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Updated: Jul 10, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
T2 Relaxometry Evidence of Microstructural Changes in Diffusely Abnormal White Matter in Relapsing-Remitting Multiple
Efrosini Papadaki1,2, Vasileios Mastorodemos3, Theodora Panou4
1Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece.
Background:
Although diffusely abnormal white matter (DAWM) is commonly seen in multiple sclerosis (MS), it is rarely considered in clinical/imaging studies.
Purpose:
To evaluate quantitative markers of microstructural changes in DAWM of patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RR-MS) in relation to MS lesions and degree of neurocognitive impairment, by using a multi-echo spin echo (MESE) Proton Density PD-to-T2 sequence.
Study Type:
Prospective, cross-sectional.
Population:
Thirty-seven RR-MS patients, 33 CIS patients, and 52 healthy controls.
Field Strength/Sequence:
1.5 T/T1-, T2-weighted, fluid-attenuated inversion recovery, and MESE sequences.
Assessment:
Long T2, short T2, and myelin water fraction (MWF) values were estimated as indices of intra/extracellular water content and myelin content, respectively, in DAWM, posterior periventricular normal appearing white matter (NAWM), and focal MS lesions, classified according to their signal intensity on T1 sequences. Patients were, also, administered a battery of neuropsychological tests.
Statistical Tests:
Comparisons of T2 and MWF values in DAWM, NAWM, and MS lesions were examined, using two-way mixed analyses of variance. Associations of Grooved Pegboard performance with T2 and MWF values in DAWM and NAWM were assessed using Pearson correlation coefficients.
Results:
T2 and MWF values of DAWM were intermediate between the respective values of NAWM and T1 hypointense focal lesions, while there was no difference between the respective values of DAWM and T1-isointense lesions. T2 values in DAWM were strongly associated with visuomotor performance in CIS patients.
Data Conclusion:
Intra/extracellular water and myelin water content of DAWM are similar to those of T1-isointense lesions and predict visuomotor performance in CIS patients.
Level Of Evidence:
2 TECHNICAL EFFICACY: Stage 2.
Insights
Diffusely abnormal white matter (DAWM) in multiple sclerosis (MS) shows microstructural changes similar to T1-isointense lesions. These DAWM changes correlate with visuomotor performance in patients with clinically isolated syndrome (CIS).
Area of Science:
- Neuroimaging
- Neuroscience
- Radiology
Background:
- Diffusely abnormal white matter (DAWM) is a common finding in multiple sclerosis (MS) but is often overlooked in clinical and imaging studies.
- Understanding the microstructural characteristics of DAWM is crucial for assessing disease progression and cognitive impairment.
Purpose of the Study:
- To quantitatively assess microstructural changes in DAWM in patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RR-MS).
- To correlate these DAWM changes with the presence of MS lesions and the degree of neurocognitive impairment.
- To utilize multi-echo spin echo (MESE) Proton Density (PD)-to-T2 sequences for evaluating these changes.
Main Methods:
- A prospective, cross-sectional study involving 37 RR-MS patients, 33 CIS patients, and 52 healthy controls.
- Quantitative markers including T2 relaxation time and myelin water fraction (MWF) were measured in DAWM, normal-appearing white matter (NAWM), and MS lesions using MESE sequences.
- Neuropsychological tests, including the Grooved Pegboard test, were administered to assess cognitive function.
Main Results:
- DAWM exhibited T2 and MWF values intermediate between NAWM and T1 hypointense MS lesions.
- No significant difference was found between DAWM and T1-isointense MS lesions in terms of T2 and MWF values.
- T2 values in DAWM were strongly associated with visuomotor performance in CIS patients.
Conclusions:
- Microstructural changes in DAWM, characterized by intra/extracellular water and myelin content, are comparable to T1-isointense MS lesions.
- These DAWM characteristics can predict visuomotor performance in patients with CIS, highlighting their clinical relevance.
