recent research by our collaborators in London and Amsterdam has supported the inclusion of oculography to measure remyelination of single white matter tracts (such as the medial longitudinal fasciculus [MLF] of the brainstem) and of wider distributed neuronal networks. We are therefore incorporating this technique into our clinical trials and into our observational studies.
%20-%20DANIEL-MS%20image.png)
