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Diffusion tensor imaging in multiple sclerosis at different final outcomes

Journal article
Authors Oluf Andersen
Anders Hildeman
Marco Longfils
Helen Tedeholm
Bengt Skoog
Wei Tian
Jianhui Zhong
Sven Ekholm
Lenka Novakova
Björn Runmarker
Olle Nerman
Stephan E Maier
Published in Acta Neurologica Scandinavica
Volume 137
Issue 2
Pages 165–173
ISSN 0001-6314
Publication year 2018
Published at Department of Mathematical Sciences
Institute of Neuroscience and Physiology
Department of Mathematical Sciences, Applied Mathematics and Statistics
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Institute of Clinical Sciences, Department of Radiology
Institute of Clinical Sciences
Pages 165–173
Language en
Keywords axial diffusivity, diffusion tensor imaging, fractional anisometropy, magnetic resonance imaging, multiple sclerosis, radial diffusivity, relapsing-remitting phase, secondary progressive phase
Subject categories Neurology


Objectives: Methods to evaluate the relative contributions of demyelination vs axonal degeneration over the long-term course of MS are urgently needed. We used magnetic resonance diffusion tensor imaging (DTI) to estimate degrees of demyelination and axonal degeneration in the corpus callosum (CC) in cases of MS with different final outcomes. Materials and methods: We determined DTI measures mean diffusivity (MD), fractional anisotropy (FA), and axial (AD) and radial (RD) diffusivities in the CC of 31 MS patients, of whom 13 presented a secondary progressive course, 11 a non-progressive course, and seven a monophasic course. The study participants were survivors from an incidence cohort of 254 attack-onset MS patients with 50 years of longitudinal follow- up. As reference, we included five healthy individuals without significant morbidity. Results: In patients with secondary progression, compared to all other groups, the corpus callosum showed increased RD and reduced FA, but no change in AD. None of the parameters exhibited differences among non-progressive and monophasic course groups and controls. Conclusion: Increased RD was observed in secondary progressive MS, indicating significant myelin loss. Normal RD values observed in the clinically isolated syndrome and non-progressive groups confirm their benign nature. AD was not a characterizing parameter for long-term outcome. Demyelination revealed by increased RD is a distinguishing trait for secondary progression.

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