A recent study has revealed that low-intensity repetitive transcranial magnetic stimulation (LI-rTMS) enhances myelin repair in laboratory models of multiple sclerosis (MS). The research, led by Professor Kaylene Young at the Menzies Institute for Medical Research and supported by MS Australia, offers a promising avenue for addressing the unmet need for myelin repair therapies in MS. The study was published in Cellular and Molecular Life Sciences.
The research team investigated whether LI-rTMS could promote myelin repair by tracing the fate of new and mature oligodendrocytes, the cells responsible for producing myelin, in laboratory models of MS. They used fluorescent tags to label these cells and advanced microscopy to observe their interactions in the brain.
The study found that LI-rTMS boosted the myelin repair capacity of both new and mature oligodendrocytes. Notably, the treatment particularly enhanced myelin production in the corpus callosum, a critical communication pathway between the brain's hemispheres. Furthermore, LI-rTMS increased the length and thickness of each myelin section, suggesting more efficient myelin repair and greater nerve fiber coverage.
Professor Young stated, "Our laboratory experiments told us that LI-rTMS could push brain cells to replace lost myelin." She added that the next step was to determine if it could do the same in people with MS, leading to the TAURUS clinical trial.
LI-rTMS involves using a rapidly changing magnetic field to generate small electrical pulses in the brain, stimulating specific areas. It is already used to treat depression in cases where antidepressants are ineffective. Previous small clinical trials of rTMS in MS patients have reported reductions in fatigue and muscle spasticity, as well as improved memory, although the underlying mechanisms were not well understood.
The TAURUS phase 1 clinical trial demonstrated that LI-rTMS is safe and well-tolerated by individuals with MS. The trial has now progressed to Phase 2, which will assess the effectiveness of LI-rTMS in promoting myelin repair and improving clinical measures such as mobility, fatigue, and MRI metrics. Recruitment for the Phase 2 trial is complete, and the data is currently being analyzed.
Treatments that promote myelin repair are greatly needed, as they can restore nerve function and limit nerve damage. The current findings suggest that LI-rTMS could be a valuable addition to existing MS therapies.
