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Normal Appearing Brain Matter Not Spared By Disease In Primary Progressive Multiple Sclerosis

Magnetic resonance imaging (MRI) reveals that normal appearing white and gray matter are affected by disease in patients with primary progressive multiple sclerosis.

Diffusion-tensor MRI is more sensitive to disease-related pathological processes occurring both inside and outside of visible lesions when compared with conventional MRI, explain investigators. This makes it a promising method for evaluating tissue damage related to primary progressive multiple sclerosis.

The investigators, from multiple Italian institutions including the Scientific Institute and University Ospedale San Raffaele and the University of Milan in Milan, used diffusion tensor MRI to study 96 patients with primary progressive multiple sclerosis, 47 patients with secondary progressive multiple sclerosis and 44 healthy controls.

Absolute brain volumes were found to be similar between the two multiple sclerosis groups, however, T2-hyperintense and T1-hypointense lesion volumes were lower in primary versus secondary progressive multiple sclerosis. Also, the average lesion diffusivity was higher in secondary progressive multiple sclerosis patients.

Patients with primary progressive multiple sclerosis showed significantly different fractional anisotropy histogram-derived metrics of total brain tissue and of isolated gray and white matter compared with healthy controls.

Histogram-derived quantities did not differ significantly between the two multiple sclerosis groups.

The investigators conclude that normal appearing gray and white matter are not spared from the pathological processes of disease in primary progressive multiple sclerosis.
Arch Neurol 2002; 59: 1406-1412 "Assessment of Normal-Appearing White and Gray Matter in Patients With Primary Progressive Multiple Sclerosis"

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