Neurological

MRI technique reveals early changes in normal-appearing white matter in pediatric MS

Neurite Orientation Dispersion and Density Imaging (NODDI) shows a relationship between the Orientation Dispersion Index of Normal Appearing White Matter (NAWM) and tract white matter lesion volume in pediatric multiple sclerosis (MS) patients, according to the Journal of. published study results in neurology, neurosurgery and psychiatry. This suggests the presence of early fiber disorganization in the NAWM.

According to the researchers, NODDI, a multi-compartment model of diffusion MRI, can better capture the microstructural complexity of the brain in vivo. It is able to provide the neurite density index (a measure of neuritis), volume, and orientation dispersion index. This can help measure the variability in neurite orientation, which can be beneficial in determining the relationship between inflammation and neurodegeneration in MS.

The aim of the current study was to investigate the presence of early microstructural damage and its association with physical disability and the volume of white matter lesions in the tracts using NODDI in pediatric patients with MS.

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The study population included 19 patients with relapsing-remitting pediatric MS who were either treatment-naïve (n = 8) or underwent treatment with natalizumab, and 12 age- and sex-matched patients with no history of neurological dysfunction who participated as healthy controls.

Researchers performed 3T whole-brain MRI scans to obtain sagittal three-dimensional (3D0 T1-weighted turbo-field echoes and 3D sagittal fluid-attenuated inversion recovery (FLAIR) scans showing total and tract-specific volume and lesion of T2 hyperintension lesions.) The researchers performed neurological exams within a week of the MRI scan.

They found that patients with pedMS had a significantly lower neurite density in the corpus collosum (P = 0.029; P = 0.175 corrected) and PTR (P = 0.001, P = 0.011 corrected) compared to their healthy peers. Within the normal appearing white matter of the corpus collosum, a lower neurite density index was associated with an increased orientation scatter. Both measures were associated with a larger lesion volume (r = -0.585, P = 0.008 and r = 0.440, P = 0.047, respectively).

The orientation dispersion index in the NAWM in the corticospinal tract and the posterior thalamic irradiation were linked to the lesion volume (r = 0.564, P = 0.011; r = 0.514, P = 0.024).

Neurite Density Index and Extended Disability Status Scale Scores (EDSS) were not related. The researchers said this lack of association could mean that in early MS, inflammation and demyelination promote disability.

Study limitations included a small sample size and the exploratory nature of the study.

“Our results have been particularly relevant since the clinical inception of [pediatric] pedMS is most likely very close to its biological onset and provides further in vivo evidence to support the hypothesis that inflammatory-induced neurodegeneration has been affecting the MS brain since the biological onset of the disease, ”the researchers concluded.

Disclosure: This research was supported by Biogen. Some study authors stated links with biotech, pharmaceutical, and / or device manufacturers. For a full list of specifications, see the original reference.

reference

M. Margoni, U. Villani, L. Finos, et al. Neurite orientation dispersion and density imaging reveals early changes in normal appearing white matter in pediatric multiple sclerosis. J Neurol Neurosurg Psychiatry. Published online July 16, 2021. doi: 10.1136 / jnnp-2021-326355.

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