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Related Experiment Video

Updated: Jan 30, 2026

Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
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Evidence for Progressive Microstructural Damage in Early Multiple Sclerosis by Multi-Shell Diffusion Magnetic

Nicola Toschi1, Silvia De Santis2, Tobias Granberg3

  • 1Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.

Neuroscience
|February 2, 2019
PubMed
Summary

New diffusion imaging techniques can track white matter damage in early multiple sclerosis (MS) before clinical symptoms appear. This method, using restricted diffusion signal fraction (FR), shows microstructural changes in normal-appearing white matter within one year.

Keywords:
CHARMED modelaxonal pathologylongitudinal disease progressionmulti-shell diffusion MRImultiple sclerosisnormal-appearing white matter

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Area of Science:

  • Neuroimaging
  • Neuroinflammation
  • Diffusion MRI

Background:

  • Tracking axonal pathology in early multiple sclerosis (MS) is crucial for monitoring disease progression before clinical disability.
  • Non-invasive assessment of short-term white matter integrity changes in MS remains challenging.

Purpose of the Study:

  • To assess longitudinal changes in the restricted diffusion signal fraction (FR) using advanced multi-shell diffusion MRI in early-stage MS.
  • To compare the sensitivity of FR with conventional Diffusion Tensor Imaging (DTI) metrics in detecting microstructural changes.

Main Methods:

  • Ultra-high gradient strength multi-shell diffusion MRI was employed in 11 early MS patients (disease duration ≤5 years).
  • Restricted diffusion signal fraction (FR) and DTI metrics were acquired at baseline and 1-year follow-up using the Composite Hindered and Restricted Model of Diffusion (CHARMED).

Main Results:

  • Statistically significant longitudinal changes (p < 0.01) were observed in all imaging metrics in normal-appearing white matter (NAWM) at follow-up, with FR showing the most extensive changes.
  • FR was the only metric to detect significant longitudinal changes in MS lesions (p = 0.007) and revealed pre-lesional changes at baseline.
  • Conventional DTI metrics did not show significant changes in lesions or pre-lesional alterations.

Conclusions:

  • Progressive microstructural damage in NAWM of early MS is detectable within a 1-year follow-up using multi-shell diffusion imaging.
  • FR is a sensitive biomarker for tracking disease evolution in MS, even before clinical manifestation.
  • This study underscores the value of advanced diffusion MRI techniques for early and sensitive monitoring of MS progression.