Noninvasive Assessment Follow-Up of Progress in MS Patients

Area of Science:

• Neurology
• Neuroscience
• Medical Imaging

Background:

• Multiple sclerosis (MS) is a leading cause of disability in young adults.
• Monitoring disease progression is crucial for effective management.
• Current methods for tracking MS progression include clinical assessments and advanced imaging techniques.

Purpose of the Study:

• To monitor multiple sclerosis (MS) disease progression using cognitive and physical parameters.
• To evaluate the utility of optical coherence tomography (OCT) and Magnetic Resonance Spectroscopy (MRS) in assessing MS progression.
• To identify imaging biomarkers for predicting MS disease advancement.

Main Methods:

• Inclusion of patients with relapsing-remitting (RRMS), secondary progressive (SPMS), and primary progressive (PPMS) forms of MS.
• Utilized clinical assessments: Expanded Disability Status Scale (EDSS), Nine-Hole Peg Test (9 HPT), Timed 25-Foot Walk Test (T25FWT), and cognitive tests (BICAMS, MoCA).
• Performed OCT and MRS examinations at baseline and follow-up to correlate with clinical outcomes.

Main Results:

• Primary progressive MS (PPMS) patients exhibited higher disability scores (EDSS, 9 HPT, T25FWT) and lower cognitive scores (MoCA) compared to other groups.
• Retinal nerve fiber layer (RNFL) measurements were higher in RRMS patients compared to progressive MS groups.
• A lower baseline thalamic myoinositol/creatinine (mI/Cr) ratio (<0.066) using MRS significantly predicted disease progression in MS patients with high sensitivity and specificity.

Conclusions:

• Early detection of MS disease progression is critical for timely intervention.
• Noninvasive imaging techniques like MRS can serve as valuable prognostic tools.
• The thalamic mI/Cr ratio derived from MRS is a significant, noninvasive predictor of disease progression in multiple sclerosis.