Short-term evolution of spinal cord damage in multiple sclerosis: a diffusion tensor MRI study

Area of Science:

• Neuroimaging
• Radiology
• Neurology

Background:

• Diffusion tensor imaging (DTI) shows potential for detecting spinal cord abnormalities in multiple sclerosis (MS).
• Previous studies demonstrated DTI's capability in identifying MS-related spinal cord changes.

Purpose of the Study:

• To apply DTI techniques to recently diagnosed spinal cord lesions in MS patients.
• To correlate DTI parameter variations with clinical outcomes.
• To identify DTI parameters predictive of patient outcomes.

Main Methods:

• Prospective single-centre study design.
• Inclusion of patients with recent spinal cord relapse treated with intravenous steroids.
• Clinical assessment and MRI with DTI sequences at baseline and 3-month follow-up.

Main Results:

• Sixteen patients were recruited; 12 showed clinical improvement at 3 months.
• Most patients exhibited lower fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values.
• Improved patients showed significant changes in radial diffusivity, ADC, axial diffusivity, and FA in lesions and normal-appearing spinal cord.
• Higher baseline FA and lower radial diffusivity in lesions predicted better sensory score improvement.

Conclusions:

• DTI MRI reveals more extensive spinal cord abnormalities than conventional T2 MRI.
• Lessened decrease in FA and increased radial diffusivity within inflammatory lesions correlate with better clinical outcomes.
• DTI parameters show promise in predicting treatment response in MS patients with spinal cord involvement.