Differentiation of relapsing-remitting and secondary progressive multiple sclerosis: a magnetic resonance spectroscopy study based on machine learning

Abstract

Introduction: Magnetic resonance imaging (MRI) is the most important tool for diagnosis and follow-up in multiple sclerosis (MS). The discrimination of relapsing-remitting MS (RRMS) from secondary progressive MS (SPMS) is clinically difficult, and developing the proposal presented in this study would contribute to the process. Objective: This study aimed to ensure the automatic classification of healthy controls, RRMS, and SPMS by using MR spectroscopy and machine learning methods. Methods: MR spectroscopy (MRS) was performed on a total of 91 participants, distributed into healthy controls (n=30), RRMS (n=36), and SPMS (n=25). Firstly, MRS metabolites were identified using signal processing techniques. Secondly, feature extraction was performed based on MRS Spectra. N-acetylaspartate (NAA) was the most significant metabolite in differentiating MS types. Lastly, binary classifications (healthy controls-RRMS and RRMS-SPMS) were carried out according to features obtained by the Support Vector Machine algorithm. Results: RRMS cases were differentiated from healthy controls with 85% accuracy, 90.91% sensitivity, and 77.78% specificity. RRMS and SPMS were classified with 83.33% accuracy, 81.81% sensitivity, and 85.71% specificity. Conclusions: A combined analysis of MRS and computer-aided diagnosis may be useful as a complementary imaging technique to determine MS types.

Applications of magnetic resonance spectroscopy in diagnosis of neurodegenerative diseases: A systematic review

“…In RRMS patients, the mean Cr level was 5.88 ± 1.41, and the mean Cho level was 5.89 ± 1. These amounts were 4.93 ± 1.95 and 4.93 ± 2.11 in SPMS patients, respectively [ 11 ] ( Table 3 ).…”

“…5 MR images and MRS signals of healthy controls and RRMS and SPMS patients. The NAA peak in progressive MS cases has a tendency to decrease, however, Cr and Co show and increasing trend in MS patients [ 11 ].. (Adapted with permission.) …”

“…Four of the selected articles referred to MS even though they used different methods in their evaluations. Moreover, it is necessary to consider NAA as a metabolite in distinguishing the type of MS [ 11 ]. In PRMS, NAA amount and ratios decrease [ 11 , 22 ], but another study divided PRMS patients into three groups of LF, MF, and HF, and the results were different between LF and HF groups [ 23 ].…”

“…Moreover, it is necessary to consider NAA as a metabolite in distinguishing the type of MS [ 11 ]. In PRMS, NAA amount and ratios decrease [ 11 , 22 ], but another study divided PRMS patients into three groups of LF, MF, and HF, and the results were different between LF and HF groups [ 23 ]. Another type of MS discussed in studies was SPMS, which has increasing Cr and Co levels [ 11 ] ( Fig.…”

“…RRMS is characterized as active or non-active. PMS can be primary progressive (PP) or secondary progressive (SP) [ 11 ].…”