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Updated: Mar 29, 2026
Positron Emission Tomography Imaging for In Vivo Measuring of Myelin Content in the Lysolecithin Rat Model of Multiple Sclerosis
Published on: February 28, 2021
Brain and cord myelin water imaging: a progressive multiple sclerosis biomarker
Shannon Kolind1, Arshia Seddigh2, Anna Combes3
1Department of Medicine (Division of Neurology), University of BC, Vancouver, Canada.
Objectives:
Conventional magnetic resonance imaging (MRI) is used to diagnose and monitor inflammatory disease in relapsing remitting (RR) multiple sclerosis (MS). In the less common primary progressive (PP) form of MS, in which focal inflammation is less evident, biomarkers are still needed to enable evaluation of novel therapies in clinical trials. Our objective was to characterize the association - across the brain and cervical spinal cord - between clinical disability measures in PPMS and two potential biomarkers (one for myelin, and one for atrophy, both resulting from the same imaging technique).
Methods:
Multi-component driven equilibrium single pulse observation of T1 and T2 (mcDESPOT) MRI of the brain and cervical spinal cord were obtained for 15 PPMS patients and 11 matched controls. Data were analysed to estimate the signal related to myelin water (VFM), as well as volume measurements. MS disability was assessed using the Multiple Sclerosis Functional Composite score, which includes measures of cognitive processing (Paced Auditory Serial Addition Test), manual dexterity (9-Hole Peg Test) and ambulatory function (Timed 25-Foot Walk); and the Expanded Disability Status Scale.
Results:
Brain and spinal cord volumes were different in PPMS compared to controls, particularly ventricular (+ 46%, p = 0.0006) and cervical spinal cord volume (- 16%, p = 0.0001). Brain and spinal cord myelin (VFM) were also reduced in PPMS (brain: - 11%, p = 0.01; spine: - 19%, p = 0.000004). Cognitive processing correlated with brain ventricular volume (p = 0.009). Manual dexterity correlated with brain ventricular volume (p = 0.007), and both brain and spinal cord VFM (p = 0.01 and 0.06, respectively). Ambulation correlated with spinal cord volume (p = 0.04) and spinal cord VFM (p = 0.04).
Interpretation:
In this study we demonstrated that mcDESPOT can be used to measure myelin and atrophy in the brain and spinal cord. Results correlate well with clinical disability scores in PPMS representing cognitive, fine motor and ambulatory disability.
Insights
New MRI techniques show myelin and atrophy changes in primary progressive multiple sclerosis (PPMS). These imaging biomarkers correlate with clinical disability, offering potential for tracking disease progression and evaluating new treatments.
Area of Science:
- Neuroimaging
- Biomarkers
- Multiple Sclerosis Research
Background:
- Conventional MRI is limited for diagnosing and monitoring primary progressive multiple sclerosis (PPMS).
- PPMS lacks the focal inflammation seen in relapsing-remitting MS, necessitating new biomarkers for clinical trials.
- Objective assessment of myelin and atrophy is crucial for evaluating novel therapies in PPMS.
Purpose of the Study:
- To investigate the association between clinical disability measures and potential imaging biomarkers of myelin and atrophy in PPMS.
- To characterize these associations across the brain and cervical spinal cord.
- To evaluate the utility of multi-component driven equilibrium single pulse observation of T1 and T2 (mcDESPOT) MRI in PPMS.
Main Methods:
- mcDESPOT MRI scans of the brain and cervical spinal cord were acquired from 15 PPMS patients and 11 controls.
- Analysis focused on estimating myelin water (VFM) and assessing volume measurements.
- Clinical disability was measured using the Multiple Sclerosis Functional Composite and the Expanded Disability Status Scale.
Main Results:
- Significant differences in brain and spinal cord volumes were observed between PPMS patients and controls.
- Reduced brain and spinal cord myelin (VFM) was detected in PPMS patients.
- Clinical measures of cognitive processing, manual dexterity, and ambulation showed significant correlations with specific volumetric and myelin measures.
Conclusions:
- mcDESPOT MRI effectively measures myelin and atrophy in the brain and spinal cord of PPMS patients.
- These imaging biomarkers demonstrate strong correlations with clinical disability scores.
- The findings support mcDESPOT as a valuable tool for assessing disability and therapeutic efficacy in PPMS clinical trials.
