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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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Comparing MRI metrics to quantify white matter microstructural damage in multiple sclerosis.

Ilona Lipp1,2,3, Derek K Jones2,4, Sonya Bells2,5

  • 1Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.

Human Brain Mapping
|March 21, 2019
PubMed
Summary

This study found that multiple MRI metrics for white matter damage in multiple sclerosis (MS) are partially correlated but capture different aspects of pathology, offering complementary insights for therapeutic trials.

Keywords:
brain MRIdiffusionlesionsmagnetisation transfer ratiomultiple sclerosismyelin water fraction

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Area of Science:

  • Neuroimaging
  • Neuroscience
  • Biomedical Engineering

Background:

  • Quantifying white matter damage in vivo is crucial for evaluating neuroprotective and repair strategies in multiple sclerosis (MS).
  • The relationship between different MRI-based microstructural metrics and their complementary information in MS remains underexplored.

Purpose of the Study:

  • To investigate the relationship and complementarity of four MRI-based microstructural metrics in different white matter tissue states in MS patients.
  • To assess the sensitivity of individual metrics and their combination in quantifying white matter damage.

Main Methods:

  • Acquired four microstructural metrics (fractional anisotropy, radial diffusivity, myelin water fraction, magnetisation transfer ratio) from 123 MS patients and 27 controls.
  • Quantified voxel-wise damage scores in normal appearing white matter (NAWM), T2-lesions (T2L), and T1-lesions (T1L) relative to healthy tissue.
  • Analyzed correlations between metrics and their sensitivity in differentiating tissue states; principal component analysis was used to combine metrics.

Main Results:

  • All MRI indices indicated significant white matter damage across NAWM, T2L, and T1L, with T1L showing the greatest damage.
  • Correlations between metrics ranged from 0.18 to 0.87, suggesting partial overlap but distinct information.
  • Myelin water fraction (MWF) best differentiated T2L from NAWM, while magnetisation transfer ratio (MTR) best differentiated T1L from NAWM and T2L.
  • Combining the four metrics did not improve sensitivity to damage compared to individual metrics.

Conclusions:

  • The investigated MRI metrics are partially correlated but sensitive to different aspects of white matter pathology in MS.
  • Leveraging the complementary information from these distinct metrics could enhance the assessment of therapeutic interventions in clinical trials for MS.