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Validation of rapid magnetic resonance myelin imaging in multiple sclerosis

Russell Ouellette, Gabriel Mangeat, Ildiko Polyak, Marcel Warntjes, Yngve Forslin, Åsa Bergendal, Michael Plattén, Martin Uppman, Constantina Andrada Treaba, Julien Cohen-Adad, Fredrik Piehl, Maria Kristoffersen Wiberg, Sten Fredrikson, Caterina Mainero and Tobias Granberg

Article (2020)

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Abstract

Objective Magnetic resonance imaging (MRI) is essential for multiple sclerosis diagnostics but is conventionally not specific to demyelination. Myelin imaging is often hampered by long scanning times, complex postprocessing, or lack of clinical approval. This study aimed to assess the specificity, robustness, and clinical value of Rapid Estimation of Myelin for Diagnostic Imaging, a new myelin imaging technique based on time-efficient simultaneous T1/T2 relaxometry and proton density mapping in multiple sclerosis.

Methods Rapid myelin imaging was applied using 3T MRI ex vivo in 3 multiple sclerosis brain samples and in vivo in a prospective cohort of 71 multiple sclerosis patients and 21 age/sex-matched healthy controls, with scan–rescan repeatability in a subcohort. Disability in patients was assessed by the Expanded Disability Status Scale and the Symbol Digit Modalities Test at baseline and 2-year follow-up.

Results Rapid myelin imaging correlated with myelin-related stains (proteolipid protein immunostaining and Luxol fast blue) and demonstrated good precision. Multiple sclerosis patients had, relative to controls, lower normalized whole-brain and normal-appearing white matter myelin fractions, which correlated with baseline cognitive and physical disability. Longitudinally, these myelin fractions correlated with follow-up physical disability, even with correction for baseline disability.

Interpretation Rapid Estimation of Myelin for Diagnostic Imaging provides robust myelin quantification that detects diffuse demyelination in normal-appearing tissue in multiple sclerosis, which is associated with both cognitive and clinical disability. Because the technique is fast, with automatic postprocessing and US Food and Drug Administration/CE clinical approval, it can be a clinically feasible biomarker that may be suitable to monitor myelin dynamics and evaluate treatments aiming at remyelination. ANN NEUROL 2020;87:710–724

Subjects: 1900 Biomedical engineering > 1900 Biomedical engineering
1900 Biomedical engineering > 1901 Biomedical technology
Department: Department of Electrical Engineering
Institut de génie biomédical
Research Center: NeuroPoly - Laboratoire de Recherche en Neuroimagerie
Funders: Stockholm Region and Karolinska Institutet, MultipleMS, COMBAT-MS, Swedish Society for Medical Research, Christer Lindgren and Eva Fredholm Foundation
Grant number: ALF grants 20120213, ALF grants 20150166, ALF grants 20170036, CIMED junior grant 20190565, EU Horizon 2020 grant 733161, Patient-Centered Outcomes Research Institute grant MS-1511–33196
PolyPublie URL: https://publications.polymtl.ca/45373/
Journal Title: Movement Disorders (vol. 87, no. 5)
Publisher: Wiley Blackwell
DOI: 10.1002/ana.25705
Official URL: https://doi.org/10.1002/ana.25705
Date Deposited: 18 Apr 2023 15:01
Last Modified: 01 Oct 2024 13:09
Cite in APA 7: Ouellette, R., Mangeat, G., Polyak, I., Warntjes, M., Forslin, Y., Bergendal, Å., Plattén, M., Uppman, M., Treaba, C. A., Cohen-Adad, J., Piehl, F., Kristoffersen Wiberg, M., Fredrikson, S., Mainero, C., & Granberg, T. (2020). Validation of rapid magnetic resonance myelin imaging in multiple sclerosis. Movement Disorders, 87(5), 710-724. https://doi.org/10.1002/ana.25705

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