PD Dr. med. Athina Papadopoulou

Multiple sclerosis (MS) is a disease of the central nervous system (CNS), with inflammatory and neurodegenerative components. Most sufferers experience progressive neurological deterioration (“progression”) over the course of the disease, which can significantly impair their quality of life. There is an urgent need for accurate/early markers of progression in MS. 

The retina of the eye offers fascinating possibilities in this regard: it is often affected early during the course of MS and it is the only part of the CNS that is easily accessible to us, using non-invasive imaging techniques (through the pupils). 

With this project we investigate retinal changes and the value of different retinal markers to predict progression in MS. We will assess the following markers: i) thinning of retinal axons and neurons, ii) stability of fixation and iii) changes in the diameters of retinal vessels. All markers are non-invasive and quick/patient-friendly; they capture different pathophysiological proccesses that probably contribute to progression of disability in MS. 

Our study aims at a better understanding of the mechanisms of progression in people with MS and to the early identification of patients at risk. The latter is very important, not only for therapeutic decisions in clinical practice (patient stratification), but also for studies with new, potentially neuroprotective therapies.

Migraine is one the most common causes of neurological disability worldwide, affecting approximately 1 million of people in Switzerland. Treatment in migraine is acute (treatment of attacks) and prophylactic, with development of several new agents during the last years.

In this project, we aim at understanding the mechanisms behind different response to prophylactic migraine treatments, particularly to migraine-specific therapies, like those targeting the calcitonin gene-related peptide (CGRP) pathway.

In this longitudinal study, we assess clinical characteristics (e.g. sex, comorbidities, duration of migraine etc.) and specific biomarkers (in blood, like the serum neurofilament light chain: sNfL, and on the skin, using quantitative sensory testing, QST) in patients with migraine. We analyse their associations with the severity of migraine and response to different prophylactic treatments.

Preliminary results showed that migraineurs frequently show allodynia not only on their face, but also on their hands, as tested by QST. Current analysis is focusing on the predictive value of allodynia, combined with other characteristics, in treatment response. Moreover, we are currently analysing how serum biomarkers like the sNfL may be related to migraine and if they can be modified during treatment with CGRP in responders.