The contribution of diffusion-weighted MR imaging in multiple sclerosis during acute attack

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Multiple Sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
• Diffusion-weighted imaging (DWI) is a sensitive MRI technique for detecting microstructural changes in brain tissue.
• Understanding white matter alterations in MS is crucial for diagnosis and monitoring disease progression.

Purpose of the Study:

• To compare diffusion-weighted imaging (DWI) characteristics of normal-appearing white matter (NAWM) in patients with acute multiple sclerosis (MS) and healthy controls.
• To investigate the correlation between the Expanded Disability Status Scale (EDSS) and DWI metrics in both active MS plaques and NAWM.

Main Methods:

• Apparent diffusion coefficients (ADC) were measured in active plaques, NAWM (centrum semiovale and occipital horns), and control white matter.
• A cohort of 50 patients with acute MS attacks and 18 healthy volunteers were included.
• Statistical analysis, including the Mann-Whitney U-test, was used to compare ADC values and correlate them with EDSS scores.

Main Results:

• ADC values in active MS plaques were significantly higher than in white matter of both MS patients and controls.
• Statistically significant differences in ADC values were observed in the white matter at the centrum semiovale and occipital horns between MS patients and controls.
• A significant correlation was found between EDSS scores and ADC values in the occipital white matter, but not in active plaques.

Conclusions:

• Subtle white matter abnormalities can be detected in MS patients using DWI, even in regions appearing normal on conventional MRI.
• Early microstructural alterations in white matter, particularly in the occipital region, show a moderate correlation with clinical disability (EDSS).
• Further validation in larger studies is recommended to confirm these findings.