Predictive MRI Biomarkers in MS—A Critical Review

Tiu, Vlad Eugen; Enache, Iulian; Panea, Cristina; Tiu, Cristina; Popescu, Bogdan Ovidiu

doi:10.3390/medicina58030377

Cited by 13 publications

(6 citation statements)

References 199 publications

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“…Among these parameters, white matter lesions (WMLs) are a characteristic feature of MS, which are usually detected by contrast-enhanced MRI. Recent research has revealed that GM abnormalities manifest early in the course of the disease and predict both conversion to MS and the progressive accrual of disability [ 86 ]. Moreover, GM atrophy is more severe than WM atrophy in the early stages of the disease [ 87 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of multiple sclerosis progression: A systematic review of conventional magnetic resonance imaging studies

Lomer,

Asalemi,

Saberi

et al. 2024

PLoS ONE

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Introduction Multiple Sclerosis (MS) is a chronic neurodegenerative disorder that affects the central nervous system (CNS) and results in progressive clinical disability and cognitive decline. Currently, there are no specific imaging parameters available for the prediction of longitudinal disability in MS patients. Magnetic resonance imaging (MRI) has linked imaging anomalies to clinical and cognitive deficits in MS. In this study, we aimed to evaluate the effectiveness of MRI in predicting disability, clinical progression, and cognitive decline in MS. Methods In this study, according to PRISMA guidelines, we comprehensively searched the Web of Science, PubMed, and Embase databases to identify pertinent articles that employed conventional MRI in the context of Relapsing-Remitting and progressive forms of MS. Following a rigorous screening process, studies that met the predefined inclusion criteria were selected for data extraction and evaluated for potential sources of bias. Results A total of 3028 records were retrieved from database searching. After a rigorous screening, 53 records met the criteria and were included in this study. Lesions and alterations in CNS structures like white matter, gray matter, corpus callosum, thalamus, and spinal cord, may be used to anticipate disability progression. Several prognostic factors associated with the progression of MS, including presence of cortical lesions, changes in gray matter volume, whole brain atrophy, the corpus callosum index, alterations in thalamic volume, and lesions or alterations in cross-sectional area of the spinal cord. For cognitive impairment in MS patients, reliable predictors include cortical gray matter volume, brain atrophy, lesion characteristics (T2-lesion load, temporal, frontal, and cerebellar lesions), white matter lesion volume, thalamic volume, and corpus callosum density. Conclusion This study indicates that MRI can be used to predict the cognitive decline, disability progression, and disease progression in MS patients over time.

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Section: Discussionmentioning

confidence: 99%

Predictors of multiple sclerosis progression: A systematic review of conventional magnetic resonance imaging studies

Lomer,

Asalemi,

Saberi

et al. 2024

PLoS ONE

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“…The non-linear progression of this scale, the non-uniform progression between different stages, and the inter and intra-assessor variability when implementing at different clinical visits. It is also not easy to implement and imprecise at the lower end of the scale, too driven by mobility distances at the middle and higher end of the scale and fails to take into account upper limb function which means a patient can score very highly for having one severe cord relapse ending the patient wheelchair dependent [24][25][26].…”

Section: No Evidence Of Disease Activity (Neda)mentioning

confidence: 99%

Advances in Magnetic Resonance Imaging in Multiple Sclerosis

Abdel-Fahim¹

2024

Frontiers in Neuroimaging

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Multiple sclerosis is the second most common cause of disability in young adults. Conventional imaging so far failed to explain the extent of clinical disability even by careful examination of white matter lesion volume and their topographical distribution. The increasing availability of ultra-high field imaging allowed the improvement in understanding the dynamic lesional and extralesional pathology in different stages of the disease and their potential contribution to clinical and cognitive disability. The contribution of cortical lesions of different subtypes, the degree of microstructural damage in those lesions has been examined. This is in addition to the influence of white matter lesions and spinal cord pathology on the degree of disability in multiple sclerosis. Prognostic factors influencing long-term disability in patients with multiple sclerosis have also been a subject of interest for many years, particularly their significance in early decision-making with regard to disease-modifying treatment choice and early initiation. The frequency of iron rims in white matter lesions has been linked to increased disease severity in multiple sclerosis. Iron rim lesions’ potential evolution to slowly expanding lesions as well as the long-term prognostic impact of such lesions on the degree of clinical disability has also been examined in this chapter.

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“…In these days, the successive increase in neurodegenerative features is clinically estimated by indirect measurements of relevant parameters, such as disability accumulation (expanded disability status scale—EDSS), cognitive tests, and brain atrophy index based on magnetic resonance imaging (MRI) [ 12 ]. Nevertheless, reliable biomarkers indicating an accurate estimation of quality and degree of neurodegeneration during MS progression are still missing [ 13 , 14 ].…”

Section: Multiple Sclerosismentioning

confidence: 99%

Neurodegeneration in Multiple Sclerosis: The Role of Nrf2-Dependent Pathways

et al. 2022

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Multiple sclerosis (MS) encompasses a chronic, irreversible, and predominantly immune-mediated disease of the central nervous system that leads to axonal degeneration, neuronal death, and several neurological symptoms. Although various immune therapies have reduced relapse rates and the severity of symptoms in relapsing-remitting MS, there is still no cure for this devastating disease. In this brief review, we discuss the role of mitochondria dysfunction in the progression of MS, focused on the possible role of Nrf2 signaling in orchestrating the impairment of critical cellular and molecular aspects such as reactive oxygen species (ROS) management, under neuroinflammation and neurodegeneration in MS. In this scenario, we propose a new potential downstream signaling of Nrf2 pathway, namely the opening of hemichannels and pannexons. These large-pore channels are known to modulate glial/neuronal function and ROS production as they are permeable to extracellular Ca2+ and release potentially harmful transmitters to the synaptic cleft. In this way, the Nrf2 dysfunction impairs not only the bioenergetics and metabolic properties of glial cells but also the proper antioxidant defense and energy supply that they provide to neurons.

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Predictive MRI Biomarkers in MS—A Critical Review

Cited by 13 publications

References 199 publications

Predictors of multiple sclerosis progression: A systematic review of conventional magnetic resonance imaging studies

Predictors of multiple sclerosis progression: A systematic review of conventional magnetic resonance imaging studies

Advances in Magnetic Resonance Imaging in Multiple Sclerosis

Neurodegeneration in Multiple Sclerosis: The Role of Nrf2-Dependent Pathways

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