Caption: An image from a standard clinical MRI, left, compared with an image from the same person using advanced methods on a stronger, 7T MRI. Compared to the standard clinical MRI, the research MRI is much clearer and multiple sclerosis lesions (dark spots) are more clearly seen.
How can clinicians better predict who will transition from relapsing to progressive Multiple Sclerosis (MS)? And can we use imaging techniques to diagnose MS more accurately and to select the right treatments for individual patients?
“These are questions people with MS and their doctors struggle with frequently, and so we hope to at least begin to answer them through our research,” says Erin S. Beck, MD, PhD, Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai and a neurologist at the Corinne Goldsmith Dickinson Center for Multiple Sclerosis.
Erin S. Beck, MD, PhD
Dr. Beck, whose research program explores the intersection of neuroimaging, immunology, and clinical care, is seeking answers using advanced magnetic resonance imaging (MRI).
“At the heart of our work is a commitment to advancing both science and patient care,” says Dr. Beck. “By deepening our understanding of cortical lesions and the inflammatory processes that drive them, we are helping to shape a more precise and informed future for MS diagnosis, treatment, and care.”
For MS patients, the implications of this work are significant. If these imaging methods are validated, cortical lesion detection could become part of routine MRI protocols within the next several years. This could enable earlier and more accurate diagnosis, improve predictions of how a patient’s disease will unfold, and support more personalized treatment decisions.
Dr. Beck’s lab studies how lesions in the brain and spinal cord form, evolve, and repair in MS and other related diseases. A central focus of her lab’s research is understanding MS lesions in the cortex, the outer layer of the brain, which helps to control most of the brain’s functions. While white matter lesions are well-established markers of MS activity, they explain only part of the disease.
Cortical lesions, though harder to detect with standard imaging, are increasingly recognized as widespread in MS and closely tied to physical disability and cognitive impairment, particularly in progressive forms of the disease. It is unclear whether current MS treatments, which work by stopping new lesions from forming in the rest of the brain, are also effective at stopping cortical lesion formation.
Using state-of-the-art imaging technologies—including more powerful, 7 tesla (T) MRI scanners—Dr. Beck combines MRI with cerebrospinal fluid (CSF) and blood analysis to investigate the formation, repair, and clinical significance of cortical lesions. Her research integrates imaging with measures of inflammation, aiming to discover how immune processes contribute to lesion development and disease progression.
One of her lab’s key contributions is the development of MRI methods to improve cortical lesion detection using widely available 3T MRI scanners. These include IR-SWIET, a novel MRI method specifically optimized for visualizing cortical lesions. The lab is currently testing whether IR-SWIET could be useful for MS diagnosis and for monitoring response to treatment.
Her investigations also extend to patients with Radiologically Isolated Syndrome (RIS)—those whose MRI scans show MS-like lesions despite having no symptoms. Through advanced imaging and CSF studies, she hopes to identify biomarkers that distinguish individuals likely to develop clinical MS from those who will remain symptom-free.
Dr. Beck earned her MD/PhD from Columbia University. Following her neurology residency at New York–Presbyterian/Columbia and a neuroimmunology fellowship at the National Institutes of Health, she joined Mount Sinai’s faculty in 2021. Since then, she has been building her research program at the intersection of neuroimaging, immunology, and clinical MS care.
Dr. Beck’s research has been recognized with awards such as a Clinician Scientist Development Award and a Career Transition Fellowship from the National MS Society. Her findings have been published in leading journals, including Brain Communications, Investigative Radiology, and Human Brain Mapping.
By Julia Bonem, a volunteer at the Corinne Goldsmith Dickinson Center for Multiple Sclerosis