Magnetic resonance relaxation time mapping in multiple sclerosis: Normal appearing white matter and the “invisible” lesion load

Several magnetic resonance (MR) techniques have proved to be sensitive enough to detect the subtle pathological changes that post-mortem studies showed to occur in the normal-appearing white matter (NAWM) from patients with multiple sclerosis (MS). Although these abnormalities can be detected in other neurological conditions, they seem to be more frequent and diffuse in MS. However, the contribution of NAWM changes to the diagnosis is still unclear. Their nature is also unknown and perhaps differs in different phases and clinical manifestations of the disease. Nevertheless, the extent and severity of NAWM damage seems to be relevant in causing disability and influencing the clinical evolution in MS patients. This review will summarize the present knowledge about MR-detected NAWM changes in MS and their relevance to the diagnosis and the understanding of disease evolution.

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Diffusion tensor imaging in multiple sclerosis: a tool for monitoring changes in normal-appearing white matter

Multiple Sclerosis Journal ◽

10.1191/1352458504ms997oa ◽

2004 ◽

Vol 10 (2) ◽

pp. 188-196 ◽

Cited By ~ 57

Author(s):

Emmanuelle Cassol ◽

Jean-Philippe Ranjeva ◽

Danielle Ibarrola ◽

Claude Mékies ◽

Claude Manelfe ◽

...

Keyword(s):

Multiple Sclerosis ◽

Diffusion Tensor Imaging ◽

White Matter ◽

Diffusion Tensor ◽

Lesion Load ◽

Normal Appearing White Matter ◽

Relapsing Remitting ◽

One Year ◽

Diffusion Tensor Imaging Dti

Our objectives were to determine the reproducibility of diffusion tensor imaging (DTI) in volunteers and to evaluate the ability of the method to monitor longitudinal changes occurring in the normal-appearing white matter (NAWM) of patients with multiple sclerosis (MS). DTI was performed three-mo nthly for one year in seven MS patients: three relapsing-remitting (RRMS), three secondary progressive (SPMS) and one relapsing SP. They were selected with a limited cerebral lesion load. Seven age- and sex-matched controls also underwent monthly examinations for three months. Diffusivity and anisotropy were quantified over the segmented whole supratentorial white matter, with the indices of trace (Tr) and fractional anisotropy (FA). Results obtained in volunteers show the reproducibility of the method. Patients had higher trace and lower anisotropy than matched controls (P B-0.0001). O ver the follow-up, both Tr and FA indicated a recovery after the acute phase in RRMS and a progressive shift towards abnormal values in SPMS. A lthough this result is not statistically significant, it suggests that DTI is sensitive to microscopic changes occurring in tissue of normal appearance in conventional images and could be useful for monitoring the course of the disease, even though it was unable to clearly distinguish between the various physiopathological processes involved.

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Metabolic changes in normal appearing white matter in multiple sclerosis patients using multivoxel magnetic resonance spectroscopy imaging

Medicine ◽

10.1097/md.0000000000006534 ◽

2017 ◽

Vol 96 (14) ◽

pp. e6534 ◽

Cited By ~ 6

Author(s):

Jubao Sun ◽

Hao Song ◽

Yong Yang ◽

Kun Zhang ◽

Xiuju Gao ◽

...

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Metabolic Changes ◽

Resonance Spectroscopy ◽

Normal Appearing White Matter ◽

Magnetic Resonance Spectroscopy Imaging ◽

Multiple Sclerosis Patients

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Evaluation of white matter in patients with multiple sclerosis through diffusion tensor magnetic resonance imaging

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000400002 ◽

2007 ◽

Vol 65 (3a) ◽

pp. 561-564 ◽

Cited By ~ 10

Author(s):

Rachel E. Maia de Andrade ◽

Emerson L. Gasparetto ◽

Luiz Celso Hygino Cruz Jr. ◽

Fabiana Brito Ferreira ◽

Roberto Cortês Domingues ◽

...

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Magnetic Resonance ◽

Mr Imaging ◽

Diffusion Tensor ◽

Statistical Treatment ◽

Control Group ◽

Normal Appearing White Matter ◽

Significant Difference ◽

Normal White Matter

OBJECTIVE: To study the white matter of patients with multiple sclerosis (MS) with diffusion tensor magnetic resonance (MR) imaging (DTI). METHOD: Forty patients with clinical-laboratorial diagnosis of relapsing-remitting MS and 40 age- and sex-matched controls, who underwent conventional and functional (DTI) MR imaging, were included in the study. The DTI sequences resulted in maps of fractional anisotropy (FA) and regions of interest were placed on the plaques, peri-plaque regions, normal-appearing white matter (NAWM) around the plaques, contralateral normal white matter (CNWM) and normal white matter of the controls (WMC). The FA values were compared and the statistical treatment was performed with the Mann-Whitney U test. RESULTS: The mean FA in plaques was 0.268, in peri-plaque regions 0.365, in NAWM 0.509, in CNWM 0.552 and in WMC 0.573. Statistical significant differences in FA values were observed in plaques, peri-plaque regions and in NAWM around the plaques when compared to the white matter in the control group. There was no significant difference between the FA values of the CNWM of patients with MS and normal white matter of controls. CONCLUSION: Patients with MS show difference in the FA values of the plaques, peri-plaques and NAWM around the plaques when compared to the normal white matter of controls. As a result, DTI may be considered more efficient than conventional MR imaging for the study of patients with MS.

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