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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
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Cine cerebrospinal fluid imaging in multiple sclerosis.

Christopher Magnano1, Claudiu Schirda, Bianca Weinstock-Guttman

  • 1Buffalo Neuroimaging Analysis Center, State University of New York, Buffalo, New York, USA.

Journal of Magnetic Resonance Imaging : JMRI
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Cerebrospinal fluid (CSF) flow is significantly reduced in multiple sclerosis (MS) patients. Altered CSF dynamics correlate with disease severity and predict future MS conversion in early stages.

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Area of Science:

  • Neurology
  • Neuroimaging
  • Cerebrospinal Fluid Dynamics

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease characterized by demyelination and axonal damage.
  • Cerebrospinal fluid (CSF) dynamics play a crucial role in maintaining central nervous system homeostasis.
  • Previous studies suggest potential alterations in CSF flow in MS, but detailed investigation is warranted.

Purpose of the Study:

  • To investigate cerebrospinal fluid (CSF) dynamics in the aqueduct of Sylvius in multiple sclerosis (MS) patients and healthy controls (HC).
  • To assess the relationship between CSF flow parameters and clinical/MRI outcomes in MS.
  • To evaluate CSF flow as a potential predictor of disease progression in early MS stages.

Main Methods:

  • Cine phase contrast imaging was used to quantify CSF flow and velocity in 67 MS patients (including relapsing-remitting [RR] and secondary-progressive [SP] subtypes), 9 patients with clinically isolated syndrome (CIS), and 35 healthy controls (HC).
  • A semiautomated method was employed for CSF flow quantification.
  • Statistical analyses compared CSF measures between groups and correlated them with clinical and MRI disease outcomes.

Main Results:

  • MS patients exhibited significantly decreased CSF net flow compared to HC (-3.7 vs. -7.1 μL/beat, P = 0.005).
  • Altered CSF flow and velocity measures were associated with increased lesion volumes (T1 and T2), ventricular volumes, and third ventricular width in MS and CIS patients (P < 0.01).
  • In CIS patients, reduced CSF net flow predicted conversion to clinically definite MS within one year (P = 0.007).

Conclusions:

  • Cerebrospinal fluid (CSF) flow dynamics are demonstrably altered in multiple sclerosis (MS) patients.
  • The severity of clinical and MRI outcomes in MS and CIS patients is linked to these altered CSF flow and velocity measures.
  • CSF flow dynamics may serve as a valuable biomarker for disease progression and prediction in MS.