Original Research

Relationships of brain white matter microstructure with clinical and MR measures in relapsing-remitting multiple sclerosis

  1. Antonio Giorgio MD1,2,
  2. Jacqueline Palace MD3,
  3. Heidi Johansen-Berg PhD1,
  4. Stephen M. Smith PhD1,
  5. Stefan Ropele PhD4,
  6. Siegrid Fuchs MD4,
  7. Mirja Wallner-Blazek MD4,
  8. Christian Enzinger MD4,
  9. Franz Fazekas MD4,*

Article first published online: 23 JAN 2010

DOI: 10.1002/jmri.22062

Issue

Journal of Magnetic Resonance Imaging

Journal of Magnetic Resonance Imaging

Volume 31, Issue 2, pages 309–316, February 2010

Additional Information

How to Cite

Giorgio, A., Palace, J., Johansen-Berg, H., Smith, S. M., Ropele, S., Fuchs, S., Wallner-Blazek, M., Enzinger, C. and Fazekas, F. (2010), Relationships of brain white matter microstructure with clinical and MR measures in relapsing-remitting multiple sclerosis. J. Magn. Reson. Imaging, 31: 309–316. doi: 10.1002/jmri.22062

Author Information

  1. 1

    Centre for Functional MRI of the Brain, University of Oxford, Oxford, UK

  2. 2

    Neurology and Neurometabolic Unit, Department of Neurological and Behavioural Sciences, University of Siena, Italy

  3. 3

    John Radcliffe Hospital Department of Clinical Neurology, Oxford, UK

  4. 4

    Department of Neurology, Medical University of Graz, Graz, Austria

*Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036 Graz, Austria

Publication History

  1. Issue published online: 23 JAN 2010
  2. Article first published online: 23 JAN 2010
  3. Manuscript Accepted: 20 NOV 2009
  4. Manuscript Received: 20 JUL 2009

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Keywords:

  • multiple sclerosis;
  • clinical disability;
  • diffusion tensor imaging;
  • tract-based spatial statistics;
  • lesions

Abstract

Purpose:

To assess the relationships of microstructural damage in the cerebral white matter (WM), as measured by diffusion tensor imaging (DTI), with clinical parameters and magnetic resonance imaging (MRI) measures of focal tissue damage in patients with multiple sclerosis (MS).

Materials and Methods:

Forty-five relapsing-remitting (RR) MS patients (12 male, 33 female; median age = 29 years, Expanded Disability Status Scale (EDSS) = 1.5, disease duration = 3 years) were studied. T2-lesion masks were created and voxelwise DTI analyses performed with Tract-Based Spatial Statistics (TBSS).

Results:

T2-lesion volume (T2-LV) was significantly (P < 0.05, corrected) correlated with fractional anisotropy (FA) in both lesions and normal-appearing WM (NAWM). Relationships (P = 0.08, corrected) between increasing EDSS score and decreasing FA were found in the splenium of the corpus callosum (sCC) and along the pyramidal tract (PY). All FA associations were driven by changes in the perpendicular (to primary tract direction) diffusivity. No significant global and voxelwise FA changes were found over a 2-year follow-up.

Conclusion:

FA changes related to clinical disability in RR-MS patients with minor clinical disability are localized to specific WM tracts such as the sCC and PY and are driven by changes in perpendicular diffusivity both within lesions and NAWM. Longitudinal DTI measurements do not seem able to chart the early disease course in the WM of MS patients. Imaging 2010; 31:309–316. © 2010 Wiley-Liss, Inc.

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