Association between MRI parameters and the MS severity scale: a 12 year follow-up study

Minneboo, A.; Uitdehaag, Bernard M. J.; Jongen, Peter Joseph; Vrenken, Hugo; Knol, Dirk L.; Walderveen, M.A.A. van; Polman, Chris H.; Castelijns, Jonas A.; Barkhof, Frederik

doi:10.1177/1352458509102617

Cited by 35 publications

(50 citation statements)

References 36 publications

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“…Over time, T2 decreases to that of chronic lesions (84,139,170), similar to the behaviour of T1. One study detected monoexponential relaxation in acute WM lesions, which became bi-exponential during remission, and finally returned to mono-exponential as the lesion turned into a chronic lesion (168).…”

Section: Qmri In Mssupporting

confidence: 61%

“…Some lesions, when viewed on T1-weighted images, appear hypo-intense compared to surrounding WM ,and the inclusion of T1-weighted imaging may increase the correlation with clinical disability, but only to a limited degree (138,139). Factors believed to explain this discrepancy include cortical reorganisation (140), where other parts of the brain may compensate for focal injury; brain plasticity (141,142), where signal transmissions may use alternative pathways; and the consideration of strategic lesion location (143,144).…”

Section: Mri In Msmentioning

confidence: 99%

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Quantitative Magnetic Resonance Imaging of the Brain : Applications for Tissue Segmentation and Multiple Sclerosis

West¹

2014

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Magnetic resonance imaging (MRI) is a sensitive technique for assessing white matter (WM) lesions in multiple sclerosis (MS), but there is a low correlation between MRI findings and clinical disability. Because of this, other pathological changes are of interest, including changes in normal appearing white matter (NAWM) and diffusely abnormal white matter (DAWM). Even so, the mechanisms leading to permanent disability in MS remain unclear. In contrast to conventional MRI, quantitative MRI (qMRI) is aimed at the direct measurement of the physical tissue properties, such as the relaxation times, T1 and T2, as well as the proton density (PD). QMRI is promising for characterising and quantifying changes in MS and for brain tissue segmentation. The present work describes a novel method of qMRI for the human brain (QMAP), and a segmentation method based on this. The developed methods were validated in control subjects and MR phantoms. Furthermore, an application in diseased human brain was demonstrated in MS patients. In all, 50 healthy controls and 35 MS patients were scanned with qMRI in a total of 225 acquisitions. One major finding of this work was that qMRI was able to detect and quantify changes in the MS disease that were not visible using conventional MRI. In particular, it was found that DAWM appears to constitute an intermediate between focal white matter (WM) lesions and NAWM. These changes may be caused by pathological processes that are not entirely attributable to Wallerian degeneration. This study showed that the QMAP method had high accuracy and relatively high precision, within a clinically acceptable time. This work also demonstrated that qMRI could be used for brain tissue segmentation and volume estimation of the whole brain, using pre-defined tissue characteristics. The results showed that brain tissue segmentation had high repeatability, which was somewhat lower when different geometries were acquired or different field strengths used. In particular, small differences were found between 1.5 T and 3.0 T in deep brain structures, the cerebellum and the brain stem. This work leads the way for early clinical applications of qMRI, and the challenge for the years to come is to understand the connection between qMRI properties of the brain and underlying biology.Bildtagning med magnetresonanstomografi (MRT) är en teknik som kan användas för att upptäcka lesioner i vit substans hos patienter med multipel skleros (MS), men sambandet mellan lesioner och klinisk funktionsnedsättning är svagt. På grund av detta har intresset för andra patologiska processer i hjärnan ökat. Exempel är förändringar i vit substans som ser normal ut vid MRT (NAWM) och även så kallad diffus vit vävnad (DAWM). Det är emellertid fortfarande oklart vilka mekanismer i MS som leder till klinisk funktionsnedsättning. Med kvantitativ MRT (qMRT) kan fysiologiska egenskaper i vävnaden, som till exempel relaxationstiderna (T1 och T2) samt protontäthet (PD), mätas. QMRT kan användas för att mäta förändringar i hjärnan hos MS patienter och des...

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Section: Qmri In Mssupporting

confidence: 61%

Section: Mri In Msmentioning

confidence: 99%

Quantitative Magnetic Resonance Imaging of the Brain : Applications for Tissue Segmentation and Multiple Sclerosis

West¹

2014

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“…[11][12][13] In an analysis of multiple studies in MS, a cross-sectional correlation was reported between MRI T 2 parameters and EDSS scores in MS patients at different disease stages (correlation coefficients were 0.15 for secondary progressive MS (SPMS), 0.55 for CIS and 0.60 for relapsing-remitting…”

Section: Methods For General Assessment Of Activities and Social Partmentioning

confidence: 99%

“…12 Another study in The Netherlands showed that during 12 years of follow-up of 46 patients with confirmed MS, increasing lesion loads, atrophy and axonal loss were associated with disease severity as determined by the MS Severity Score (MSSS). 13 The MSSS method is based on the EDSS, but uses an algorithm that incorporates the distribution of disability in patients with similar disease durations.…”

Section: Ms [Rrms]mentioning

confidence: 99%

Disease Progression in Multiple Sclerosis II. Methods for the Determination of Walking Impairment and Its Impact on Activities and Social Participation

Kesselring¹

2010

European Neurological Review

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Walking ability is a vital component of validated test procedures to assess mobility impairment in multiple sclerosis (MS). The methods used to assess walking ability vary widely between treatment centres, and the accuracy of the methods used and numbers of parameters determined to analyse specific aspects of walking and gait are often limited. The questionnaire-and task-based methods used to assess walking in MS can be divided into different categories. First, there are the general-purpose tests such as the Expanded Disability Status Scale (EDSS), the Multiple Sclerosis Functional Composite (MSFC), the Family Assessment of Multiple Sclerosis Trial Outcome Index (FAMS-TOI) and the Short Form-36 (SF-36). These, particularly EDSS, are widely used in MS to assess limitations of all activities and social participation, of which walking is only a part. Others, such as SF-36, assess health-related quality of life (HRQoL). Second, there are methods designed to specifically assess walking or gait, including the timed 25-foot walk (T25FW), the Dynamic Gait Index (DGI), the 12-Item MS Walking Scale (MSWS-12) and the Timed Up and Go Test (TUGT). These test methods require minimal equipment to perform such as a stopwatch, a hallway or a chair, and can be completed at a medical centre in a few minutes. Most of these tests provide reliable and valid data but some lack accurate assessment of gait and some require clinician training. Third, there are tests that specifically measure balance, such as the Berg Balance Test, in which the patient completes a series of balance exercises while being observed. A recent development is the use of accelerometers to monitor MS patients over extended periods; these can provide more accurate data than patient self-report tools. In future, it is likely that more specific tests of walking ability will be more widely used as an important part of MS diagnosis and to more precisely monitor disease progression and assess patient needs. KeywordsMultiple sclerosis, walking impairment, ambulation tests, gait, balance, mobility determination methods Disclosure: Jürg Kesselring serves or has served on data safety monitoring and advisory boards of clinical trials in multiple sclerosis sponsored by Biogen, Novartis, Serono, Schering and Wyeth.

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“…[1][2][3] Instead, brain-tissue loss shows a stronger correlation with disease progression, especially in a later stage of the disease. [3][4][5][6][7][8][9] The key for the practical, clinical application of brain-tissue volume measurements is an automated, fast method that can be integrated into the clinical workflow. Numerous automated methods exist for this purpose, generally based on conventional T1-weighted, T2-weighted, and FLAIR images or a combination thereof.…”

mentioning

confidence: 99%

Effects of Gadolinium Contrast Agent Administration on Automatic Brain Tissue Classification of Patients with Multiple Sclerosis

Warntjes¹,

Tisell

Landtblom

et al. 2014

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The administration of gadolinium contrast agent is a common part of MR imaging examinations in patients with MS. The presence of gadolinium may affect the outcome of automated tissue classification. The purpose of this study was to investigate the effects of the presence of gadolinium on the automatic segmentation in patients with MS by using the synthetic tissue-mapping method.

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Association between MRI parameters and the MS severity scale: a 12 year follow-up study

Abstract: MRI measures of axonal loss are associated with higher overall disease severity in MS patients.

Cited by 35 publications

References 36 publications

Quantitative Magnetic Resonance Imaging of the Brain : Applications for Tissue Segmentation and Multiple Sclerosis

Quantitative Magnetic Resonance Imaging of the Brain : Applications for Tissue Segmentation and Multiple Sclerosis

Disease Progression in Multiple Sclerosis II. Methods for the Determination of Walking Impairment and Its Impact on Activities and Social Participation

Effects of Gadolinium Contrast Agent Administration on Automatic Brain Tissue Classification of Patients with Multiple Sclerosis

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