Magnetic Resonance Imaging and Analysis in Multiple Sclerosis

Jakimovski, Dejan; Ramasamy, Deepa P.; Zivadinov, Robert

doi:10.1007/978-3-030-24436-1_6

Cited by 5 publications

(4 citation statements)

References 184 publications

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“…One of the most commonly utilized diagnostic and prognostic paraclinical measures in MS is the use of magnetic resonance imaging (MRI) that allows for in vivo visualization of MS pathology and anatomical damage. 19 However, conventional MRI-based measures of MS explain a small portion of clinical outcomes in MS. 20 Better known as the clinico-radiological paradox, current research is looking to bridge the gap between MRI abnormalities and concurrent clinical presentation of MS. 21 PROs may provide a plausible avenue that could rectify the discrepancy between objective disability measures and MS-based pathological changes. The current study aims at determining the neuroimaging correlates of PROs in PwMS.…”

Section: Introductionmentioning

confidence: 99%

Neuroimaging Correlates of Patient-Reported Outcomes in Multiple Sclerosis

Jakimovski¹,

Wicks²,

Bergsland³

et al. 2023

DNND

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Background Patient-reported outcomes (PROs) are increasingly associated with concurrent and future impairments in persons with multiple sclerosis (pwMS). The structural and pathological relationships with PROs in pwMS have not been elucidated. Methods One hundred and forty-two pwMS and 47 healthy controls (HCs) were scanned using 3T MRI and completed a PRO questionnaire named Lifeware ® that outlines the physical and psychosocial abilities. Beck’s Depression Inventory (BDI) assessed levels of depression. T1- and T2-lesion volume, volumes of the whole brain (WBV), gray matter (GMV), white matter (WMV) and lateral ventricle (LVV) were derived using JIM and SIENAX software. Additional deep GM (DGMV) and nuclei-specific volumes of the thalamus, caudate, globus pallidus, putamen, and hippocampus were calculated using FIRST. Ordinal regression models adjusted for age and depression and mediation analyses were used. Results When compared to HCs, pwMS reported significantly greater limitations in mobility domains, including standing up from low seat (p < 0.001), climbing flight of stairs (p < 0.001), lower limb limitation (p < 0.001), limitations in bladder continence (p = 0.001) and fatigability (p < 0.001). Patient-reported limitations related to lower extremity function were explained by age, BDI, and all DGM nuclei volumes (p < 0.029). No such relationships were seen in the HCs. Fatiguability and the extent of life satisfaction were only related to depression (BDI p < 0.001) and not associated with any MRI-based outcomes. Most relationships between structural pathology and PROs were mediated by BDI scores (p < 0.001). In the pwMS group, there were no significant differences in any MRI-based brain volumes between the levels of reported life satisfaction. Conclusion PRO measures of lower extremity limitations were associated with DGM structures and DGM-specific nuclei. These findings promote the relevance of measuring DGM structures as measures directly related to subjective well-being and walking limitations. Depression is a significant mediator of PROs and in particular of life satisfaction.

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Section: Introductionmentioning

confidence: 99%

Neuroimaging Correlates of Patient-Reported Outcomes in Multiple Sclerosis

Jakimovski¹,

Wicks²,

Bergsland³

et al. 2023

DNND

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“…The use of non-invasive OCT and OCT angiography (OCT-A) techniques over conventional vessel analysis methods are multifold. MRI-based studies such as MR angiography and conventional angiography requires the injection of gadolinium-based fluorescein and indocyanine green dyes that could cause anaphylactic reactions and other systemic adverse events [9]. Moreover, gadolinium-based contrast agents are limited to only subjects with healthy kidney function and repeated use of such agents can result in both systemic and cerebral contrast accumulation [10].…”

Section: Introductionmentioning

confidence: 99%

Retinal Blood Vessel Analysis Using Optical Coherence Tomography (OCT) in Multiple Sclerosis

et al. 2023

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Background: Both greater retinal neurodegenerative pathology and greater cardiovascular burden are seen in people with multiple sclerosis (pwMS). Studies also describe multiple extracranial and intracranial vascular changes in pwMS. However, there have been few studies examining the neuroretinal vasculature in MS. Our aim is to determine differences in retinal vasculature between pwMS and healthy controls (HCs) and to determine the relationship between retinal nerve fiber layer (RNFL) thickness and retinal vasculature characteristics. Methods: A total of 167 pwMS and 48 HCs were scanned using optical coherence tomography (OCT). Earlier OCT scans were available for 101 pwMS and 35 HCs for an additional longitudinal analysis. Segmentation of retinal vasculature was performed in a blinded manner in MATLAB’s optical coherence tomography segmentation and evaluation GUI (OCTSEG) software. Results: PwMS has fewer retinal blood vessels when compared to HCs (35.1 vs. 36.8, p = 0.017). Over the 5.4 year follow up, and when compared to HCs, pwMS has a significant decrease in number of retinal vessels (average loss of −3.7 p = 0.007). Moreover, the total vessel diameter in pwMS does not change when compared to the increase in vessel diameter in the HCs (0.06 vs. 0.3, p = 0.017). Only in pwMS is there an association between lower RNFL thickness and fewer retinal vessel number and smaller diameter (r = 0.191, p = 0.018 and r = 0.216, p = 0.007). Conclusions: Over 5 years, pwMS exhibit significant retinal vascular changes that are related to greater atrophy of the retinal layers.

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“…However, standard clinical MRI correlates only modestly with disability and lacks specificity to MS pathology. 3,5,6 Moreover, the normal-appearing white matter (NAWM) of MS brain is typically not truly normal. Gray matter demyelinating lesions are often widespread as well, but gray matter lesions are almost undetectable by conventional MR imaging.…”

Section: Introductionmentioning

confidence: 99%

“…MRI plays a critical role in MS diagnosis and disease monitoring 2–4 by detecting focal white matter lesions. However, standard clinical MRI correlates only modestly with disability and lacks specificity to MS pathology 3,5,6 . Moreover, the normal‐appearing white matter (NAWM) of MS brain is typically not truly normal.…”

Section: Introductionmentioning

confidence: 99%

Evaluating brain damage in multiple sclerosis with simultaneous multi‐angular‐relaxometry of tissue

Xiang

Wen

Schmidt

et al. 2022

Ann Clin Transl Neurol

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Objective Multiple sclerosis (MS) is a common demyelinating central nervous system disease. MRI methods that can quantify myelin loss are needed for trials of putative remyelinating agents. Quantitative magnetization transfer MRI introduced the macromolecule proton fraction (MPF), which correlates with myelin concentration. We developed an alternative approach, Simultaneous‐Multi‐Angular‐Relaxometry‐of‐Tissue (SMART) MRI, to generate MPF. Our objective was to test SMART‐derived MPF metric as a potential imaging biomarker of demyelination. Methods Twenty healthy control (HC), 11 relapsing–remitting MS (RRMS), 22 progressive MS (PMS), and one subject with a biopsied tumefactive demyelinating lesion were scanned at 3T using SMART MRI. SMART‐derived MPF metric was determined in normal‐appearing cortical gray matter (NAGM), normal‐appearing subcortical white matter (NAWM), and demyelinating lesions. MPF metric was evaluated for correlations with physical and cognitive test scores. Comparisons were made between HC and MS and between MS subtypes. Furthermore, correlations were determined between MPF and neuropathology in the biopsied person. Results SMART‐derived MPF in NAGM and NAWM were lower in MS than HC (p < 0.001). MPF in NAGM, NAWM and lesions differentiated RRMS from PMS (p < 0.01, p < 0.001, p < 0.001, respectively), whereas lesion volumes did not. MPF in NAGM, NAWM and lesions correlated with the Expanded Disability Status Scale (p < 0.01, p < 0.001, p < 0.001, respectively) and nine‐hole peg test (p < 0.001, p < 0.001, p < 0.01, respectively). MPF was lower in the histopathologically confirmed inflammatory demyelinating lesion than the contralateral NAWM and increased in the biopsied lesion over time, mirroring improved clinical performance. Interpretation SMART‐derived MPF metric holds potential as a quantitative imaging biomarker of demyelination and remyelination.

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Magnetic Resonance Imaging and Analysis in Multiple Sclerosis

Cited by 5 publications

References 184 publications

Neuroimaging Correlates of Patient-Reported Outcomes in Multiple Sclerosis

Neuroimaging Correlates of Patient-Reported Outcomes in Multiple Sclerosis

Retinal Blood Vessel Analysis Using Optical Coherence Tomography (OCT) in Multiple Sclerosis

Evaluating brain damage in multiple sclerosis with simultaneous multi‐angular‐relaxometry of tissue

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