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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Spatiotemporal distribution of white matter lesions in relapsing-remitting and secondary progressive multiple
Lukas Filli1, Louis Hofstetter, Pascal Kuster
1Medical Image Analysis Center, University Hospital Basel, Basel, Switzerland.
Background:
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. MS lesions show a typical distribution pattern and primarily affect the white matter (WM) in the periventricular zone and in the centrum semiovale.
Objective:
To track lesion development during disease progression, we compared the spatiotemporal distribution patterns of lesions in relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS).
Methods:
We used T1 and T2 weighted MR images of 209 RRMS and 62 SPMS patients acquired on two different 1.5 Tesla MR scanners in two clinical centers followed up for 25 (± 1.7) months. Both cross-sectional and longitudinal differences in lesion distribution between RRMS and SPMS patients were analyzed with lesion probability maps (LPMs) and permutation-based inference.
Results:
MS lesions clustered around the lateral ventricles and in the centrum semiovale. Cross-sectionally, compared to RRMS patients, the SPMS patients showed a significantly higher regional probability of T1 hypointense lesions (p ≤ 0.03) in the callosal body, the corticospinal tract, and other tracts adjacent to the lateral ventricles, but not of T2 lesions (peak probabilities were RRMS: T1 9%, T2 18%; SPMS: T1 21%, T2 27%). No longitudinal changes of regional T1 and T2 lesion volumes between baseline and follow-up scan were found.
Conclusion:
The results suggest a particular vulnerability to neurodegeneration during disease progression in a number of WM tracts.
Insights
Secondary progressive multiple sclerosis (SPMS) patients show increased T1 lesion probability in specific white matter tracts compared to relapsing-remitting MS (RRMS) patients. No longitudinal lesion volume changes were observed over 25 months.
Area of Science:
- Neuroimaging
- Neurology
- Medical Research
Background:
- Multiple sclerosis (MS) is a chronic central nervous system inflammatory disease.
- MS lesions typically impact white matter (WM) near ventricles and in the centrum semiovale.
Purpose of the Study:
- Compare lesion distribution patterns in relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS).
- Track lesion development during disease progression.
Main Methods:
- Analyzed T1/T2 MRI scans from 209 RRMS and 62 SPMS patients over 25 months.
- Utilized lesion probability maps (LPMs) for cross-sectional and longitudinal analysis.
- Employed permutation-based inference for statistical analysis.
Main Results:
- SPMS patients exhibited higher T1 lesion probability in callosal body and specific WM tracts compared to RRMS patients.
- No significant differences in T2 lesion probability were found between RRMS and SPMS.
- No longitudinal changes in regional T1 or T2 lesion volumes were detected.
Conclusions:
- SPMS demonstrates a distinct pattern of white matter lesion vulnerability.
- Suggests specific WM tracts are susceptible to neurodegeneration during MS progression.
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