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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
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.
Objectives:
Microstructural characterization of patients with multiple sclerosis (MS) has been shown to correlate better with disability compared to conventional radiological biomarkers. Quantitative MRI provides effective means to characterize microstructural brain tissue changes both in lesions and normal-appearing brain tissue. However, the impact of the location of microstructural alterations in terms of neuronal pathways has not been thoroughly explored so far. Here, we study the extent and the location of tissue changes probed using quantitative MRI along white matter (WM) tracts extracted from a connectivity atlas.
Methods:
We quantified voxel-wise T1 tissue alterations compared to normative values in a cohort of 99 MS patients. For each WM tract, we extracted metrics reflecting tissue alterations both in lesions and normal-appearing WM and correlated these with cross-sectional disability and disability evolution after 2 years.
Results:
In early MS patients, T1 alterations in normal-appearing WM correlated better with disability evolution compared to cross-sectional disability. Further, the presence of lesions in supratentorial tracts was more strongly associated with cross-sectional disability, while microstructural alterations in infratentorial pathways yielded higher correlations with disability evolution. In progressive patients, all major WM pathways contributed similarly to explaining disability, and correlations with disability evolution were generally poor.
Conclusions:
We showed that microstructural changes evaluated in specific WM pathways contribute to explaining future disability in early MS, hence highlighting the potential of tract-wise analyses in monitoring disease progression. Further, the proposed technique allows to estimate WM tract-specific microstructural characteristics in clinically compatible acquisition times, without the need for advanced diffusion imaging.
Insights
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.
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.
