Knowing exactly what’s happening inside the brain is no easy task. That is, unless you have some of the most powerful imaging technology in the world at your fingertips.

Such is the case for researchers at the University of Minnesota’s Center for Magnetic Resonance Research.

Pramod Pisharady, PhD, an assistant professor in the Medical School’s Department of Radiology, and David Walk, MD, an M Health Fairview neurologist and professor in the Medical School’s Department of Neurology, are using MRI scans to better understand how amyotrophic lateral sclerosis, or ALS, progresses over time. ALS affects nerve cells in the brain and spinal cord and does not yet have a cure.

“In the ALS world, where so many drugs have been tested and so few have shown benefit,” Walk says, “one of the big questions is, were the drugs no good, or were we not good at measuring their benefit?”

In a 2022 study that was supported by philanthropy, Walk, Pisharady, and their colleagues, including assistant professor of radiology Christophe Lenglet, PhD, used the center’s 3 Tesla MRIs—scanners that are twice as powerful as those typically found in hospitals today—to see inside the brains of people with ALS over six- and 12-month periods. The initial findings showed that the changes in the brain, even in people whose ALS was progressing slowly, were measurable and evident.

Being able to see the subtlest of changes in the brain will allow experts to understand ALS better than ever before, Pisharady says, which could lead to better, more effective treatments.

Next up, Pisharady and Walk are collecting more imaging data to create standardized models of ALS’ progression over time. From there, they plan to use artificial intelligence (AI) to predict how individuals will respond to certain treatments.

Data is being collected through a multicenter study led by Pisharady and Walk that includes the University of Minnesota, University of Florida, and Northwestern University. Pisharady envisions a future where imaging plus AI allows doctors to quickly and accurately devise treatment plans specific to each patient.

“Measuring the progression of ALS is very important in developing medications and seeing whether a medication is working or not,” Pisharady says. “Can we predict the progression for a new patient from their baseline data, and will it help us decide their treatment?”