A cross-sectional multicentre study of multishell diffusion MRI in multiple sclerosis

Area of Science:

• Neuroimaging
• Medical Physics
• Radiology

Background:

• White matter (WM) microstructural changes in multiple sclerosis (MS) are linked to clinical disability.
• Advanced multishell diffusion MRI (dMRI) offers detailed WM property assessment.

Purpose of the Study:

• To compute WM metrics using multishell dMRI.
• To identify differences in WM metrics between people with MS (pwMS) and healthy controls (HCs).
• To investigate associations between WM metrics and clinical disability (EDSS).

Main Methods:

• Multishell dMRI data from 251 pwMS/clinically isolated syndrome (CIS) and 543 HCs were analyzed.
• Eleven scalar metric maps were derived using diffusion tensor imaging (DTI) and restriction spectrum imaging (RSI).
• Tract-based spatial statistics (TBSS) and linear regression models were used to test for group differences and correlations with Expanded Disability Status Scale (EDSS).

Main Results:

• Significant group differences were observed in nine out of eleven dMRI metrics.
• Linear regression showed correlations between EDSS and fractional anisotropy (FA) fast, and apparent diffusion coefficient (ADC) fast.
• These correlations lost statistical significance after Bonferroni correction.

Conclusions:

• Clinically feasible multishell dMRI can detect WM differences between pwMS and HCs.
• Only a subset of advanced multishell parameters were sensitive to disability.
• No statistically significant correlations between dMRI metrics and disability remained after correction.