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Konstantinos Papadopoulos1, Daniel J Tozer, Leonora Fisniku

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Multiple Sclerosis (Houndmills, Basingstoke, England)
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Subtle changes in normal-appearing brain tissue occur in early multiple sclerosis (MS). T1-relaxation time measurements reveal progressive, sub-clinical pathology in normal-appearing white and grey matter, independent of lesion load.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Physics

Background:

  • Multiple sclerosis (MS) pathology extends beyond visible lesions.
  • Subtle changes in normal-appearing brain matter are increasingly recognized in MS.
  • T1-relaxation time measurement is a sensitive MRI technique for detecting these subtle changes.

Purpose of the Study:

  • To investigate the longitudinal evolution of T1-relaxation time changes in normal-appearing white matter (NAWM) and normal-appearing grey matter (NAGM) in early relapsing-remitting MS (RRMS).
  • To compare these changes between RRMS patients and healthy controls over a 3- to 5-year period.

Main Methods:

  • Analysis of 3- and 5-year follow-up MRI data from 35 early RRMS patients and 15 healthy controls.
  • Extraction of T1-relaxation time histograms from NAWM and NAGM.
  • Estimation of mean, peak height, and peak location values from T1-relaxation time histograms.

Main Results:

  • A significant decline in T1-relaxation time peak height was observed in the NAWM and NAGM of RRMS patients, but not in controls (p = 0.024 for NAWM, p = 0.038 for NAGM).
  • No significant differences in other T1-relaxation time measures were found between groups.
  • Changes in T1-relaxation time did not correlate with lesion load or disability scores.

Conclusions:

  • T1-relaxation time changes in NAWM and NAGM in early RRMS suggest progressive, sub-clinical pathology.
  • These findings indicate pathological processes distinct from, and not immediately linked to, white matter lesion formation.
  • T1-relaxation time MRI may serve as a valuable tool for monitoring diffuse brain changes in MS.