Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio

Background: Multiple sclerosis (MS) has traditionally been regarded as a disease confined to the central nervous system (CNS). However, neuropathological, electrophysiological, and imaging studies have demonstrated that the peripheral nervous system (PNS) is also involved, with demyelination and, to...

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Autores principales:	Ratthaporn Boonsuth, Rebecca S. Samson, Carmen Tur, Marco Battiston, Francesco Grussu, Torben Schneider, Masami Yoneyama, Ferran Prados, Antrea Ttofalla, Sara Collorone, Rosa Cortese, Olga Ciccarelli, Claudia A. M. Gandini Wheeler-Kingshott, Marios C. Yiannakas
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	magnetic resonance neurography (MRN) magnetisation transfer ratio (MTR) multiple sclerosis relapsing-remitting multiple sclerosis (RRMS) peripheral nervous system (PNS) Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/17fc0d037d774a59be8c71199fce4a84
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spelling	oai:doaj.org-article:17fc0d037d774a59be8c71199fce4a842021-11-30T21:35:11ZAssessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio1664-229510.3389/fneur.2021.763143https://doaj.org/article/17fc0d037d774a59be8c71199fce4a842021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.763143/fullhttps://doaj.org/toc/1664-2295Background: Multiple sclerosis (MS) has traditionally been regarded as a disease confined to the central nervous system (CNS). However, neuropathological, electrophysiological, and imaging studies have demonstrated that the peripheral nervous system (PNS) is also involved, with demyelination and, to a lesser extent, axonal degeneration representing the main pathophysiological mechanisms.Aim: The purpose of this study was to assess PNS damage at the lumbar plexus and sciatic nerve anatomical locations in people with relapsing-remitting MS (RRMS) and healthy controls (HCs) in vivo using magnetisation transfer ratio (MTR), which is a known imaging biomarker sensitive to alterations in myelin content in neural tissue, and not previously explored in the context of PNS damage in MS.Method: Eleven HCs (7 female, mean age 33.6 years, range 24-50) and 15 people with RRMS (12 female, mean age 38.5 years, range 30-56) were recruited for this study and underwent magnetic resonance imaging (MRI) investigations together with clinical assessments using the expanded disability status scale (EDSS). Magnetic resonance neurography (MRN) was first used for visualisation and identification of the lumbar plexus and the sciatic nerve and MTR imaging was subsequently performed using identical scan geometry to MRN, enabling straightforward co-registration of all data to obtain global and regional mean MTR measurements. Linear regression models were used to identify differences in MTR values between HCs and people with RRMS and to identify an association between MTR measures and EDSS.Results: MTR values in the sciatic nerve of people with RRMS were found to be significantly lower compared to HCs, but no significant MTR changes were identified in the lumbar plexus of people with RRMS. The median EDSS in people with RRMS was 2.0 (range, 0-3). No relationship between the MTR measures in the PNS and EDSS were identified at any of the anatomical locations studied in this cohort of people with RRMS.Conclusion: The results from this study demonstrate the presence of PNS damage in people with RRMS and support the notion that these changes, suggestive of demyelination, maybe occurring independently at different anatomical locations within the PNS. Further investigations to confirm these findings and to clarify the pathophysiological basis of these alterations are warranted.Ratthaporn BoonsuthRebecca S. SamsonCarmen TurCarmen TurMarco BattistonFrancesco GrussuFrancesco GrussuFrancesco GrussuTorben SchneiderMasami YoneyamaFerran PradosFerran PradosFerran PradosAntrea TtofallaSara ColloroneRosa CorteseOlga CiccarelliClaudia A. M. Gandini Wheeler-KingshottClaudia A. M. Gandini Wheeler-KingshottClaudia A. M. Gandini Wheeler-KingshottMarios C. YiannakasFrontiers Media S.A.articlemagnetic resonance neurography (MRN)magnetisation transfer ratio (MTR)multiple sclerosisrelapsing-remitting multiple sclerosis (RRMS)peripheral nervous system (PNS)Neurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	magnetic resonance neurography (MRN) magnetisation transfer ratio (MTR) multiple sclerosis relapsing-remitting multiple sclerosis (RRMS) peripheral nervous system (PNS) Neurology. Diseases of the nervous system RC346-429
spellingShingle	magnetic resonance neurography (MRN) magnetisation transfer ratio (MTR) multiple sclerosis relapsing-remitting multiple sclerosis (RRMS) peripheral nervous system (PNS) Neurology. Diseases of the nervous system RC346-429 Ratthaporn Boonsuth Rebecca S. Samson Carmen Tur Carmen Tur Marco Battiston Francesco Grussu Francesco Grussu Francesco Grussu Torben Schneider Masami Yoneyama Ferran Prados Ferran Prados Ferran Prados Antrea Ttofalla Sara Collorone Rosa Cortese Olga Ciccarelli Claudia A. M. Gandini Wheeler-Kingshott Claudia A. M. Gandini Wheeler-Kingshott Claudia A. M. Gandini Wheeler-Kingshott Marios C. Yiannakas Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio
description	Background: Multiple sclerosis (MS) has traditionally been regarded as a disease confined to the central nervous system (CNS). However, neuropathological, electrophysiological, and imaging studies have demonstrated that the peripheral nervous system (PNS) is also involved, with demyelination and, to a lesser extent, axonal degeneration representing the main pathophysiological mechanisms.Aim: The purpose of this study was to assess PNS damage at the lumbar plexus and sciatic nerve anatomical locations in people with relapsing-remitting MS (RRMS) and healthy controls (HCs) in vivo using magnetisation transfer ratio (MTR), which is a known imaging biomarker sensitive to alterations in myelin content in neural tissue, and not previously explored in the context of PNS damage in MS.Method: Eleven HCs (7 female, mean age 33.6 years, range 24-50) and 15 people with RRMS (12 female, mean age 38.5 years, range 30-56) were recruited for this study and underwent magnetic resonance imaging (MRI) investigations together with clinical assessments using the expanded disability status scale (EDSS). Magnetic resonance neurography (MRN) was first used for visualisation and identification of the lumbar plexus and the sciatic nerve and MTR imaging was subsequently performed using identical scan geometry to MRN, enabling straightforward co-registration of all data to obtain global and regional mean MTR measurements. Linear regression models were used to identify differences in MTR values between HCs and people with RRMS and to identify an association between MTR measures and EDSS.Results: MTR values in the sciatic nerve of people with RRMS were found to be significantly lower compared to HCs, but no significant MTR changes were identified in the lumbar plexus of people with RRMS. The median EDSS in people with RRMS was 2.0 (range, 0-3). No relationship between the MTR measures in the PNS and EDSS were identified at any of the anatomical locations studied in this cohort of people with RRMS.Conclusion: The results from this study demonstrate the presence of PNS damage in people with RRMS and support the notion that these changes, suggestive of demyelination, maybe occurring independently at different anatomical locations within the PNS. Further investigations to confirm these findings and to clarify the pathophysiological basis of these alterations are warranted.
format	article
author	Ratthaporn Boonsuth Rebecca S. Samson Carmen Tur Carmen Tur Marco Battiston Francesco Grussu Francesco Grussu Francesco Grussu Torben Schneider Masami Yoneyama Ferran Prados Ferran Prados Ferran Prados Antrea Ttofalla Sara Collorone Rosa Cortese Olga Ciccarelli Claudia A. M. Gandini Wheeler-Kingshott Claudia A. M. Gandini Wheeler-Kingshott Claudia A. M. Gandini Wheeler-Kingshott Marios C. Yiannakas
author_facet	Ratthaporn Boonsuth Rebecca S. Samson Carmen Tur Carmen Tur Marco Battiston Francesco Grussu Francesco Grussu Francesco Grussu Torben Schneider Masami Yoneyama Ferran Prados Ferran Prados Ferran Prados Antrea Ttofalla Sara Collorone Rosa Cortese Olga Ciccarelli Claudia A. M. Gandini Wheeler-Kingshott Claudia A. M. Gandini Wheeler-Kingshott Claudia A. M. Gandini Wheeler-Kingshott Marios C. Yiannakas
author_sort	Ratthaporn Boonsuth
title	Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio
title_short	Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio
title_full	Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio
title_fullStr	Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio
title_full_unstemmed	Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio
title_sort	assessing lumbar plexus and sciatic nerve damage in relapsing-remitting multiple sclerosis using magnetisation transfer ratio
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/17fc0d037d774a59be8c71199fce4a84
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Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio

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