MR spectroscopy (MRS) and magnetisation transfer imaging (MTI), lesion load and clinical scores in early relapsing remitting multiple sclerosis: a combined cross-sectional and longitudinal study |
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Authors: | J Bellmann-Strobl H Stiepani J Wuerfel G Bohner F Paul C Warmuth O Aktas K P Wandinger F Zipp R Klingebiel |
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Affiliation: | 2. Cecilie Vogt Clinic for Neurology, Charité—University Medicine Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany 1. Department of Neuroradiology, Charité—University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany 5. Institute of Neuroradiology, Campus Luebeck, University Schleswig-Holstein, Kiel, Germany 3. Department of Radiology, Charité—University Medicine Berlin, Berlin, Germany 4. Department of Neurology, Charité—University Medicine Berlin, Berlin, Germany
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Abstract: | The purpose of this study was to correlate magnetic resonance imaging (MRI)-based lesion load assessment with clinical disability
in early relapsing remitting multiple sclerosis (RRMS). Seventeen untreated patients (ten women, seven men; mean age 33.0 ± 7.9 years)
with the initial diagnosis of RRMS were included for cross-sectional as well as longitudinal (24 months) clinical and MRI-based
assessment in comparison with age-matched healthy controls. Conventional MR sequences, MR spectroscopy (MRS) and magnetisation
transfer imaging (MTI) were performed at 1.5 T. Lesion number and volume, MRS and MTI measurements for lesions and normal
appearing white matter (NAWM) were correlated to clinical scores Expanded Disability Status Scale (EDSS), Multiple Sclerosis
Functional Composite (MSFC)] for monitoring disease course after treatment initiation (interferon β-1a). MTI and MRS detected
changes magnetisation transfer ratio (MTR), N-acetylaspartate (NAA)/creatine ratio] in NAWM over time. EDSS and lesional MTR increases correlated throughout the disease
course. Average MTR of NAWM raised during the study (p < 0.05) and correlated to the MSFC score (r = 0.476, p < 0.001). At study termination, NAA/creatine ratio of NAWM correlated to the MSFC score (p < 0.05). MTI and MRS were useful for initial disease assessment in NAWM. MTI and MRS correlated with clinical scores, indicating
potential for monitoring the disease course and gaining new insights into treatment-related effects.
J. Bellmann-Strobl, H. Stiepani and J. Wuerfel contributed equally to this work. |
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Keywords: | Multiple sclerosis MR spectroscopy Magnetisation transfer imaging White matter |
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