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Updated: May 24, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Brain volume and diffusion markers as predictors of disability and short-term disease evolution in multiple sclerosis
1Neuroimaging Research Group, Max Planck Institute of Psychiatry, Munich, Germany. saemann@mpipsykl.mpg.de
Background And Purpose:
MRI markers of neuroaxonal damage in MS have emerged as critical long-term predictors of MS-related disability. Here we investigated the potential of whole-brain diffusivity and brain volume for the prediction of cross-sectional disability and short- to medium-term clinical evolution.
Materials And Methods:
In this multimodal prospective longitudinal MRI study of 54 patients with MS (87% under immunomodulatory therapy, baseline and follow-up at a median of 12 months), ADC histogram analysis, WM lesion load, BPF, whole-brain atrophy rate, MSFC score, and EDSS score were obtained. A total of 44 patients with no relapse at both time points were included.
Results:
At both time points, ADC histogram analysis provided robust predictors of the MSFC scores (maximal R(2) = 0.576, P < .001), incorporated cognition and fine-motor skill subscores, and EDSS scores. Significant changes beyond physiologic age-related changes at follow-up were noted for ADC histogram markers and BPF. Stronger diffusivity alterations and brain volume at baseline predicted MSFC decline, as demonstrated by multiple linear regression analysis (mean ADC, R(2) = 0.203; P = .003) and lower baseline BPF in patients with declined compared with stable MSFC scores (P = .001). Results were independent of intercurrent relapses.
Conclusions:
Diffusion histogram analysis provided stable surrogates of disability in MS and proved sensitive for monitoring disease progression during a median of 12 months. Advanced neuroaxonal pathology at baseline was indicative of an increased risk for sustained progression during a median of 12 months, independent of intercurrent relapses.
Insights
Diffusion histogram analysis and brain volume effectively predict disability in multiple sclerosis (MS). Advanced neuroaxonal damage at baseline indicates a higher risk of sustained MS progression over 12 months.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Neuroaxonal damage in Multiple Sclerosis (MS) is a key predictor of long-term disability.
- Understanding MRI markers for predicting MS progression is crucial for patient management.
Purpose of the Study:
- To investigate whole-brain diffusivity and brain volume as predictors of cross-sectional disability in MS.
- To assess the potential of these MRI markers for predicting short- to medium-term clinical evolution in MS patients.
Main Methods:
- A prospective longitudinal MRI study involving 54 MS patients.
- Utilized ADC histogram analysis, white matter lesion load, brain parenchymal fraction (BPF), and atrophy rates.
- Assessed Expanded Disability Status Scale (EDSS) and MS Functional Composite (MSFC) scores at baseline and 12-month follow-up.
Main Results:
- ADC histogram analysis robustly predicted MSFC and EDSS scores at both time points.
- Significant changes in ADC histogram markers and BPF were observed over 12 months.
- Baseline diffusivity alterations and lower BPF predicted MSFC decline, independent of relapses.
Conclusions:
- Diffusion histogram analysis serves as a reliable surrogate for disability in MS.
- It is sensitive for monitoring disease progression over a 12-month period.
- Early neuroaxonal pathology predicts sustained MS progression, irrespective of relapses.
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