Research Article| Volume 276, ISSUE 1-2, P49-53, January 15, 2009

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Longitudinal changes in myelin water fraction in two MS patients with active disease


      Multiple sclerosis (MS) is characterised by focal areas that undergo cycles of demyelination and remyelination. Although conventional magnetic resonance imaging is very effective in localising areas of damage, these techniques are not pathology specific. A newer technique, T2 relaxation, can separate water from brain into three compartments: (1) a long T2 component (>2 s) arising from CSF, (2) an intermediate T2 component (~80 ms) attributed to intra- and extra-cellular water and (3) a short T2 component (~20 ms) assigned to water trapped in between the myelin bilayers (termed myelin water). Histological evidence shows that myelin water is a specific marker of myelination. The goal of this work was to follow changes in total water content (WC) and myelin water fraction (MWF) in evolving MS lesions over one year. Multi-echo T2 relaxation data was collected and used to measure water content and myelin water fraction from three new MS lesions in two patients. WC increased in the three large (>1 cm3) lesions at lesion appearance and remained elevated in the central core. Two lesions showed low MWF in the core suggesting demyelination upon first appearance. At later time points, one lesion showed a decrease in volume of low MWF, reflecting remyelination whereas the volume of low MWF in the other lesion core remained constant. This work provides evidence that MWF and WC can monitor demyelination and remyelination in MS.


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        • Moore G.R.W.
        Neuropathology and pathophysiology of the multiple sclerosis lesion.
        in: Paty D. Ebers G.C. Multiple sclerosis. F.A. Davis, Philadelphia1998
        • Willoughby E.W.
        • Grochowski E.
        • Li D.K.
        • Oger J.
        • Kastrukoff L.F.
        • Paty D.W.
        Serial magnetic resonance scanning in multiple sclerosis: a second prospective study in relapsing patients.
        Ann Neurol. 1989; 25: 43-49
        • MacKay A.
        • Whittall K.
        • Adler J.
        • Li D.
        • Paty D.
        • Graeb D.
        In vivo visualization of myelin water in brain by magnetic resonance.
        Magn Reson Med. 1994; 31: 673-677
        • Whittall K.P.
        • MacKay A.L.
        • Graeb D.A.
        • Nugent R.A.
        • Li D.K.
        • Paty D.W.
        In vivo measurement of T2 distributions and water contents in normal human brain.
        Magn Reson Med. 1997; 37: 34-43
        • Menon R.S.
        • Allen P.S.
        Application of continuous relaxation time distributions to the fitting of data from model systems and excised tissue.
        Magn Reson Med. 1991; 20: 214-227
        • Vasilescu V.
        • Katona E.
        • Simplaceanu V.
        • Demco D.
        Water compartments in the myelinated nerve. III. Pulsed NMR results.
        Experientia. 1978; 34: 1443-1444
        • Vavasour I.M.
        • Whittall K.P.
        • Li D.K.
        • MacKay A.L.
        Different magnetization transfer effects exhibited by the short and long T(2) components in human brain.
        Magn Reson Med. 2000; 44: 860-866
        • Laule C.
        • Leung E.
        • Lis D.K.
        • Traboulsee A.L.
        • Paty D.W.
        • MacKay A.L.
        • et al.
        Myelin water imaging in multiple sclerosis: quantitative correlations with histopathology.
        Mult Scler. 2006; 12: 747-753
        • Laule C.
        • Vavasour I.M.
        • Moore G.R.W.
        • Oger J.
        • Li D.K.B.
        • Paty D.W.
        • et al.
        Water content and myelin water fraction in multiple sclerosis: a T2 relaxation study.
        J Neurol. 2004; 251: 284-293
        • Vavasour I.M.
        • Whittall K.P.
        • MacKay A.L.
        • Li D.K.
        • Vorobeychik G.
        • Paty D.W.
        A comparison between magnetization transfer ratios and myelin water percentages in normals and multiple sclerosis patients.
        Magn Reson Med. 1998; 40: 763-768
        • Tozer D.J.
        • Davies G.R.
        • Altmann D.R.
        • Miller D.H.
        • Tofts P.S.
        Correlation of apparent myelin measures obtained in multiple sclerosis patients and controls from magnetization transfer and multicompartmental T2 analysis.
        Magn Reson Med. 2006; 53: 1415-1422
        • Oh J.
        • Han E.T.
        • Lee M.C.
        • Nelson S.J.
        • Pelletier D.
        Multislice brain myelin water fractions at 3T in multiple sclerosis.
        J Neuroimaging. 2007; 17: 156-163
        • Poser C.M.
        • Paty D.W.
        • Scheinberg L.
        • McDonald W.I.
        • Davis F.A.
        • Ebers G.C.
        • et al.
        New diagnostic criteria for multiple sclerosis: guidelines for research protocols.
        Ann Neurol. 1983; 13: 227-231
        • Whittall K.P.
        • MacKay A.L.
        Quantitative interpretation of NMR relaxation data.
        J Magn Reson. 1989; 84: 64-71
        • Webb S.
        • Munro C.A.
        • Midha R.
        • Stanisz G.J.
        Is multicomponent T2 a good measure of myelin content in peripheral nerve?.
        Magn Reson Med. 2003; 49: 638-645
        • Trapp B.D.
        • Peterson J.
        • Ransohoff R.M.
        • Rudick R.
        • Mork S.
        • Bo L.
        Axonal transection in the lesions of multiple sclerosis.[see comment].
        N Engl J Med. 1998; 338: 278-285
        • Filippi M.
        • Rocca M.A.
        • Martino G.
        • Horsfield M.A.
        • Comi G.
        Magnetization transfer changes in the normal appearing white matter precede the appearance of enhancing lesions in patients with multiple sclerosis.
        Ann Neurol. 1998; 43: 809-814
        • Narayana P.A.
        • Doyle T.J.
        • Lai D.
        • Wolinsky J.S.
        Serial proton magnetic resonance spectroscopic imaging, contrast-enhanced magnetic resonance imaging, and quantitative lesion volumetry in multiple sclerosis.
        Ann Neurol. 1998; 43: 56-71