Permanent tissue damage in multiple sclerosis lesions is associated with reduced pre-lesion myelin and axon volume fractions. (November 2022)

• Record Type: Journal Article
• Authors: Tagge, Ian J; Leppert, Ilana R; Fetco, Dumitru; Campbell, Jennifer SW; Rudko, David A; Brown, Robert A; Stikov, Nikola; Pike, G Bruce; Giacomini, Paul S; Arnold, Douglas L; Narayanan, Sridar
• Is Part Of: Multiple sclerosis. Volume 28:Number 13(2022)
• Page Start: 2027
• Page End: 2037
• Publication Date: 2022-11
• Subjects: MRI -- multiple sclerosis -- demyelination -- quantitative MRI -- biomarkers -- T2 lesions; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/13524585221110585
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: The use of advanced magnetic resonance imaging (MRI) techniques in MS research has led to new insights in lesion evolution and disease outcomes. It has not yet been determined if, or how, pre-lesional abnormalities in normal-appearing white matter (NAWM) relate to the long-term evolution of new lesions. Objective: To investigate the relationship between abnormalities in MRI measures of axonal and myelin volume fractions (AVF and MVF) in NAWM preceding development of black-hole (BH) and non-BH lesions in people with MS. Methods: We obtained magnetization transfer and diffusion MRI at 6-month intervals in patients with MS to estimate MVF and AVF during lesion evolution. Lesions were classified as either BH or non-BH on the final imaging visit using T1 maps. Results: Longitudinal data from 97 new T2 lesions from 9 participants were analyzed; 25 lesions in 8 participants were classified as BH 6–12 months after initial appearance. Pre-lesion MVF, AVF, and MVF/AVF were significantly lower, and T1 was significantly higher, in the lesions that later became BHs ( p < 0.001) compared to those that did not. No significant pre-lesion abnormalities were found in non-BH lesions ( p > 0.05). Conclusion: The present work demonstrated that pre-lesion abnormalities are associated with worse long-term lesion-level outcome.