Irene M Vavasour1, Sophie C Huijskens2, David Kb Li3, Anthony L Traboulsee4, Burkhard Mädler5, Shannon H Kolind3, Alexander Rauscher6, Gr Wayne Moore7, Alex L MacKay8, Cornelia Laule9. 1. Department of Radiology, The University of British Columbia, Vancouver, BC, Canada. 2. Department of Physics and Astronomy, The University of British Columbia, Vancouver, BC, Canada. 3. Department of Radiology, The University of British Columbia, Vancouver, BC, Canada; Department of Medicine, The University of British Columbia, Vancouver, BC, Canada. 4. Department of Medicine, The University of British Columbia, Vancouver, BC, Canada. 5. Philips Healthcare, Hamburg, Germany. 6. Paediatrics, Centre for Brain Health, Child and Family Research Institute, The University of British Columbia, Vancouver, BC, Canada. 7. Department of Medicine, The University of British Columbia, Vancouver, BC, Canada/Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada/International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada. 8. Department of Radiology, The University of British Columbia, Vancouver, BC, Canada; Department of Physics and Astronomy, The University of British Columbia, Vancouver, BC, Canada. 9. Department of Radiology, The University of British Columbia, Vancouver, BC, Canada/Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada/International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada.
Abstract
BACKGROUND: Reduced myelin water fraction (MWF, a marker for myelin), increased geometric mean T2 (ieGMT2, reflecting intra/extracellular water properties), and increased T1 (related to total water content) have been observed in cross-sectional studies of multiple sclerosis (MS) normal-appearing white matter (NAWM). OBJECTIVE: To assess longitudinal changes of magnetic resonance (MR) measures in relapsing-remitting MS (RRMS) brain NAWM. METHODS: A total of 11 subjects with RRMS and 4 controls were scanned on a 3T MRI at baseline and long-term follow-up (LTFU; 3.2-5.8 years) with a 32-echo T2 relaxation and an inversion recovery T1 sequence. For every voxel, MWF, ieGMT2, and T1 were obtained. Mean, peak height, and peak location from NAWM mask-based histograms were determined. RESULTS: In MS subjects, NAWM MWF mean decreased by 8% ( p = 0.0016). No longitudinal changes were measured in T1 or ieGMT2. There was no relationship between change in any MR metric and change in EDSS. Control white matter showed no differences over time in any metric. CONCLUSION: The decreases we observed in MWF suggest that changes in myelin integrity and loss of myelin may be occurring diffusely and over long time periods in the MS brain. The timescale of these changes indicates that chronic, progressive myelin damage is an evolving process occurring over many years.
BACKGROUND: Reduced myelin water fraction (MWF, a marker for myelin), increased geometric mean T2 (ieGMT2, reflecting intra/extracellular water properties), and increased T1 (related to total water content) have been observed in cross-sectional studies of multiple sclerosis (MS) normal-appearing white matter (NAWM). OBJECTIVE: To assess longitudinal changes of magnetic resonance (MR) measures in relapsing-remitting MS (RRMS) brain NAWM. METHODS: A total of 11 subjects with RRMS and 4 controls were scanned on a 3T MRI at baseline and long-term follow-up (LTFU; 3.2-5.8 years) with a 32-echo T2 relaxation and an inversion recovery T1 sequence. For every voxel, MWF, ieGMT2, and T1 were obtained. Mean, peak height, and peak location from NAWM mask-based histograms were determined. RESULTS: In MS subjects, NAWM MWF mean decreased by 8% ( p = 0.0016). No longitudinal changes were measured in T1 or ieGMT2. There was no relationship between change in any MR metric and change in EDSS. Control white matter showed no differences over time in any metric. CONCLUSION: The decreases we observed in MWF suggest that changes in myelin integrity and loss of myelin may be occurring diffusely and over long time periods in the MS brain. The timescale of these changes indicates that chronic, progressive myelin damage is an evolving process occurring over many years.
Entities:
Keywords:
Multiple sclerosis; longitudinal; myelin water fraction; normal-appearing white matter
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