Normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.

<h4>Introduction</h4>Magnetic Resonance Imaging is a sensitive technique for detecting white matter (WM) MS lesions, but the relation with clinical disability is low. Because of this, changes in both 'normal appearing white matter' (NAWM) and 'diffusely abnormal white matt...

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Autores principales:	Janne West, Anne Aalto, Anders Tisell, Olof Dahlqvist Leinhard, Anne-Marie Landtblom, Örjan Smedby, Peter Lundberg
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dc6a9f1de5fd445294afcaf197e6e82e
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spelling	oai:doaj.org-article:dc6a9f1de5fd445294afcaf197e6e82e2021-11-18T08:22:28ZNormal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.1932-620310.1371/journal.pone.0095161https://doaj.org/article/dc6a9f1de5fd445294afcaf197e6e82e2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24747946/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>Magnetic Resonance Imaging is a sensitive technique for detecting white matter (WM) MS lesions, but the relation with clinical disability is low. Because of this, changes in both 'normal appearing white matter' (NAWM) and 'diffusely abnormal white matter' (DAWM) have been of interest in recent years. MR techniques, including quantitative magnetic resonance imaging (qMRI) and quantitative magnetic resonance spectroscopy (qMRS), have been developed in order to detect and quantify such changes. In this study, qMRI and qMRS were used to investigate NAWM and DAWM in typical MS patients and in MS patients with low number of WM lesions. Patient data were compared to 'normal white matter' (NWM) in healthy controls.<h4>Methods</h4>QMRI and qMRS measurements were performed on a 1.5 T Philips MR-scanner. 35 patients with clinically definite MS and 20 healthy controls were included. Twenty of the patients fulfilled the 'Barkhof-Tintoré criteria' for MS, ('MRIpos'), whereas 15 showed radiologically atypical findings with few WM lesions ('MRIneg'). QMRI properties were determined in ROIs of NAWM, DAWM and lesions in the MS groups and of NWM in controls. Descriptive statistical analysis and comparisons were performed. Correlations were calculated between qMRI measurements and (1) clinical parameters and (2) WM metabolite concentrations. Regression analyses were performed with brain parenchyma fraction and MSSS.<h4>Results</h4>NAWM in the MRIneg group was significantly different from NAWM in the MRIpos group and NWM. In addition, R1 and R2 of NAWM in the MRIpos group correlated negatively with EDSS and MSSS. DAWM was significantly different from NWM, but similar in the MS groups. N-acetyl aspartate correlated negatively with R1 and R2 in MRIneg. R2 of DAWM was associated with BPF.<h4>Conclusions</h4>Changes in NAWM and DAWM are independent pathological entities in the disease. The correlation between qMRI and clinical status may shed new light on the clinicoradiological paradox.Janne WestAnne AaltoAnders TisellOlof Dahlqvist LeinhardAnne-Marie LandtblomÖrjan SmedbyPeter LundbergPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e95161 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Janne West Anne Aalto Anders Tisell Olof Dahlqvist Leinhard Anne-Marie Landtblom Örjan Smedby Peter Lundberg Normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.
description	<h4>Introduction</h4>Magnetic Resonance Imaging is a sensitive technique for detecting white matter (WM) MS lesions, but the relation with clinical disability is low. Because of this, changes in both 'normal appearing white matter' (NAWM) and 'diffusely abnormal white matter' (DAWM) have been of interest in recent years. MR techniques, including quantitative magnetic resonance imaging (qMRI) and quantitative magnetic resonance spectroscopy (qMRS), have been developed in order to detect and quantify such changes. In this study, qMRI and qMRS were used to investigate NAWM and DAWM in typical MS patients and in MS patients with low number of WM lesions. Patient data were compared to 'normal white matter' (NWM) in healthy controls.<h4>Methods</h4>QMRI and qMRS measurements were performed on a 1.5 T Philips MR-scanner. 35 patients with clinically definite MS and 20 healthy controls were included. Twenty of the patients fulfilled the 'Barkhof-Tintoré criteria' for MS, ('MRIpos'), whereas 15 showed radiologically atypical findings with few WM lesions ('MRIneg'). QMRI properties were determined in ROIs of NAWM, DAWM and lesions in the MS groups and of NWM in controls. Descriptive statistical analysis and comparisons were performed. Correlations were calculated between qMRI measurements and (1) clinical parameters and (2) WM metabolite concentrations. Regression analyses were performed with brain parenchyma fraction and MSSS.<h4>Results</h4>NAWM in the MRIneg group was significantly different from NAWM in the MRIpos group and NWM. In addition, R1 and R2 of NAWM in the MRIpos group correlated negatively with EDSS and MSSS. DAWM was significantly different from NWM, but similar in the MS groups. N-acetyl aspartate correlated negatively with R1 and R2 in MRIneg. R2 of DAWM was associated with BPF.<h4>Conclusions</h4>Changes in NAWM and DAWM are independent pathological entities in the disease. The correlation between qMRI and clinical status may shed new light on the clinicoradiological paradox.
format	article
author	Janne West Anne Aalto Anders Tisell Olof Dahlqvist Leinhard Anne-Marie Landtblom Örjan Smedby Peter Lundberg
author_facet	Janne West Anne Aalto Anders Tisell Olof Dahlqvist Leinhard Anne-Marie Landtblom Örjan Smedby Peter Lundberg
author_sort	Janne West
title	Normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.
title_short	Normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.
title_full	Normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.
title_fullStr	Normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.
title_full_unstemmed	Normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.
title_sort	normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative mr.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/dc6a9f1de5fd445294afcaf197e6e82e
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Normal appearing and diffusely abnormal white matter in patients with multiple sclerosis assessed with quantitative MR.

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