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Relationship of cranial bone signal intensity to multiple sclerosis clinical course and progression
Furkan Sarıdaş1, Rıfat Özpar2, Ülkünur Fikriye Özdemir2
1Department of Neurology, Bursa Uludağ University Medicine Faculty, Bursa, Türkiye.
Abstract:
ObjectivesMultiple sclerosis (MS) usually relapses, about half become progressive after a period of time, few are progressive from the onset. Leptomeningeal ectopic lymphoid follicles with cell flow from the cranial bone marrow may be associated with progression. The aim of this retrospective study was to determine the predictive value of cranial bone signal intensity and to correlate it with other clinical features.MethodsRetrospective clinical and radiological characteristics of 96 MS patients (16 primary progressive multiple sclerosis, 80 relapsing-remitting multiple sclerosis (RRMS)) and 60 controls (tension-type headache) were recorded. Frontal (F), occipital (O), clivus (C) and vitreous body (V) signal intensities were measured. The relationship between clinical features, disease course and radiological findings were analyzed.ResultsThe mean age was 39.58±0.84 years. Twenty-five patients converted to secondary progressive multiple sclerosis (SPMS). Changes in the ratio of F, O, C density to V were similar between groups. At baseline, ratio of frontal bone marrow intensity to vitreous body intensity (F/V) was lower in SPMS and RRMS compared to control, and ratio of occipital bone marrow intensity to vitreous body intensity (O/V) was lower in SPMS compared to control. Low F/V on initial magnetic resonance imaging had diagnostic potential for RRMS, and low F/V and low O/V had diagnostic marker potential for conversion to SPMS.ConclusionsCranial bone intensity in multiple sclerosis patients may be a clue for future disease severity or conversion to SPMS.
Insights
Cranial bone marrow signal intensity may predict multiple sclerosis (MS) disease course. Lower frontal and occipital bone marrow intensity ratios are linked to MS progression and conversion to secondary progressive MS (SPMS).
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Multiple sclerosis (MS) is a chronic neurological disease with varied progression patterns.
- Leptomeningeal ectopic lymphoid follicles, potentially linked to cranial bone marrow, may influence MS progression.
- Current understanding of cranial bone marrow's role in MS progression requires further investigation.
Purpose of the Study:
- To investigate the predictive value of cranial bone signal intensity in multiple sclerosis (MS).
- To correlate cranial bone signal intensity with clinical features and disease course.
- To assess the potential of cranial bone marrow intensity as a biomarker for MS progression.
Main Methods:
- Retrospective analysis of 96 MS patients (16 primary progressive MS, 80 relapsing-remitting MS) and 60 controls.
- Measurement of frontal (F), occipital (O), clivus (C), and vitreous body (V) signal intensities using MRI.
- Statistical analysis to correlate clinical features, disease course, and radiological findings.
Main Results:
- Lower frontal bone marrow intensity to vitreous body intensity ratio (F/V) was observed in SPMS and RRMS patients compared to controls.
- Lower occipital bone marrow intensity to vitreous body intensity ratio (O/V) was found in SPMS patients compared to controls.
- Low F/V showed diagnostic potential for RRMS, while low F/V and O/V indicated potential for conversion to SPMS.
Conclusions:
- Cranial bone intensity, particularly frontal and occipital bone marrow signal, may serve as an early indicator of MS disease severity.
- Reduced cranial bone marrow intensity ratios could be a valuable biomarker for predicting conversion to secondary progressive multiple sclerosis (SPMS).
- Further research into cranial bone marrow changes could offer new insights into MS pathogenesis and progression.
