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Early structural changes in acute MS lesions assessed by serial magnetization transfer studies
V Dousset1, A Gayou, B Brochet
1Laboratoire de Neurobiologie et Neuro-imagerie Expérimentales, Université Victor-Segalen Bordeaux 2, France.
Background:
Whether acute MS lesions are primarily inflammatory or demyelinative is unresolved. Our study examined acute MS lesions longitudinally by quantitative magnetization transfer (MT), an MRI technique that identifies tissue integrity and destruction.
Methods:
Four MS patients were studied by serial MRI including MT, conventional T2-weighted images, and postgadolinium T1-weighted images for 9 to 12 months. In 15 new lesions, the MT ratio (MTR) was calculated retrospectively.
Results:
In 13 lesions, a marked decrease in the MTR was present early during the first 2 months after the onset of the lesion and was followed by a variable increase. In two other lesions, the MTR progressively declined.
Conclusions:
These results suggest that major early structural changes compatible with demyelination and followed by remyelination and gliosis, or by continuous demyelination, occur in new MS lesions. The various MTR profiles provide in vivo confirmation of the current knowledge of the progression in MS lesions. Furthermore, MTR may be used to monitor in vivo drug efficacy in new MS lesions.
Insights
Quantitative magnetization transfer (MT) MRI reveals early structural changes in acute multiple sclerosis (MS) lesions, indicating demyelination and potential remyelination or continuous demyelination. This technique may monitor MS lesion progression and drug efficacy.
Area of Science:
- Neuroimaging
- Neuroimmunology
- Magnetic Resonance Imaging
Background:
- The primary nature of acute multiple sclerosis (MS) lesions, whether inflammatory or demyelinative, remains debated.
- Quantitative magnetization transfer (MT) MRI offers insights into tissue integrity and destruction in MS lesions.
Purpose of the Study:
- To longitudinally examine acute MS lesions using quantitative MT MRI.
- To assess tissue integrity and destruction in new MS lesions over time.
Main Methods:
- Serial MRI, including quantitative MT, conventional T2-weighted, and postgadolinium T1-weighted images, was performed on four MS patients over 9-12 months.
- The magnetization transfer ratio (MTR) was retrospectively calculated for 15 new lesions.
Main Results:
- A significant decrease in MTR was observed in 13 lesions within the first two months, followed by a variable increase.
- Two lesions showed a progressive decline in MTR throughout the study period.
Conclusions:
- Early structural changes in new MS lesions are compatible with demyelination, followed by either remyelination and gliosis or ongoing demyelination.
- MT MRI provides in vivo confirmation of MS lesion progression dynamics.
- MTR shows potential for monitoring in vivo drug efficacy in acute MS lesions.