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Updated: Aug 24, 2025
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Associations between myelin water imaging and measures of fall risk and functional mobility in multiple sclerosis
Erin M Edwards1,2, Jeffrey A Stanley1,3, Ana M Daugherty4,5
1Translational Neuroscience Program, Wayne State University, Detroit, Michigan, USA.
Background And Purpose:
Myelin water fraction (MWF) deficits as measured by myelin water imaging (MWI) have been related to worse motor function in persons with multiple sclerosis (PwMS). However, it is unknown if measures from MWI metrics in motor areas relate to fall risk measures in PwMS. The objective of this study was to examine the relationship between MWI measures in motor areas to performance on clinical measures of fall risk and disability in PwMS.
Methods:
Sixteen individuals with relapsing-remitting MS participated (1 male, 15 female; age 47.1 years [12.3]; Expanded Disability Status Scale 4.0 [range 0-6.5]) and completed measures of walking and fall risk (Timed 25 Foot Walk [T25FW] and Timed Up and Go). MWF and the geometric mean of the intra-/extracellular water T2 (geomT2IEW ) values reflecting myelin content and contribution of large-diameter axons/density, respectively, were assessed in three motor-related regions.
Results:
The geomT2IEW of the corticospinal tract (r = -.599; p = .018) and superior cerebellar peduncles (r = -.613; p = .015) demonstrated significant inverse relationships with T25FW, suggesting that decreased geomT2IEW was related to slower walking. Though not significant, MWF in the corticospinal tract and superior cerebellar peduncles also demonstrated fair relationships with the T25FW, suggesting that worse performance on the T25FW was associated with lower MWF values.
Conclusions:
MWI of key motor regions was associated with walking performance in PwMS. Further MWI studies are needed to identify relationships between pathology and clinical function in PwMS to guide targeted rehabilitation therapies aimed at preventing falls.
Insights
Myelin water imaging (MWI) in motor areas correlates with walking speed in multiple sclerosis (MS). This finding suggests MWI can help assess fall risk and guide rehabilitation for persons with MS.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Myelin water fraction (MWF) deficits, measured by myelin water imaging (MWI), are linked to impaired motor function in persons with multiple sclerosis (PwMS).
- The relationship between MWI metrics in motor regions and fall risk in PwMS remains unclear.
Purpose of the Study:
- To investigate the association between MWI measures in motor-related brain regions and clinical fall risk assessments in PwMS.
- To determine if MWI can predict functional performance related to fall risk.
Main Methods:
- Sixteen individuals with relapsing-remitting MS underwent MWI scans.
- MWF and geometric mean of intra-/extracellular water T2 (geomT2IEW) were assessed in motor regions.
- Participants completed the Timed 25 Foot Walk (T25FW) and Timed Up and Go tests for fall risk evaluation.
Main Results:
- Decreased geomT2IEW in the corticospinal tract and superior cerebellar peduncles correlated with slower walking speed (T25FW).
- Lower MWF values in these motor regions showed a trend towards association with slower T25FW performance.
- These findings suggest MWI metrics in motor pathways relate to walking performance and potentially fall risk.
Conclusions:
- MWI of key motor regions is associated with walking performance in PwMS.
- Further research using MWI is warranted to link specific pathologies to clinical function for targeted fall prevention strategies in MS.
- MWI may serve as a valuable tool for assessing disability and guiding rehabilitation in PwMS.
