Linking structural, metabolic and functional changes in multiple sclerosis

In patients with multiple sclerosis (MS), conventional magnetic resonance imaging (MRI) has markedly improved our ability to detect the macroscopic abnormalities of the brain and spinal cord. New quantitative magnetic resonance (MR) approaches with increased sensitivity to subtle normal‐appearing white matter (NAWM) and grey matter changes and increased specificity to the heterogeneous pathological substrates of MS may give information complementary to conventional MRI. Magnetization transfer imaging (MTI) and diffusion‐weighted imaging (DWI) have the potential to provide important information on the structural changes occurring within and outside T2‐visible lesions. Magnetic resonance spectroscopy (MRS) adds information on the biochemical nature of such changes. Functional MRI might quantify the efficiency of brain plasticity in response to MS injury and improve our understanding of the link between structural damage and clinical manifestations. The present review summarizes how the application of these MR techniques to the study of MS is dramatically changing our understanding of how MS causes irreversible neurological deficits.

[1]  P M Matthews,et al.  Assessment of lesion pathology in multiple sclerosis using quantitative MRI morphometry and magnetic resonance spectroscopy. , 1996, Brain : a journal of neurology.

[2]  P M Matthews,et al.  The motor cortex shows adaptive functional changes to brain injury from multiple sclerosis , 2000, Annals of neurology.

[3]  G. Barker,et al.  Correlation of magnetization transfer ration with clinical disability in multiple sclerosis , 1994, Annals of neurology.

[4]  P. Matthews,et al.  Chemical pathology of acute demyelinating lesions and its correlation with disability , 1995, Annals of neurology.

[5]  R. Rudick,et al.  Axonal transection in the lesions of multiple sclerosis. , 1998, The New England journal of medicine.

[6]  R I Grossman,et al.  Quantitative volumetric magnetization transfer analysis in multiple sclerosis: Estimation of macroscopic and microscopic disease burden , 1996, Magnetic resonance in medicine.

[7]  P. Matthews,et al.  Reversible decreases in N‐acetylaspartate after acute brain injury , 1995, Magnetic resonance in medicine.

[8]  F. Barkhof,et al.  Accumulation of hypointense lesions ("black holes") on T1 spin-echo MRI correlates with disease progression in multiple sclerosis , 1996, Neurology.

[9]  J K Udupa,et al.  Brain atrophy in relapsing-remitting multiple sclerosis and secondary progressive multiple sclerosis: longitudinal quantitative analysis. , 2000, Radiology.

[10]  G J Barker,et al.  Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions. , 1994, Brain : a journal of neurology.

[11]  A J Thompson,et al.  Correlations between changes in disability and T2‐weighted brain MRI activity in multiple sclerosis , 1995, Neurology.

[12]  M Cercignani,et al.  Diffusion tensor magnetic resonance imaging in multiple sclerosis , 2001, Neurology.

[13]  G. Barker,et al.  Serial magnetisation transfer ratios in gadolinium-enhancing lesions in multiple sclerosis , 1997, Journal of Neurology.

[14]  R. Rudick,et al.  Use of the brain parenchymal fraction to measure whole brain atrophy in relapsing-remitting MS , 1999, Neurology.

[15]  A. Compston,et al.  Monoclonal antibody treatment exposes three mechanisms underlying the clinical course of multiple sclerosis , 1999, Annals of neurology.

[16]  M. Filippi,et al.  Magnetization transfer ratio changes in a symptomatic lesion of a patient at presentation with possible multiple sclerosis , 1997, Journal of the Neurological Sciences.

[17]  A. Thompson,et al.  Spinal cord MRI using multi‐array coils and fast spin echo , 1993, Neurology.

[18]  I. Allen,et al.  A histological, histochemical and biochemical study of the macroscopically normal white matter in multiple sclerosis , 1979, Journal of the Neurological Sciences.

[19]  R I Grossman,et al.  Total brain N-acetylaspartate , 2000, Neurology.

[20]  M Rovaris,et al.  Magnetic resonance techniques to monitor disease evolution and treatment trial outcomes in multiple sclerosis. , 1999, Current opinion in neurology.

[21]  F. Barkhof,et al.  Axonal loss in multiple sclerosis lesions: Magnetic resonance imaging insights into substrates of disability , 1999, Annals of neurology.

[22]  F. Barkhof,et al.  Cortical lesions in multiple sclerosis. , 1999, Brain : a journal of neurology.

[23]  C. Mainero,et al.  Correlates of MS disability assessed in vivo using aggregates of MR quantities , 2001, Neurology.

[24]  F. Barkhof,et al.  Patterns of lesion development in multiple sclerosis: longitudinal observations with T1-weighted spin-echo and magnetization transfer MR. , 1998, AJNR. American journal of neuroradiology.

[25]  How does brain MRI lesion volume change on serial scans in patients with multiple sclerosis? , 1998, Magnetic resonance imaging.

[26]  F. Roncaroli,et al.  Neuropathology of multiple sclerosis , 2012 .

[27]  M Filippi,et al.  Comparison of MS clinical phenotypes using conventional and magnetization transfer MRI , 1999, Neurology.

[28]  M Rovaris,et al.  Changes in the normal appearing brain tissue and cognitive impairment in multiple sclerosis , 2000, Journal of neurology, neurosurgery, and psychiatry.

[29]  F. Barkhof,et al.  Histopathologic correlate of hypointense lesions on T1-weighted spin-echo MRI in multiple sclerosis , 1998, Neurology.

[30]  M. Rovaris,et al.  Relative contributions of brain and cervical cord pathology to multiple sclerosis disability: a study with magnetisation transfer ratio histogram analysis , 2000, Journal of neurology, neurosurgery, and psychiatry.

[31]  C. W. Adams,et al.  Pathology of multiple sclerosis: progression of the lesion. , 1977, British medical bulletin.

[32]  M Filippi,et al.  A Magnetization Transfer Imaging Study of Normal-Appearing White Matter in Multiple Sclerosis , 1995, Neurology.

[33]  M Filippi,et al.  The role of non-conventional magnetic resonance techniques in monitoring evolution of multiple sclerosis. , 1998, Journal of neurology, neurosurgery, and psychiatry.

[34]  A J Thompson,et al.  Diagnostic criteria for primary progressive multiple sclerosis: A position paper , 2000, Annals of neurology.

[35]  M Rovaris,et al.  Whole brain volume changes in patients with progressive MS treated with cladribine , 2000, Neurology.

[36]  M Cercignani,et al.  A quantitative study of water diffusion in multiple sclerosis lesions and normal-appearing white matter using echo-planar imaging. , 2000, Archives of neurology.

[37]  M Filippi,et al.  Magnetization transfer changes in the normal appering white matter precede the appearance of enhancing lesions in patients with multiple sclerosis , 1998, Annals of neurology.

[38]  M Rovaris,et al.  Cortical/subcortical disease burden and cognitive impairment in patients with multiple sclerosis. , 2000, AJNR. American journal of neuroradiology.

[39]  J A Frank,et al.  Guidelines for using quantitative measures of brain magnetic resonance imaging abnormalities in monitoring the treatment of multiple sclerosis , 1998, Annals of neurology.

[40]  B. Brownell,et al.  The distribution of plaques in the cerebrum in multiple sclerosis , 1962, Journal of neurology, neurosurgery, and psychiatry.

[41]  M Rovaris,et al.  Relation between MR abnormalities and patterns of cognitive impairment in multiple sclerosis , 1998, Neurology.

[42]  P. Matthews,et al.  Use of proton magnetic resonance spectroscopy for monitoring disease progression in multiple sclerosis , 1994, Annals of neurology.

[43]  J. Kurtzke.  Rating neurologic impairment in multiple sclerosis , 1983, Neurology.

[44]  G. Comi,et al.  Magnetization transfer ratios in multiple sclerosis lesions enhancing after different doses of gadolinium , 1998, Neurology.

[45]  M Filippi,et al.  Long-term changes of magnetization transfer-derived measures from patients with relapsing-remitting and secondary progressive multiple sclerosis. , 1999, AJNR. American journal of neuroradiology.

[46]  G. Comi,et al.  Prognostic value of MR and magnetization transfer imaging findings in patients with clinically isolated syndromes suggestive of multiple sclerosis at presentation. , 2000, AJNR. American journal of neuroradiology.

[47]  M S Buchsbaum,et al.  Whole-brain diffusion MR histograms differ between MS subtypes , 2000, Neurology.

[48]  P M Matthews,et al.  Axonal damage correlates with disability in patients with relapsing-remitting multiple sclerosis. Results of a longitudinal magnetic resonance spectroscopy study. , 1998, Brain : a journal of neurology.

[49]  W. I. McDonald,et al.  Quantitative brain MRI lesion load predicts the course of clinically isolated syndromes suggestive of multiple sclerosis , 1994, Neurology.

[50]  G. Comi,et al.  Pathologic damage in MS assessed by diffusion-weighted and magnetization transfer MRI , 2000, Neurology.

[51]  Ludwin Sk,et al.  The neuropathology of multiple sclerosis. , 2000 .

[52]  M N Rossor,et al.  Progressive cerebral atrophy in MS , 2000, Neurology.

[53]  M. Horsfield,et al.  A conventional and magnetization transfer MRI study of the cervical cord in patients with MS , 2000, Neurology.

[54]  A J Thompson,et al.  Quantitative MRI in patients with clinically isolated syndromes suggestive of demyelination. , 1999, Neurology.

[55]  J K Udupa,et al.  Correlation of volumetric magnetization transfer imaging with clinical data in MS , 1998, Neurology.

[56]  J S Wolinsky,et al.  Serial proton magnetic resonance spectroscopic imaging, contrast‐enhanced magnetic resonance imaging, and quantitative lesion volumetry in multiple sclerosis , 1998, Annals of neurology.

[57]  M Cercignani,et al.  Magnetisation transfer ratio and mean diffusivity of normal appearing white and grey matter from patients with multiple sclerosis , 2001, Journal of neurology, neurosurgery, and psychiatry.

[58]  G. Barker,et al.  Diffusion tensor imaging of lesions and normal-appearing white matter in multiple sclerosis , 1999, Neurology.

[59]  C Becker,et al.  Quantitative assessment of MRI lesion load in multiple sclerosis. A comparison of conventional spin-echo with fast fluid-attenuated inversion recovery. , 1996, Brain : a journal of neurology.

[60]  M Cercignani,et al.  Weekly diffusion-weighted imaging of normal-appearing white matter in MS , 2000, Neurology.

[61]  P M Matthews,et al.  Proton magnetic resonance spectroscopic imaging for metabolic characterization of demyelinating plaques , 1992, Annals of neurology.

[62]  P M Matthews,et al.  Imaging axonal damage of normal-appearing white matter in multiple sclerosis. , 1998, Brain : a journal of neurology.

[63]  G. Comi,et al.  Magnetization transfer imaging to monitor the evolution of MS , 2000, Neurology.

[64]  J H Simon,et al.  Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis. CHAMPS Study Group. , 2000, The New England journal of medicine.

[65]  M Filippi,et al.  A magnetization transfer histogram study of normal-appearing brain tissue in MS , 2000, Neurology.

[66]  G. Barker,et al.  1H magnetic resonance spectroscopy of chronic cerebral white matter lesions and normal appearing white matter in multiple sclerosis , 1997, Journal of neurology, neurosurgery, and psychiatry.

[67]  M W Weiner,et al.  A serial study of new MS lesions and the white matter from which they arise , 1998, Neurology.

[68]  P M Matthews,et al.  Evidence for adaptive functional changes in the cerebral cortex with axonal injury from multiple sclerosis. , 2000, Brain : a journal of neurology.

[69]  J. Caillé,et al.  Early structural changes in acute MS lesions assessed by serial magnetization transfer studies , 1998, Neurology.

[70]  Nick C Fox,et al.  Detection of ventricular enlargement in patients at the earliest clinical stage of MS , 2000, Neurology.

[71]  G J Barker,et al.  Serial magnetization transfer imaging to characterize the early evolution of new MS lesions , 1998, Neurology.

[72]  Patients with clinically isolated syndromes suggestive of MS , 2003, Neurology.

[73]  G. Comi,et al.  Mean diffusivity and fractional anisotropy histograms of patients with multiple sclerosis. , 2001, AJNR. American journal of neuroradiology.

[74]  A J Thompson,et al.  Progressive cerebral atrophy in multiple sclerosis. A serial MRI study. , 1996, Brain : a journal of neurology.

[75]  R. Herndon,et al.  A longitudinal study of brain atrophy in relapsing multiple sclerosis , 1999, Neurology.

[76]  P. C. de Freitas Mathias,et al.  Insulin Secretion and Acetylcholinesterase Activity in Monosodium L-Glutamate-Induced Obese Mice , 2001, Hormone Research in Paediatrics.

[77]  P. Matthews,et al.  The use of magnetic resonance spectroscopy in the evaluation of the natural history of multiple sclerosis. , 1998, Journal of neurology, neurosurgery, and psychiatry.