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Title of Journal: J Neurol

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Abbravation: Journal of Neurology

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Springer Berlin Heidelberg

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ISSN

1432-1459

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Tissue damage within normal appearing white matter

Authors: A Beer V Biberacher P Schmidt R Righart D Buck A Berthele J Kirschke C Zimmer B Hemmer M Mühlau
Publish Date: 2016/05/13
Volume: 263, Issue: 8, Pages: 1495-1502
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Abstract

Histopathological and magnetic resonance imaging MRI studies have shown white matter WM damage in early stages of multiple sclerosis MS beyond the apparent T2hyperintense lesions These changes in normal appearing WM NAWM are important with regard to the clinical picture and prognosis However the detection of changes within NAWM has so far required special imaging techniques commonly not available in clinical routine and hence at large scale The purpose of this study was to detect MSrelated damage of NAWM by conventional MRI As within NAWM the myelin content mainly drives the T1weighted T1w signal we scaled it by the T2w signal We tested the hypothesis that the mean T1w/T2w ratio of NAWM is decreased in MS compared to healthy controls HC and that it correlates with clinical measures We developed a pipeline to determine the individual mean values of this ratio within NAWM We studied 244 patients in early disease stages of MS mean age 37 ± 10 years mean disease duration 31 ± 23 Expanded Disability Status Scale 13 ± 1 and 78 HC mean age 31 ± 8 years Compared to HC the mean T1w/T2w ratio was lowered in the patient group P  0001 The difference remained significant after restricting the analysis to patients with a disease duration of 5 years or less and without disease modifying drugs Our measures also correlated with clinical scores We believe that the mean T1w/T2w ratio is a promising candidate to assess MSrelated tissue damage within NAWM at large scale

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