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Updated: Jun 16, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Relationships of brain white matter microstructure with clinical and MR measures in relapsing-remitting multiple
Antonio Giorgio1, Jacqueline Palace, Heidi Johansen-Berg
1Centre for Functional MRI of the Brain, University of Oxford, Oxford, UK.
Purpose:
To assess the relationships of microstructural damage in the cerebral white matter (WM), as measured by diffusion tensor imaging (DTI), with clinical parameters and magnetic resonance imaging (MRI) measures of focal tissue damage in patients with multiple sclerosis (MS).
Materials And Methods:
Forty-five relapsing-remitting (RR) MS patients (12 male, 33 female; median age = 29 years, Expanded Disability Status Scale (EDSS) = 1.5, disease duration = 3 years) were studied. T2-lesion masks were created and voxelwise DTI analyses performed with Tract-Based Spatial Statistics (TBSS).
Results:
T2-lesion volume (T2-LV) was significantly (P < 0.05, corrected) correlated with fractional anisotropy (FA) in both lesions and normal-appearing WM (NAWM). Relationships (P = 0.08, corrected) between increasing EDSS score and decreasing FA were found in the splenium of the corpus callosum (sCC) and along the pyramidal tract (PY). All FA associations were driven by changes in the perpendicular (to primary tract direction) diffusivity. No significant global and voxelwise FA changes were found over a 2-year follow-up.
Conclusion:
FA changes related to clinical disability in RR-MS patients with minor clinical disability are localized to specific WM tracts such as the sCC and PY and are driven by changes in perpendicular diffusivity both within lesions and NAWM. Longitudinal DTI measurements do not seem able to chart the early disease course in the WM of MS patients.
Insights
Diffusion tensor imaging (DTI) reveals localized white matter (WM) damage in multiple sclerosis (MS) patients, correlating with disability. Early disease progression in MS WM is not detectable with longitudinal DTI.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Cerebral white matter (WM) damage is a hallmark of MS, impacting neurological function.
- Diffusion Tensor Imaging (DTI) offers a non-invasive method to assess WM microstructure.
Purpose of the Study:
- To investigate the relationship between DTI-derived WM microstructural integrity and clinical/MRI measures in relapsing-remitting MS (RR-MS).
- To identify specific WM tracts affected by microstructural damage in early MS.
- To explore the utility of DTI in tracking early disease progression.
Main Methods:
- Study included 45 RR-MS patients with a median Expanded Disability Status Scale (EDSS) of 1.5 and disease duration of 3 years.
- T2-lesion masks were generated, and voxelwise DTI analyses were performed using Tract-Based Spatial Statistics (TBSS).
- Fractional anisotropy (FA) was analyzed in relation to T2-lesion volume (T2-LV) and EDSS scores.
Main Results:
- Significant correlations were found between T2-lesion volume and FA in both lesions and normal-appearing white matter (NAWM).
- Decreasing FA in the splenium of the corpus callosum (sCC) and pyramidal tract (PY) correlated with increasing EDSS scores.
- FA changes were primarily attributed to increased perpendicular diffusivity, and no significant changes were observed over a 2-year follow-up.
Conclusions:
- Microstructural damage, indicated by FA changes, is localized to specific WM tracts (sCC, PY) in early RR-MS and relates to clinical disability.
- These FA alterations are driven by perpendicular diffusivity changes within both lesions and NAWM.
- Longitudinal DTI measurements are not sensitive enough to monitor the early course of WM changes in MS patients.
