Recovery after spinal cord relapse in multiple sclerosis is predicted by radial diffusivity

Multiple Sclerosis, 2010 · DOI: 10.1177/1352458510376180 · Published: January 1, 2010

Spinal Cord Injury Neuroimaging Neurology

Simple Explanation

This study investigates how changes in the spinal cord's microstructure, specifically using measures called radial diffusivity (RD) and axial diffusivity (AD), relate to the clinical recovery of patients with multiple sclerosis (MS) after a spinal cord relapse. The study found that lower RD in the cortico-spinal tract (CST) at the beginning of the study was linked to better clinical recovery. As patients got better, their RD in the CST decreased more than in healthy controls. The findings suggest that RD may reflect processes in the spinal cord, like the reduction of inflammation and the repair of myelin (the protective layer around nerve fibers), which contribute to clinical improvement in MS.

Study Duration

6 months

Participants

14 MS patients and 13 age-matched healthy controls

Evidence Level

Not specified

Key Findings

1
Lower baseline radial diffusivity (RD) in the cortico-spinal tract (CST) predicts better clinical outcomes in MS patients after a spinal cord relapse.
2
Patients who showed clinical improvement during the follow-up period experienced a greater decrease in RD of the CST compared to healthy controls.
3
Higher baseline fractional anisotropy (FA) of the mean lateral CST-ROI also predicted better outcome

Research Summary

The study aimed to determine if diffusion tensor imaging (DTI) measures, radial diffusivity (RD) and axial diffusivity (AD), in the cortico-spinal tract (CST) can predict clinical recovery after a spinal cord relapse in multiple sclerosis (MS) patients. The study found that lower RD in the CST at baseline was associated with better clinical outcome, and patients who improved clinically showed a greater decrease in RD compared to controls. The conclusions suggest that RD reflects spinal cord pathological processes, such as resolution of inflammation and remyelination, contributing to clinical recovery in MS, and may be useful in trials promoting recovery after spinal cord injury.

Practical Implications

Clinical Trials

Radial diffusivity could be used as a marker in clinical trials evaluating therapies that promote recovery after spinal cord injury.

Understanding MS Pathology

The study enhances understanding of the pathological processes, such as inflammation resolution and remyelination, that contribute to clinical recovery in MS.

Application to Other Diseases

The findings suggest that investigations of spinal cord RD could be extended to other neurological diseases affecting the spinal cord.

Study Limitations

1
The study could not investigate the association between lesion location and the diffusion indices
2
Differentiation of lesional tissue from the normal-appearing white matter was not possible on the diffusion maps.
3
The exact correspondence between the reconstructed tracts and the real pathways cannot be confirmed as convincingly as in animals

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