Related Experiment Video
Updated: Jul 4, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
A 3-year diffusion tensor MRI study of grey matter damage progression during the earliest clinical stage of MS
Marco Rovaris1, Elda Judica, Antonia Ceccarelli
1Neuroimaging Research Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Objective:
To investigate the medium-term evolution of grey matter (GM) damage in patients at presentation with clinically isolated syndrome suggestive of multiple sclerosis (MS), and to assess whether it is associated with clinical disease activity during the initial stage of MS.
Methods:
In 30 patients enrolled within three months from the onset of a clinically isolated syndrome, conventional and diffusion tensor MRI scans of the brain were acquired at baseline and after 3 years. Percentage brain volume change between baseline and follow-up scans was computed. Histograms of mean diffusivity and fractional anisotropy for the normal-appearing white matter and histograms of mean diffusivity for the GM were produced.
Results:
Mean percentage brain volume change was -1.04 % (p < 0.001 vs. null change). GM mean diffusivity showed an increase at follow-up (p = 0.004), whose magnitude was greater, but not significantly, in patients who relapsed than in those who did not. There was no correlation between on-study relapse rate and GM mean diffusivity changes over time.
Conclusions:
In patients with clinically isolated syndrome suggestive of MS, GM damage begins to accumulate during the initial stage of the disease, possibly as a consequence of GM lesion accumulation. The magnitude of such a damage does not seem to be associated with the concomitant clinical activity.
Insights
Grey matter damage in early multiple sclerosis (MS) begins accumulating within three years, even without clinical relapses. This grey matter (GM) damage progression is not linked to clinical disease activity in the initial MS stage.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
- Grey matter (GM) damage is increasingly recognized as a significant contributor to irreversible disability in MS.
- Understanding the early evolution of GM damage is crucial for predicting disease progression.
Purpose of the Study:
- To investigate the medium-term evolution of grey matter (GM) damage in patients with clinically isolated syndrome (CIS) suggestive of MS.
- To assess the association between GM damage progression and clinical disease activity during the initial stage of MS.
Main Methods:
- 30 patients with CIS underwent brain MRI (conventional and diffusion tensor) at baseline and 3-year follow-up.
- Quantified percentage brain volume change and analyzed diffusion metrics (mean diffusivity, fractional anisotropy) in GM and normal-appearing white matter.
- Assessed correlation between on-study relapse rate and GM diffusivity changes.
Main Results:
- Significant brain volume loss (-1.04%) observed over 3 years (p < 0.001).
- Increased GM mean diffusivity at follow-up (p = 0.004), indicating ongoing GM damage.
- No significant association found between GM diffusivity changes and on-study relapse rate.
Conclusions:
- GM damage accrues early in the course of MS, starting from the CIS stage.
- This early GM damage may result from GM lesion accumulation.
- The extent of early GM damage progression is not significantly correlated with clinical disease activity (relapses).
