Clinical and imaging metrics for monitoring disease progression in patients with multiple sclerosis

Abstract

Multiple sclerosis (MS) is an autoimmune disease of the CNS leading to clinical disability in 250,000–350,000 young adults in the USA and Europe. The disease affects both white matter (WM) and gray matter (GM) tissues of the brain and spinal cord. While WM disease is easily quantified using currently available magnetic resonance imaging (MRI) techniques, identification and quantification of GM disease present a daily challenge. Nonconventional brain and spinal cord MRI techniques, including magnetization transfer, MRI spectroscopy and diffusion tensor imaging, have improved our understanding of MS pathology in the deep GM. The sensitivity of high-resolution MRI obtained at a high magnetic field will improve the detection of spinal cord and brain cortical GM disease. The appropriate use of the above-mentioned techniques has the potential to more accurately explain the level of disability in MS patients.

Keywords::

• expanded disability status scale
• gray matter
• magnetic resonance imaging
• multiple sclerosis
• white matter

Acknowledgements

Licia Finamore (Figure 1), Lukas Pezawas and John Butman (Figure 2) are acknowledged for postprocessing analysis of the data presented in the paper. The authors are grateful to Fernanda Tovar-Moll for her support in image acquisitions on the 3 T magnet (Figure 3). The authors thank to Stefano Bastianello for his support in spinal cord image acquisitions on the 1.5 T magnet (Figure 4). Patients whose images appear are gratefully acknowledged for their kindness in allowing the authors to present their images.