Spinal cord fibre density in MS

EpubUkmar et al. Fiber density index in the evaluation of the spinal cord in patients with multiple sclerosis. Radiol Med. 2012 Jun 28.

PURPOSE: The aims of this study were to determine fractional anisotropy (FA) and the fibre density index (FDi) in the cervical spinal cord of MSers by using diffusion-tensor magnetic resonance imaging (DT-MRI) to identify possible differences between MS patients and controls.

DT-MRI is a MRI method to assess the integrity of nerve fibres.

MATERIALS AND METHODS: They studied 27 MSers – 9 with primary progressive (PPMS), 9 with secondary progressive (SPMS) and 9 with relapsing-remitting (RRMS) disease – and 18 healthy individuals as controls. Conventional and DTI sequences with diffusion gradients applied in 32 directions were obtained. The results were compared between healthy controls and MSers, between healthy controls and individual forms of MS and between the three forms of MS. Statistical analysis was performed by analysis of variance (ANOVA) and Student’s t test.

RESULTS: The FDi in the three subgroups of patients and in controls showed a statistically significant difference. Using the t test, they found results from both PPMS and SPMS groups were different from controls. The correlation between FA and FDi was significant both in healthy controls and in MSers evaluated as a single group. 

CONCLUSIONS: Despite the small group of MSers, these findings suggest that FDi associated with FA is a sensitive parameter for assessing spinal cord damage in patients with MS.

“This study simply shows that by using a technique to assess axonal integrity you can see differences between MSers and controls and MSers with different types of MS. Why is this important? It may allow us to use these methods to assess pre-existing damage in the spinal cord of MSers before and after treatments targeting recovery mechanisms. The question is whether of not DT-MRI is good enough in terms of its metric to be used in clinical trials. Let us watch this space.”

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