Multiple sclerosis (MS) is an autoimmune disease of the brain and spinal cord (together termed the central nervous system), where inflammation of the myelin coating of nerves leads to cell damage and varying degrees of disability. Neuromyelitis optica (NMO) is another inflammatory demyelinating disease of the central nervous system; however, it differs from MS in a few subtle but important aspects. NMO primarily affects the optic nerves and spinal cord, and evidence suggests that the flow of water in cells is very important in NMO. The similar characteristics of MS and NMO make it difficult to differentiate between the two; however, patient prognosis and optimal treatment for these two diseases are very different. Dr. Shannon Kolind is working to develop a non-invasive quantitative imaging tool for assessing both myelin and total water content throughout the entire central nervous system with the aim of differentiating between MS and NMO in terms of disease processes, diagnosis, prognosis, and treatment outcome. She is using a newly-developed magnetic resonance imaging (MRI) technique that is sensitive and specific to myelin and allows for high-resolution imaging of the brain and spinal cord in clinically feasible times. This technique can also be modified to estimate total water content. Dr. Kolind is using this technique to study the regional differences in myelin and inflammation in areas of focal damage (known as lesions) in MS and NMO, as well as areas of the brain and spinal cord that appear normal but might also have important damage. Ultimately, this research will provide new sensitive and specific imaging markers of excess water (inflammation/edema), myelin health (neuroprotection), myelin loss (neurodegeneration) and myelin repair (remyelination). The importance of this project lies in two potential improvements to the lives of people with MS and NMO. Rapidly and accurately making a diagnosis has a major impact on quality of life by determining the most effective treatment; it also reduces the stress of uncertainty, particularly with regard to prognosis. Furthermore, developing imaging markers and relating them to clinical symptoms will allow easier and more reliable monitoring and prediction of disease progression, which will aid in clinical trials of potential therapies, ultimately leading to the earlier availability of successful treatments.