Visualizing the Central Nervous System: Imaging Tools for Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Transient enlargement of brain ventricles during relapsing-remitting multiple sclerosis and experimental autoimmune encephalomyelitis

“…MRI is an indispensable tool in diagnosing MS and monitoring disease progression (3)(4)(5)(6). Disruptions of the BBB can be revealed by MRI using gadolinium-based contrast agents (GBCA).…”

Gray Matter Matters: A Longitudinal Magnetic Resonance Voxel-Based Morphometry Study of Primary Progressive Multiple Sclerosis

“…The importance of GM integrity in preserving clinical and cognitive function makes it essential to have an accurate means of measuring the degree of GM pathology. New techniques employing 3D VBM MRI have improved specificity and sensitivity in monitoring the anatomic substrate for a patient's clinical condition (20,37,38,40,41,72,(82)(83)(84). These quantitative MR applications have allowed precise measurements of GM tissue damage that lead to disability accumulation.…”

“…These quantitative MR applications have allowed precise measurements of GM tissue damage that lead to disability accumulation. Automated 3D VBM techniques have been shown to perform as well as, or better than, manual segmentation performed by expert Neuroradiologists, Radiologists and Neurologists, who have had specialized training and expertise in anatomic labeling of MR images (40,41,82,84). NeuroQuant R was able to provide a precise and reproducible means of measuring volumes of cortical GM and deep GM nuclei, with an easily interpretable imaging technique (37,40,41).…”

Spinal cord and brain MRI should be routinely performed during follow-up in patients with NMOSD – Commentary

“…However, there is accumulating evidence for subclinical tissue damage in NMOSD and MOGAD from recent MRI and retinal imaging studies with optical coherence tomography (OCT) even in the absence of clinical symptoms. [8][9][10] Microstructural brain tissue alterations, spinal cord atrophy, and loss of retinal ganglion cells without brain or spinal cord symptoms or optic neuritis attacks have been repeatedly reported which challenges the current view that tissue damage does not occur independently of relapses in these conditions. However, these findings are still too preliminary to justify routine imaging follow-up in these patients as we cannot judge whether switch of immunotherapy based solely on imaging studies would result in a better prognosis with less long-term disability.…”

“…no cases have yet been described when rituximab was used alone to treat patients with NMOSD or other neuroinflammatory disorders. 10 Similarly, to AQP4-antibody NMOSD, MOGAD is an antibody-mediated disease, where disability is thought to be relapse-related, therefore routine MRI is usually not a part of clinical practice in specialist clinics. Follow-up brain imaging performed in the aftermath of clinical attacks in MOGAD patients typically shows resolution of acute lesions and the absence of new ones rather than lesion accumulation as observed in MS. 2 Performing a one-off MRI scan after the attack both in MOGAD and NMOSD might be reasonable as allows to re-baseline the imaging when the patient is recovering from an acute attack to allow comparison should they develop symptoms suggestive of a relapse in the future.…”