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Semin Neurol 2016; 36(02): 163-176
DOI: 10.1055/s-0036-1579737
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Advanced Structural and Functional Brain MRI in Multiple Sclerosis

Antonio Giorgio
1   Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
,
Nicola De Stefano
1   Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
› Author Affiliations
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Publication History

Publication Date:
26 April 2016 (online)

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Abstract

Conventional magnetic resonance imaging (MRI) of the central nervous system is crucial for an early and reliable diagnosis and monitoring of patients with multiple sclerosis (MS). Focal white matter (WM) lesions, as detected by MRI, are the pathological hallmark of the disease and show some relation to clinical disability, especially in the long run. Gray matter (GM) involvement is evident from disease onset and includes focal (i.e., cortical lesions) and diffuse pathology (i.e., atrophy). Both accumulate over time and show close relation to physical disability and cognitive impairment. Using advanced quantitative MRI techniques such as magnetization transfer imaging (MTI), diffusion tensor imaging (DTI), proton MR spectroscopy (1H-MRS), and iron imaging, subtle MS pathology has been demonstrated from early stages outside focal WM lesions in the form of widespread abnormalities of the normal appearing WM and GM. In addition, studies using functional MRI have demonstrated that brain plasticity is driven by MS pathology, playing adaptive or maladaptive roles to neurologic and cognitive status and explaining, at least in part, the clinicoradiological paradox of MS.

Keywords

multiple sclerosis - magnetic resonance imaging lesions - normal-appearing brain - atrophy - magnetization transfer - diffusion tensor imaging - proton magnetic resonance spectroscopy - iron - susceptibility weighted imaging - functional magnetic resonance imaging - resting state networks - brain connectivity - high-field magnetic resonance imaging - demyelination - neurodegeneration
 

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