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Neurite Orientation Dispersion and Density Imaging for Assessing Acute Inflammation and Lesion Evolution in MS
S Sacco1,2, E Caverzasi1, N Papinutto1
1From the Department of Neurology (S.S., E.C., N.P., C.C., A.B., T.G., S.C., C.A., G.K., J.M., W.A.S., R.M.B., J.M.G., D.S.G., A.J.G., E.W., M.R.W., S.S.Z, B.A.C., S.L.H., and R.G.H.), University of California, San Francisco Weill Institute for Neurosciences, University of California, San Francisco, California.
Neurite orientation dispersion and density imaging (NODDI) shows promise in detecting acute multiple sclerosis (MS) inflammation. This advanced MRI technique reveals lesion heterogeneity, potentially indicating varying severity and recovery.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- Conventional MRI has limitations in assessing axonal damage and remyelination in multiple sclerosis (MS).
- Gadolinium-based contrast agents highlight acute inflammation but pose safety and cost concerns.
- Neurite orientation dispersion and density imaging (NODDI) offers a novel approach to evaluate white matter microstructure.
Purpose of the Study:
- To investigate the utility of NODDI in characterizing MS lesions and detecting acute inflammation.
- To explore the potential of NODDI to overcome limitations of conventional MRI in MS assessment.
Main Methods:
- Serial enhanced MRIs, including NODDI, were performed on 21 MS patients over 12.6 months.
- NODDI metrics (neurite density index, orientation dispersion index) were analyzed in enhancing and non-enhancing lesions.
- Comparison with 21 healthy controls using similar MRI protocols.
Main Results:
- The orientation dispersion index was significantly higher in gadolinium-enhancing lesions compared to non-enhancing ones (AUC=0.73).
- Two lesion subgroups were identified based on neurite density index changes over time.
- Type 1 lesions (increased neurite density) showed a greater reduction in size compared to Type 2 lesions (decreased neurite density).
Conclusions:
- NODDI is a promising tool for detecting acute MS inflammation.
- Lesion heterogeneity observed with NODDI may reflect varying MS severity and clinical recovery potential.
