Ravi Menon is clear: important advances in diagnosing multiple sclerosis (MS) are the result of collaboration and amazing technology.

A neurophysicist and medical biophysics professor at the Schulich School of Medicine & Dentistry at Western University, Ravi says the earlier the MS diagnosis, the more lifelong disability can be avoided.  

He and his colleagues have found a way to use a powerful technology called ultra-high field magnetic resonance imaging (MRI) to pinpoint MS more accurately than ever before, thus making an early diagnosis more likely.  

MS often begins in young adulthood. It’s a neurological disease that causes the body’s immune system to mistakenly attack myelin, a covering that protects nerve fibres. Myelin is needed for messages to be sent to and from areas within the brain and allows the brain to tell the body what to do. Without the myelin, the nerve fibres are lost, which can lead to a host of health challenges that worsen over time, such as vision loss, bladder and bowel issues, dizziness, vertigo and memory and concentration problems. 

There is no cure for MS, but there are treatments that can dramatically slow the disease – again, if it’s caught early.  

And catching it early was, for a long time, a huge problem.

“It was very hard to diagnose and distinguish from other potential conditions,” says Ravi.  

“When MRI was first introduced, it could see lesions in the brain, but not with the clarity needed to definitively say it was MS. Patients were often sent home and scanned again only after new symptoms appeared, sometimes months or years later. Eventually, they would be diagnosed with MS, but in that intervening time the disease had often progressed past the point of treatment.”

But ultra-high field human MRI scanners, first installed in Canada at Western, have allowed Ravi and his team at Western’s Robarts Research Institute to revolutionize MS diagnosis. While conventional MRI yields very useful pictures, ultra-high field MRI creates images with a level of detail previously only visible through autopsy.

It enables scientists to assess MS lesions in a way that was never before possible and allows for non-invasive examination of the brain.

Ravi and his team have made important advances in the technology to improve our understanding of the relationship between human brain structure and function.

“We now we have the ability to see things at very high resolution. We can make that diagnosis with the very first scan, and that completely changes disease management of MS.”  

Ravi, who has also led influential MRI‑based research on concussions, emphasizes these advances are not the result of his work alone. Local and global collaboration, he says, is always at the heart.  

“We’ve continued to be very successful in this area because we have a unique, team-based approach at Western. In most institutions, MRI scanners are in different places, but here we're fully integrated. Robarts is physically attached to University Hospital and our students, whether they're scanning mice or patients, sit next to one another. They learn from each other, and techniques transfer from one scanner to the other. This kind of collaboration is absolutely invaluable.”

Empowered by the possibilities of ultra-high field MRI, Ravi is now setting out to further improve the lives of people with MS.

“Our progress is particularly gratifying because Canada has one of the highest rates of MS in the world – and we still don’t know why. The disease impacts women three to four times as often as it does men, also for reasons we don't understand. That uncertainty creates a lot of potential for this technology to improve outcomes and help us answer important questions about MS.”