Neurodegeneration in Multiple Sclerosis by E. Capello, A. Uccelli, M. Pizzorno, G.L. Mancardi (auth.),

By E. Capello, A. Uccelli, M. Pizzorno, G.L. Mancardi (auth.), Massimo Filippi, Marco Rovaris, Giancarlo Comi (eds.)

In a number of sclerosis (MS), traditional magnetic resonance imaging (cMRI) has proved to be a worthy device to extend diagnostic reliability and to watch the efficacy of experimental therapy. although, cMRI has restricted specificity and accuracy as to the main disabling points of the MS pathology, identified to ensue in and out of doors macroscopic lesions. glossy quantitative MR strategies have the aptitude to beat the constraints of cMRI, and their software is dramatically altering our realizing of the way MS motives irreversible incapacity. Written by means of world-renowned scientists, the amount is crucial for anyone operating during this field.

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This may reflect the nature of the EDSS as a measure of disability weighted towards lower limb function, and thus perhaps more directly influenced by cord pathology, while regional brain atrophy may in part result in deficits in cognition [103] and fatigue [104]. Newer treatment approaches will hopefully seek to address these distressing symptoms, and will almost certainly require quantitative outcome measures to evaluate their efficacy. Both brain and cord imaging techniques are increasingly readily available, and accuracy of analysis is improving.

The earliest estimations of cross-sectional cord area required manual outlining on axial images, usually at the level of C5 generated by a two-dimensional gradient echo sequence [66, 71]. The large degree of operator input impacted negatively on reproducibility. With improved volume sequences (3D-FSPGR), a semi-automated measurement technique was developed using images reformatted with slices perpendicular to the cord at the level of C2/3 [70]. The technique is based on the differing signal intensity signatures exhibited by cord tissue and CSF.

Histopathologic Correlate of MT-MRI Changes There are several lines of evidence suggesting that a marked reduction in MTR values in MS lesions indicates severe tissue damage [3-5]. Axonal loss is likely to be an important contributor to MTR decreases in MS for several reasons. First, in a post-mortem study, MTR reduction in both lesions and normal-appearing white matter (NAWM) was correlated with the percentage of residual axons and the degree of demyelination [5]. Second, MTR reduction has been found to correlate well with the ratio of N-acetylaspartate to creatine (an accepted marker of neuro-axonal integrity and viability) measured in MS lesions [6].

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