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Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

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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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
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Tract-wise microstructural analysis informs on current and future disability in early multiple sclerosis.

Veronica Ravano1,2,3, Gian Franco Piredda4,5,6, Jan Krasensky7

  • 1Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland. veronica.ravano@epfl.ch.

Journal of Neurology
|October 11, 2023
PubMed
Summary
This summary is machine-generated.

Quantitative MRI reveals that microstructural changes in white matter (WM) tracts predict future disability in early multiple sclerosis (MS) patients, offering a new way to monitor disease progression.

Keywords:
Demyelinating diseasesMagnetic resonance imagingMultiple sclerosisRelaxometryWhite matter

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Area of Science:

  • Neuroimaging
  • Neurology
  • Biomarkers

Background:

  • Microstructural characterization in multiple sclerosis (MS) better predicts disability than conventional imaging biomarkers.
  • Quantitative MRI effectively detects microstructural changes in brain lesions and normal-appearing tissue.
  • The impact of microstructural alterations along specific neuronal pathways remains underexplored.

Purpose of the Study:

  • To investigate the extent and location of quantitative MRI-detected tissue changes along white matter (WM) tracts.
  • To correlate these microstructural alterations with cross-sectional disability and future disability progression in MS patients.

Main Methods:

  • Voxel-wise T1 alterations were quantified in 99 MS patients compared to normative data.
  • WM tract metrics for tissue alterations (lesions and normal-appearing WM) were extracted.
  • Correlations were performed between WM tract metrics and cross-sectional/evolving disability.

Main Results:

  • In early MS, T1 alterations in normal-appearing WM correlated better with disability evolution than cross-sectional disability.
  • Lesions in supratentorial tracts associated more with current disability; infratentorial alterations predicted future disability.
  • In progressive MS, all WM pathways contributed similarly to disability, with poor correlations for disability evolution.

Conclusions:

  • Microstructural changes in specific WM pathways predict future disability in early MS, supporting tract-wise analysis for disease monitoring.
  • The technique provides WM tract-specific microstructural insights within clinically feasible scan times, without requiring advanced diffusion imaging.