Advanced spinal cord MRI in multiple sclerosis: Current techniques and future directions

Combes, Anna J.E.; Clarke, Mitch; O’Grady, Kristin P.; Schilling, Kurt G.; Smith, Seth A.

doi:10.1016/j.nicl.2022.103244

Cited by 16 publications

(8 citation statements)

References 220 publications

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“…S4). This may be, at least in part, due to strong influence of strategic lesions in pyramidal or cerebellar pathways (including the spinal cord) on motor performance including gait, 48,49 which dominates the EDSS score. 12…”

Section: Relationship With Global Disability and Motor Performancementioning

confidence: 99%

Global Rearrangement of Degree Centrality Reflects Cognitive Impairment and Fatigue in Multiple Sclerosis

Hok,

Thai,

Rehák Bučková

et al. 2024

Preprint

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Background and Objectives: The aim of this secondary data analysis was to determine whether multiple sclerosis (MS) is associated with changes in global degree rank order disruption index (kD), a graph theory-based functional connectivity measure representing shift in overall distribution of nodal degree centrality. Additionally, we tested the relationship between kD and MS symptoms (cognitive and motor impairment, fatigue, and global disability). Methods: Global kD was computed in a pre-existing cross-sectional fMRI dataset and compared between patients with MS (PwMS) and healthy controls (HCs). Group differentiation was tested against other known biomarkers in MS (regional degree centrality, structural MRI with volumetry, diffusion-weighted imaging, lesion mapping) using receiver operating characteristic and logistic regression analysis. Associations between kD and cognitive processing speed (Symbol Digit Modalities Test), fatigue (Fatigue Scale for Motor and Cognitive Functions), gait (Timed Up and Go Test), and disability (Expanded Disability Status Scale [EDSS]) were evaluated using Spearman correlation coefficient and ordinal regression adjusted for structural imaging, age, sex, and disease duration. Results: Analysis included 56 PwMS and 58 HCs (35/27 women, median age 45.1/40.5 years). Global kD was lower in PwMS (median −0.30, inter-quartile range [IQR] 0.55) than in HCs (median −0.06, IQR 0.54; p = 0.009, Mann-Whitney U test). kD yielded acceptable differentiation between groups (area under curve 0.64), but did not improve such differentiation on top of structural imaging. Both kD and regional degree in medial prefrontal cortex (MPFC) were correlated with cognitive decline (kD: Spearman's ρ = 0.32, p = 0.019; MPFC: ρ = −0.45, p = 0.001, n = 55), while kD was also correlated with fatigue (ρ = −0.34, p = 0.010, n = 56), but not with EDSS (ρ = −0.06, p = 0.674, n = 56) or gait (ρ = −0.18, p = 0.211, n = 52). kD significantly explained cognitive impairment (χ2 = 4.49, p = 0.034) and fatigue (χ2 = 7.18, p = 0.007). Discussion: Our data provide evidence that kD is a potential biomarker of cognitive decline and fatigue. Further cross-validations are required to assess its generalizability.

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Section: Relationship With Global Disability and Motor Performancementioning

confidence: 99%

Global Rearrangement of Degree Centrality Reflects Cognitive Impairment and Fatigue in Multiple Sclerosis

Hok,

Thai,

Rehák Bučková

et al. 2024

Preprint

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“…Additional systemic factors, such as poor continuity of care outside of MS clinical centers, long wait times to access secondary care, and inherent limitations in the ability of conventional MRIs to capture cortical lesions and regional atrophy, create problems for obtaining appropriate health care [ 150 , 153 , 154 ]. There may also be practicable challenges, as most HETs (alemtuzumab, natalizumab, ocrelizumab, and ublituximab) require intravenous administration at specialized infusion centers or tertiary hospitals [ 26 , 29 , 155 ].…”

Section: Barriers To Adoption Of Early Hets and Potential Solutionsmentioning

confidence: 99%

Early use of high-efficacy therapies in multiple sclerosis in the United States: benefits, barriers, and strategies for encouraging adoption

Singer,

Feng,

Chiong-Rivero

2024

J Neurol

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Multiple sclerosis (MS) is characterized by progressive neuroinflammation and neurodegeneration from disease onset that, if left untreated, can result in the accumulation of irreversible neurological disability. Early intervention with high-efficacy therapies (HETs) is increasingly recognized as the best strategy to delay or mitigate disease progression from the earliest stages of the disease and to prevent long-term neurodegeneration. Although there is growing clinical and real-world evidence supporting early HET intervention, foregoing this strategy in favor of a traditional escalation approach prioritizing lower-efficacy disease-modifying therapies remains a common approach in clinical practice. This review explores potential health care professional- and patient-related barriers to the early use of HETs in patients with MS in the United States. Barriers can include regulatory and reimbursement restrictions; knowledge gaps and long-term safety concerns among health care professionals; and various individual, cultural, and societal factors affecting patients. Potential strategies for overcoming these barriers and encouraging early HET use are proposed.

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“…DTI measures have shown correlations with histological markers of demyelination and have been useful in tracking disease progression longitudinally. Other methods, including myelin water fraction (MWF), MRS, MT, and fMRI, have also provided insights into myelination, axonal density, and functional changes in the spinal cord of MS patients [ 167 , 168 ].…”

Section: Spinal Cordmentioning

confidence: 99%

Advanced MRI Techniques: Diagnosis and Follow-Up of Multiple Sclerosis

Nistri,

Ianniello,

Pozzilli

et al. 2024

Diagnostics

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Brain and spinal cord imaging plays a pivotal role in aiding clinicians with the diagnosis and monitoring of multiple sclerosis. Nevertheless, the significance of magnetic resonance imaging in MS extends beyond its clinical utility. Advanced imaging modalities have facilitated the in vivo detection of various components of MS pathogenesis, and, in recent years, MRI biomarkers have been utilized to assess the response of patients with relapsing–remitting MS to the available treatments. Similarly, MRI indicators of neurodegeneration demonstrate potential as primary and secondary endpoints in clinical trials targeting progressive phenotypes. This review aims to provide an overview of the latest advancements in brain and spinal cord neuroimaging in MS.

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Advanced spinal cord MRI in multiple sclerosis: Current techniques and future directions

Cited by 16 publications

References 220 publications

Global Rearrangement of Degree Centrality Reflects Cognitive Impairment and Fatigue in Multiple Sclerosis

Global Rearrangement of Degree Centrality Reflects Cognitive Impairment and Fatigue in Multiple Sclerosis

Early use of high-efficacy therapies in multiple sclerosis in the United States: benefits, barriers, and strategies for encouraging adoption

Advanced MRI Techniques: Diagnosis and Follow-Up of Multiple Sclerosis

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