Advanced Diffusion MR Imaging for Multiple Sclerosis in the Brain and Spinal Cord

With the recent advancements in rapid imaging methods, higher numbers of contrasts and quantitative parameters can be acquired in less and less time. Some acquisition models simultaneously obtain multiparametric images and quantitative maps to reduce scan times and avoid potential issues associated with the registration of different images. Multiparametric magnetic resonance imaging (MRI) has the potential to provide complementary information on a target lesion and thus overcome the limitations of individual techniques. In this review, we introduce methods to acquire multiparametric MRI data in a clinically feasible scan time with a particular focus on simultaneous acquisition techniques, and we discuss how multiparametric MRI data can be analyzed as a whole rather than each parameter separately. Such data analysis approaches include clinical scoring systems, machine learning, radiomics, and deep learning. Other techniques combine multiple images to create new quantitative maps associated with meaningful aspects of human biology. They include the magnetic resonance g-ratio, the inner to the outer diameter of a nerve fiber, and the aerobic glycolytic index, which captures the metabolic status of tumor tissues.

show abstract

“…7). [181][182][183][184][185] Demyelination and remyelination increase and decrease g-ratio, respectively.…”

Section: Model-based Methodsmentioning

confidence: 99%

Multiparametric MRI

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…providing more sensitive and specific biomarkers [19,35,36]. DKI datasets can be used to calculate several parameters.…”

Section: Cns Studies Of Ms Indicate a Potential Added Value Of Dkimentioning

confidence: 99%

“…Although DTI is technically limited to Gaussian diffusion behavior, its extension of diffusion kurtosis imaging (DKI) also considers the important aspect of non‐Gaussian diffusion [18]. As shown in CNS studies of MS, DKI parameters such as the model of white matter tract integrity (WMTI) could assist in better tissue characterization [19]. DKI sequences have not yet been applied clinically to human peripheral nerves.…”

Section: Introductionmentioning

confidence: 99%

Microstructural changes of peripheral nerves in early multiple sclerosis: A prospective magnetic resonance neurography study

Foesleitner,

Sturm,

Hayes

et al. 2023

Euro J of Neurology

View full text Add to dashboard Cite

Background and purposeMultiple sclerosis (MS) is a demyelinating disorder of the central nervous system (CNS). However, there is increasing evidence of peripheral nerve involvement. This study aims to characterize the pattern of peripheral nerve changes in patients with newly diagnosed MS using quantitative magnetic resonance (MR) neurography.MethodsIn this prospective study, 25 patients first diagnosed with MS according to the revised McDonald criteria (16 female, mean age = 32.8 ± 10.6 years) and 14 healthy controls were examined with high‐resolution 3‐T MR neurography of the sciatic nerve using diffusion kurtosis imaging (DKI; 20 diffusional directions, b = 0, 700, 1200 s/mm2) and magnetization transfer imaging (MTI). In total, 15 quantitative MR biomarkers were analyzed and correlated with clinical symptoms, intrathecal immunoglobulin synthesis, electrophysiology, and lesion load on brain and spine MR imaging.ResultsPatients showed decreased fractional anisotropy (mean = 0.51 ± 0.04 vs. 0.56 ± 0.03, p < 0.001), extra‐axonal tortuosity (mean = 2.32 ± 0.17 vs. 2.49 ± 0.17, p = 0.008), and radial kurtosis (mean = 1.40 ± 0.23 vs. 1.62 ± 0.23, p = 0.014) and higher radial diffusivity (mean = 1.09 ∙ 10−3 mm2/s ± 0.16 vs. 0.98 ± 0.11 ∙ 10−3 mm2/s, p = 0.036) than controls. Groups did not differ in MTI. No significant association was found between MR neurography markers and clinical/laboratory parameters or CNS lesion load.ConclusionsThis study provides further evidence of peripheral nerve involvement in MS already at initial diagnosis. The characteristic pattern of DKI parameters indicates predominant demyelination and suggests a primary coaffection of the peripheral nervous system in MS. This first human study using DKI for peripheral nerves shows its potential and clinical feasibility in providing novel biomarkers.

show abstract

“…The structural connectivity network defines the association between different areas of the CNS, but cannot determine the direction, nor distinguish between excitatory or inhibitory connections (11, 12). It can be evaluated with diffusion imaging tractography (DIT), combining diffusion magnetic resonance imaging (MRI), such as diffusion tensor imaging, with the visual representation of nerve tracts by tractography or using tract atlases (12)(13)(14). This technique focuses more on tracing white matter connections but mapping disconnections between gray matter regions due to focal lesions is possible (12).…”

Section: Assessment Of the Spasticity-plus Syndrome With Imagingmentioning

confidence: 99%

“…Most MS imaging studies focus on the brain to illustrate motor, sensitive, and cognitive impairment, even if some symptoms involve the spinal cord, such as spasticity. This is partly due to the challenging imaging of the spinal cord, since its axons have a small diameter and it is susceptible to motion artifacts (e.g., body fluid pulsation, breathing, and swallowing) (13,14). Therefore, its imaging studies usually involve part of the spinal cord at high spatial resolution, then uses it as a proxy for its entirety (18).…”

Section: Assessment Of the Spasticity-plus Syndrome With Imagingmentioning

confidence: 99%

Clinical insights on the spasticity-plus syndrome in multiple sclerosis

Marrouni

Duquette²

2022

Front. Neurol.

View full text Add to dashboard Cite

The first hypothesis introduced by Fernández et al. (2) on the SPS included only spasticity-associated symptoms in MS and based the cluster on symptoms improving with cannabinoids, mainly nabiximols, a balanced combination of tetrahydrocannabinol and cannabidiol (2). When asked about clustering the suggested symptoms in one syndrome-excluding tremor-, a panel of MS expert neurologists in SpainFrontiers in Neurology frontiersin.org

show abstract

Advanced Diffusion MR Imaging for Multiple Sclerosis in the Brain and Spinal Cord

Cited by 16 publications

References 116 publications

Multiparametric MRI

Multiparametric MRI

Microstructural changes of peripheral nerves in early multiple sclerosis: A prospective magnetic resonance neurography study

Clinical insights on the spasticity-plus syndrome in multiple sclerosis

Contact Info

Product

Resources

About