Multiple sclerosis pathology in the normal and abnormal appearing white matter of the corpus callosum by diffusion tensor imaging

Abstract

Lesions in the corpus callosum in multiple sclerosis (MS) include those that are hyperintense on T2-weighted images, which can be either focal (isolated) or connected, but there is evidence that the corpus callosum, similar to other white matter regions, contains normal appearing white matter (NAWM) which is abnormal based on quantitative MR methodologies. In this pilot study, diffusion tensor based measures were determined in corpus callosum from 10 patients with MS and 12 age and gender matched controls. T2-hyperintense lesions were carefully segmented out from normal appearing corpus callosum to minimize contamination of the NAWM fraction with these lesions. The orientationally averaged diffusion coefficient was increased and the fractional anisotropy reduced in the NAWM fraction of the MS patients. These results confirm prior studies which suggest that pathology in the NAWM occurs independent of focal MS lesions, and are not likely the result of sample contamination through or across slices. This injury to the NAWM may be the result of focal, microscopic T2-invisible lesions and/or secondary degeneration related to distant lesions whose related fibres cross the corpus callosum.

The Human Endogenous Retrovirus Envelope Glycoprotein, Syncytin-1, Regulates Neuroinflammation and Its Receptor Expression in Multiple Sclerosis: A Role for Endoplasmic Reticulum Chaperones in Astrocytes

“…8B). As Syncytin-1 Tg mice displayed no disease phenotype, we used a model of MS in which TNF-␣ was stereotaxically implanted into the corpus callosum (12), an anatomical region frequently exhibiting demyelination in MS patients (63). TNF-␣ activates GFAP (64) and also enhanced Syncytin-1 expression in astrocytes ( Fig.…”

Diffusion tensor MR imaging evaluation of the corpus callosum of patients with multiple sclerosis

“…The classic subdivision of the CC was suggested by Witelson, who tried to link the crossing fibers of the related cortical areas 2 . The callosal tracts are frequently affected in patients with multiple sclerosis (MS), which is a demyelinating disease associated with axonal destruction and Wallerian degeneration [3][4][5] . Magnetic resonance (MR) imaging is the gold standard imaging technique for the evaluation of patients with MS. however, there are microstructural pathologic alterations in MS patients that cannot be assessed with conventional MR sequences 1,6 .…”

“…Magnetic resonance (MR) imaging is the gold standard imaging technique for the evaluation of patients with MS. however, there are microstructural pathologic alterations in MS patients that cannot be assessed with conventional MR sequences 1,6 . Also, areas of normal-appearing white matter (NAWM), defined as normal signal intensity on T2-weighted images, have been shown histological abnormalities 4,5 . Advanced MR imaging techniques, such as MR spectroscopy and diffusion tensor imaging (DTI), have been employed for evaluating the NAWM in patients with MS 3,5 .…”

Neuroimaging of corpus callosum in central nervous system demyelinating disorders

“…Most recent studies agree on the fact that in MS patients all MRI indices and parameters are altered pathologically especially in the CC structure. [34] In the study by Farber et al [35] ADC was found to be helpful as a great parameter for differentiation between MS and other demyelinating diseases, as ADC was found to be significantly elevated in CC in MS patients compared to control group and patients with ADEM disease. [35] A study by Ozturk et al [13] showed all MRI indices were diffusely abnormal in the CC.…”