OBJECTIVE: To assess demyelination and remyelination in vivo in acute gadolinium (Gd)-enhancing lesions of multiple sclerosis (MS). METHODS: We measured significant changes in magnetization transfer ratio (MTR) consistent with demyelination and remyelination of individual lesion voxels, as well as the mean normalized MTR over all lesion voxels during and after contrast enhancement, in MS patients participating in a 3-year Canadian trial assessing immunoablation and autologous stem cell transplantation for treatment of MS. RESULTS: The average mean normalized lesion MTR over all lesions exhibited partial recovery over 2 to 4 months after Gd enhancement. Voxel-based analysis demonstrated that approximately 70% of the initially enhancing lesion volume (GdLV) was left with stably low MTR over 39 months of evaluation. The percentage of the GdLV undergoing significant increases in MTR consistent with remyelination increased for approximately 7 months after enhancement and then stabilized at 21 %GdLV. Significant decreases in MTR consistent with demyelination were ongoing for approximately 33 months after enhancement, stabilizing at 9 %GdLV. The estimated error of these measurements, based on scan/rescan analysis, was less than 0.4 %GdLV. INTERPRETATION: We found significant changes in MTR consistent with demyelination and remyelination that followed different temporal evolutions and were ongoing in different lesion regions for at least 3 years after lesion formation.
OBJECTIVE: To assess demyelination and remyelination in vivo in acute gadolinium (Gd)-enhancing lesions of multiple sclerosis (MS). METHODS: We measured significant changes in magnetization transfer ratio (MTR) consistent with demyelination and remyelination of individual lesion voxels, as well as the mean normalized MTR over all lesion voxels during and after contrast enhancement, in MS patients participating in a 3-year Canadian trial assessing immunoablation and autologous stem cell transplantation for treatment of MS. RESULTS: The average mean normalized lesion MTR over all lesions exhibited partial recovery over 2 to 4 months after Gd enhancement. Voxel-based analysis demonstrated that approximately 70% of the initially enhancing lesion volume (GdLV) was left with stably low MTR over 39 months of evaluation. The percentage of the GdLV undergoing significant increases in MTR consistent with remyelination increased for approximately 7 months after enhancement and then stabilized at 21 %GdLV. Significant decreases in MTR consistent with demyelination were ongoing for approximately 33 months after enhancement, stabilizing at 9 %GdLV. The estimated error of these measurements, based on scan/rescan analysis, was less than 0.4 %GdLV. INTERPRETATION: We found significant changes in MTR consistent with demyelination and remyelination that followed different temporal evolutions and were ongoing in different lesion regions for at least 3 years after lesion formation.
Authors: Mike P Wattjes; Àlex Rovira; David Miller; Tarek A Yousry; Maria P Sormani; Maria P de Stefano; Mar Tintoré; Cristina Auger; Carmen Tur; Massimo Filippi; Maria A Rocca; Franz Fazekas; Ludwig Kappos; Chris Polman Journal: Nat Rev Neurol Date: 2015-09-15 Impact factor: 42.937
Authors: Christian Enzinger; Frederik Barkhof; Olga Ciccarelli; Massimo Filippi; Ludwig Kappos; Maria A Rocca; Stefan Ropele; Àlex Rovira; Torben Schneider; Nicola de Stefano; Hugo Vrenken; Claudia Wheeler-Kingshott; Jens Wuerfel; Franz Fazekas Journal: Nat Rev Neurol Date: 2015-11-03 Impact factor: 42.937
Authors: Martina Absinta; Pascal Sati; Matthew Schindler; Emily C Leibovitch; Joan Ohayon; Tianxia Wu; Alessandro Meani; Massimo Filippi; Steven Jacobson; Irene C M Cortese; Daniel S Reich Journal: J Clin Invest Date: 2016-06-06 Impact factor: 14.808
Authors: Benedetta Bodini; Mara Cercignani; Ahmed Toosy; Nicola De Stefano; David H Miller; Alan J Thompson; Olga Ciccarelli Journal: Hum Brain Mapp Date: 2013-04-24 Impact factor: 5.038