NDLI: Deficient MWF mapping in multiple sclerosis using 3D whole-brain multi-component relaxation MRI

Content Provider	PubMed Central
Author	Kitzler, Hagen H. Su, Jason Michael, Zeineh Cynthia, Harper-little Leung, Andrew Marcelo, Kremenchutzky Deoni, Sean C. Rutt, Brian K.
Copyright Year	2011
Abstract	Recent multiple sclerosis (MS) MRI research has highlighted the need to move beyond the lesion-centric view and to develop and validate new MR imaging strategies that quantify the invisible burden of disease in the brain and establish much more sensitive and specific surrogate markers of clinical disability. One of the most promising of such measures is myelin-selective MRI that allows the acquisition of myelin water fraction (MWF) maps, a parameter that is correlated to brain white matter (WM) myelination. The aim of our study was to apply the newest myelin-selective MRI method, multi-component Driven Equilibrium Single Pulse Observation of T1 and T2 (mcDESPOT) in a controlled clinical MS pilot trial. This study was designed to assess the capabilities of this new method to explain differences in disease course and degree of disability in subjects spanning a broad spectrum of MS disease severity. The whole-brain isotropically-resolved 3D acquisition capability of mcDESPOT allowed for the first time the registration of 3D MWF maps to standard space, and consequently a formalized voxel-based analysis of the data. This approach combined with image segmentation further allowed the derivation of new measures of MWF deficiency: total deficient MWF volume (DV) in WM, in WM lesions, in diffusely abnormal white matter and in normal appearing white matter (NAWM). Deficient MWF volume fraction (DVF) was derived from each of these by dividing by the corresponding region volume. Our results confirm that lesion burden does not correlate well with clinical disease activity measured with the extended disability status scale (EDSS) in MS patients. In contrast, our measurements of DVF in NAWM correlated significantly with the EDSS score (R2 = 0.37; p < 0.001). The same quantity discriminated clinically isolated syndrome patients from a normal control population (p < 0.001) and discriminated relapsing–remitting from secondary-progressive patients (p < 0.05); hence this new technique may sense early disease-related myelin loss and transitions to progressive disease. Multivariate analysis revealed that global atrophy, mean whole-brain myelin water fraction and white matter atrophy were the three most important image-derived parameters for predicting clinical disability (EDSS). Overall, our results demonstrate that mcDESPOT-defined measurements in NAWM show great promise as imaging markers of global clinical disease activity in MS. Further investigation will determine if this measure can serve as a risk factor for the conversion into definite MS and for the secondary transition into irreversible disease progression.
Related Links	http://dx.doi.org/10.1016/j.neuroimage.2011.08.052
Ending Page	2677
Page Count	8
Starting Page	2670
File Format	PDF
ISSN	10538119
e-ISSN	10959572
Journal	NeuroImage
Issue Number	3
Volume Number	59
Language	English
Publisher Date	2012-02-01
Access Restriction	Open
Subject Keyword	Cognitive Neuroscience Neurology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Neurology Cognitive Neuroscience

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