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Mult Scler. 2019 Apr;25(5):687-698. doi: 10.1177/1352458518765671. Epub 2018 Mar 15.

Restriction spectrum imaging of white matter and its relation to neurological disability in multiple sclerosis.

Author information

1
Division of Radiology & Nuclear Medicine, Oslo University Hospital, Oslo, Norway/Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
2
Institute of Clinical Medicine, University of Oslo, Oslo, Norway/Department of Neurology, Oslo University Hospital, Oslo, Norway.
3
Department of Radiology, University of California, San Diego, La Jolla, CA, USA.
4
Department of Neurology, Oslo University Hospital, Oslo, Norway/Institute of Health and Society, University of Oslo, Oslo, Norway.
5
Department of Neurology, Oslo University Hospital, Oslo, Norway/MS Centre Hakadal, Hakadal, Norway.
6
Division of Radiology & Nuclear Medicine, Oslo University Hospital, Oslo, Norway/Department of Physics, University of Oslo, Oslo, Norway.
7
Department of Psychology, University of Oslo, Oslo, Norway/NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway.
8
NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway.
9
Department of Radiology, University of California, San Diego, La Jolla, CA, USA/Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.
10
Division of Radiology & Nuclear Medicine, Oslo University Hospital, Oslo, Norway/Department of Life Sciences and Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.

Abstract

BACKGROUND::

Restriction spectrum imaging (RSI) is a recently introduced magnetic resonance imaging diffusion technique. The utility of RSI in multiple sclerosis (MS) is unknown.

OBJECTIVE::

To investigate the association between RSI-derived parameters and neurological disability in MS.

METHODS::

Seventy-seven relapsing-remitting MS patients were scanned with RSI on a 3-T scanner. RSI-derived parameters: fast and slow apparent diffusion coefficient (sADC), fractional anisotropy, restricted fractional anisotropy, neurite density (ND), cellularity, extracellular water fraction, and free water fraction, were obtained in white matter lesions (WML) and normal appearing white matter (NAWM). Patients were divided into three groups according to their expanded disability status scale (EDSS): with minimal, low, and substantial disability (<2.5, 2.5-3, and >3, respectively). Group comparisons and correlation analyses were performed.

RESULTS::

All tested RSI-derived parameters differed between WML and NAWM ( p < 0.001 for all pairwise comparisons). The sADC in WML showed largest difference across disability subgroups (analysis of variance (ANOVA): F = 5.1, η2 = 0.12, p = 0.008). ND in NAWM showed strongest correlation with disability (ϱ = -0.39, p < 0.001).

CONCLUSION::

The strongest correlation with EDSS of ND obtained in NAWM indicates that processes outside lesions are important for disability in MS. Our study suggests that RSI-derived parameters may help understand the "clinico-radiological paradox" and improve disease monitoring in MS.

KEYWORDS:

Magnetic resonance imaging; multiple sclerosis; neurite density; neurological disability; restriction spectrum imaging

PMID:
29542336
DOI:
10.1177/1352458518765671

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