Why does Multiple Sclerosis (MS) cause thinking difficulties? That’s the question Assistant Professor Yeo Tianrong, Head and Senior Consultant, Neurology, NNI@TTSH hopes to answer after receiving a national research award.

Memory lapses, slower processing speeds, and trouble concentrating – these are some of the lesser-known yet deeply disruptive symptoms experienced by people living with Multiple Sclerosis (MS). In MS, the body’s own immune cells attack the nervous system – which includes the brain, spinal cord, and optic nerves – disrupting the flow of messages within the brain and between the brain and the rest of the body.

Current treatments are effective in reducing clinical relapses by dampening inflammation in the brain, but to date, there is no medication that can halt progression which is characterised by the gradual worsening in walking, bladder, and importantly, cognitive functions.

Asst Prof Yeo Tianrong, Head of Department and Senior Consultant, Neurology, NNI@TTSH is determined to investigate the reasons underlying these often overlooked symptoms. From studies examining brain tissue donated by people with MS, researchers have noted a distinct pattern – a significant amount of injury to the cortex, the topmost layer of the brain.

“The extent of injury in the cortex correlates very well with the severity of clinical disability in MS, especially cognitive dysfunction. However, there’s currently no way to monitor the extent of cortex injury in living patients, because while MRI scans are good at detecting damage deeper inside the brain, they currently miss up to 90% of damage in the cortex,” noted Asst Prof Yeo.

Supported by the Clinician Scientist Award (Investigator) from the National Medical Research Council, Asst Prof Yeo and his research team are taking a closer look at why injury in the cortex occurs and what can be done to prevent it.

Though we often picture the brain to be nestled directly under the skull, it is in fact encased in a protective covering called the meninges, which both protects and nourishes the brain. In people with MS, inflammation occurs beneath the meninges – an aspect which is believed may be a key driver of damage to the cortex.

To investigate this, Asst Prof Yeo and his team are using spatial transcriptomics – a technique which allows them to examine which genes are being switched on or off in the brain, including the cortex and the meninges.

“By understanding this, we will be able to work out what is wrong, and what is causing and perpetuating injury in the cortex. This will let us find potential treatments to prevent and stop damage to the cortex and allow us to find biomarkers to monitor the progression of MS in our patients,” said Asst Prof Yeo.