Myelin status is associated with change in functional mobility following slope walking in people with multiple sclerosis

Abstract

BackgroundThe level of myelin disruption in multiple sclerosis patients may impact the capacity for training-induced neuroplasticity and the magnitude of therapeutic response to rehabilitation interventions. Downslope walking has been shown to increase functional mobility in individuals with multiple sclerosis, but it is unclear if myelin status influences therapeutic response.ObjectiveThe current study aimed to examine the relationship between baseline myelin status and change in functional mobility after a walking intervention.MethodsThe Timed Up and Go test was used to measure functional mobility before and after completion of a repeated, six-session slope walking intervention in 16 participants with relapsing–remitting multiple sclerosis. Multi-component T2 relaxation imaging was used to index myelin water fraction of overall water content in brain tissue compartments.ResultsResults demonstrated that the ratio of the myelin water fraction in lesion to normal-appearing white matter (myelin water fraction ratio) significantly predicted 31% of the variance in change in Timed Up and Go score after the downslope walking intervention, where less myelin disruption was associated with greater intervention response.ConclusionsMyelin water content fraction ratio may offer a neural biomarker of myelin to identify potential responders to interventions targeting functional impairments in multiple sclerosis.

Myelin water imaging to detect demyelination and remyelination and its validation in pathology

“…NAWM MWF can differentiate between different subtypes of MS, with greater myelin loss found in more progressive forms of the disease , and reduction of MWF is related to increased clinical disability . Changes in NAWM MWF can also be discerned over time ; for example, in untreated relapsing‐remitting MS patients there was an 8% reduction in brain MWF over 5 years , suggesting that chronic, progressive myelin damage is an evolving process occurring over many years. Longitudinal assessment of brain myelin water in non‐lesional tissue has also been successfully used in clinical trials, with a recent study demonstrating NAWM MWF stability after 24 months on MS disease‐modifying therapy .…”

Myelin Measurement Using Quantitative Magnetic Resonance Imaging: A Correlation Study Comparing Various Imaging Techniques in Patients with Multiple Sclerosis

“…Various magnetic resonance (MR) techniques have been used to study the pathological evolution of demyelinating diseases, such as multiple sclerosis (MS) [3]. Myelin imaging can potentially play an important role in the clinic, for predicting and monitoring responses to treatment: myelin status has been shown to be associated with changes in functional mobility following therapeutic exercises in patients with MS [4]. However, myelin assessment is a difficult challenge, as it cannot be seen directly on MRI, which has a millimeter-scale resolution.…”

White Matter Tracts and Diffuse Lower-Grade Gliomas: The Pivotal Role of Myelin Plasticity in the Tumor Pathogenesis, Infiltration Patterns, Functional Consequences and Therapeutic Management

“…Thus, dysregulation of myelin plasticity can have a negative influence on neural processing by disrupting signal integration, propagation and synchronization within and across networks ( 39 ). This alteration in neural coherence may have direct clinical impact in brain-damaged patients, e.g., changes in myelin status in patients with multiple sclerosis were correlated with walking difficulty ( 74 ).…”