Hyperpolarized Carbon Metabolic Imaging in Multiple Sclerosis

The main purpose of this study is to assess whether hyperpolarized carbon imaging in relapsing remitting multiple sclerosis (MS) patients can be used to predict response to anti-CD20 disease modifying therapy. Study procedures will include magnetic resonance imaging (MRI) assessments with a hyperpolarized pyruvate sequence, clinical assessment as well as blood markers of disease progression. This method of imaging utilizes the Warburg effect, where innate immune cells utilize a metabolic shift to glycolysis instead of oxidative phosphorylation. In pre-clinical data, increased hyperpolarized lactate production has been found to be associated with increased microglial/macrophage infiltration in the brain. Although hyperpolarized carbon imaging in humans has been established and used in the field of oncology, this will be one of the first applications of hyperpolarized carbon the study of neuroinflammation in humans. We predict that hyperpolarized carbon imaging may have the potential to monitor and evaluate neuroinflammation in MS, and in particular the innate immune activation state that plays a role in MS progression. This imaging method may provide non-invasive monitoring of disease progression and therapy response for MS patients.

NCT Number	NCT07510607
Lead Sponsor	Ari Green Collaborators: National Institute of Neurological Disorders and Stroke (NINDS)
Conditions	Multiple Sclerosis, RRMS, Relapsing Remitting MS
Enrollment	40 participants
Start Date	2026-06-03
Primary Completion	2029-12-01 (estimated)
Study Completion	2029-12-01 (estimated)
Updated on ClinicalTrials.gov	2026-06-08