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Prof Matilde Inglese: Non-gaussian diffusion MRI allows early characterisation of tissue disruption in PPMS

Prof. Matilde Inglese-HD

Prof Inglese discusses preliminary findings of a small, ongoing study in her laboratory in patients with primary progressive MS. Poor pathological specificity limits the usefulness of conventional MRI markers in this patient population, hence many labs are searching for markers that are specific to the pathological substrate. A variant of diffusion tensor imaging MRI called diffusion kurtosis imaging allows for derivation of a matrix that is more specific to the pathological substrate. Markers include axonal water fraction, which is specific for chronic axonal damage, and the tortuosity of the extra-axonal space, which is a marker for demyelination.

While conventional diffusion tensor imaging is useful for evaluating the integrity of white-matter tracts, it is not specific for the pathological substrate. In Prof Inglese’s study, for MS patients with primary progressive MS, the axonal water fraction in the corpus callosum and the anterior thalamic radiations were significantly decreased at 1-year follow up. This is clinically meaningful as they were correlated with the Expanded Disability Status Scale (EDSS) score and the MS Functional Composite Score.

These results may help to improve our knowledge about the underlying pathological processes and improve the correlation between MRI and clinical outcomes in this challenging patient population.

The interview was recorded at the annual ECTRIMS meeting from 14-17 September 2016 in London, United Kingdom.

Professor Matilde Inglese, Neurology, Radiology and Neuroscience, Mount Sinai School of Medicine NY USA.