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Multiple Sclerosis l: Introduction01:19

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Extensive Brain Pathologic Alterations Detected with 7.0-T MR Spectroscopic Imaging Associated with Disability in

Eva Heckova1, Assunta Dal-Bianco1, Bernhard Strasser1

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High-field MR spectroscopic imaging (MRSI) reveals metabolic changes in normal-appearing white matter and gray matter in multiple sclerosis (MS). These abnormalities correlate with MS-related disability, offering new insights beyond conventional MRI.

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Area of Science:

  • Neuroimaging
  • Metabolic Neuroscience
  • Neurology

Background:

  • Magnetic Resonance Spectroscopic Imaging (MRSI) enables in vivo assessment of brain metabolism.
  • MRSI is crucial for multiple sclerosis (MS) research as conventional MRI often misses disease activity.
  • Pathologic alterations in normal-appearing white matter (NAWM) and cortical gray matter (CGM) are key in MS.

Purpose of the Study:

  • To evaluate the capability of 7.0-T MRSI in detecting and visualizing pathologic changes in NAWM and CGM in MS patients.
  • To investigate the relationship between these metabolic alterations and patient disability.

Main Methods:

  • Prospective recruitment of 65 MS participants and 20 healthy controls (January 2016 - December 2017).
  • 7.0-T free-induction decay MRSI performed to obtain metabolic ratios in white matter lesions, NAWM, and CGM.
  • Statistical analyses included subgroup analysis based on Expanded Disability Status Scale (EDSS) and partial correlations.

Main Results:

  • Increased myo-inositol (mI) and decreased N-acetylaspartate (NAA) signals observed in MS NAWM.
  • Elevated mI/total creatine (tCr) ratio found in NAWM across all MS disability subgroups.
  • Reduced NAA/tCr ratio detected in NAWM and CGM of MS subgroups with higher disability (EDSS ≥1.5).
  • mI/NAA ratio showed significant correlation with EDSS scores in various brain regions.

Conclusions:

  • 7.0-T MRSI effectively visualizes in vivo MS pathology in NAWM and CGM, undetectable by standard MRI.
  • Metabolic abnormalities identified by MRSI are significantly associated with MS-related disability.
  • This technique provides valuable biomarkers for understanding MS pathophysiology and disease progression.