Detection of Lipid-Mediated Diffused Pathological Changes in Multiple Sclerosis

Background Lipid dysregulation and myelin breakdown are hallmark features of multiple sclerosis (MS), yet current noninvasive biomarkers have limited sensitivity for detecting both focal demyelination and diffuse microstructural injury. We evaluated transient nuclear Overhauser effect (tNOE) MRI, a lipid-sensitive imaging technique, for mapping myelin-related alterations in MS. Methods tNOE-MRI was performed in four MS patients and four healthy controls using a 7T scanner equipped with a 32-channel receive phased-array coil. Scan reproducibility was assessed across repeated sessions, and tNOE signal patterns were analyzed in major white-matter regions, including corpus-callosum and internal-capsule. Results tNOE maps demonstrated strong contrast in highly myelinated structures, like splenium of corpus-callosum and internal-capsule. Inter-day and intra-day coefficients of variation were < 5%, indicating high measurement consistency. Quantitative analysis revealed that MS patients had significantly lower tNOE contrast in white-matter (12.6%vs16.1%) and grey-matter (5.9%vs7.2%) compared to healthy controls. The splenium exhibited the greatest tNOE reduction (~ 36%) in MS. Discussion Reduced tNOE contrast corresponded with known regional differences in myelin density and suggests sensitivity to myelin-integrity. Lower tNOE signals in both white and gray matter indicate diffuse tissue alterations beyond focal lesions. With an acquisition time of ~ 3 minutes, tNOE-MRI shows promise as a rapid biomarker for MS diagnosis.