White matter microstructural alterations in clinically isolated syndrome and multiple sclerosis

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
• Early detection and understanding of pathological changes in MS are crucial for effective management.
• Diffusion tensor imaging (DTI) offers insights into white matter integrity.

Purpose of the Study:

• To investigate diffusion alterations in the earliest stage of MS, specifically in clinically isolated syndrome (CIS).
• To compare diffusion metrics between CIS and relapsing-remitting MS (RRMS) patients.
• To explore the relationship between diffusion metrics and clinical variables in MS.

Main Methods:

• Tract-based spatial statistics (TBSS) analysis of DTI data.
• Inclusion of 36 CIS patients, 36 RRMS patients, and 36 age/gender-matched normal controls (NCs).
• Analysis of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ ₁), and radial diffusivity (λ ₂₃).

Main Results:

• CIS patients exhibited diffusion alterations in specific white matter (WM) regions.
• MS patients demonstrated more extensive diffusion changes compared to CIS patients.
• Exploratory analysis suggested associations between WM diffusion metrics and clinical factors like disability and disease duration.

Conclusions:

• DTI reveals abnormalities in WM in both CIS and MS.
• DTI can enhance the understanding of the pathophysiology and clinical progression of MS.
• Diffusion metrics may serve as biomarkers for early MS detection and monitoring.