Cited by 395Multiple Sclerosis Research StudiesAdvanced MRI Techniques and ApplicationsAdvanced Neuroimaging Techniques and Applications

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Magnetization transfer changes in the normal appering white matter precede the appearance of enhancing lesions in patients with multiple sclerosis

Filippi, Massimo, Rocca, Maria A., Martino, Gianvito, Horsfield, Mark A., Comi, Giancarlo·1998·Annals of Neurology

DOI 10.1002/ana.410430616

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Abstract

Serial monthly magnetization transfer (MT) imaging was performed to evaluate whether a change of the normal appearing white matter (NAWM), which precedes the appearance of enhancing lesions, is seen in patients with multiple sclerosis (MS). Every 4 weeks for 3 months, 10 patients with relapsing-remitting MS were scanned with a T1-weighted sequence, 20 minutes after injection with 0.3 mmol/kg gadolinium-DTPA (Gd-DTPA). During each of the monthly sessions, MT and dual echo scans were also performed before Gd-DTPA injection. On coregistered images, the MT ratio (MTR) was measured in NAWM subsequently involved by enhancing lesions, in NAWM areas on the same slices but outside any present or future MR abnormality, and in enhancing lesions at the time of their appearance. Forty-eight new enhancing lesions with no corresponding abnormalities on previous scans were identified. Their average MTR was 33.1% (+/-8.4%). Three, 2, and 1 month before enhancement appearance, the mean MTR in NAWM, measured from areas corresponding to future enhancing lesions, was significantly lower than the mean MTR in NAWM outside enhancing areas; the MTR decreased steadily as the time when the enhanced lesion approached. These results suggest that changes in the NAWM of patients with MS occur before lesions become evident on conventional MRI scans.

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Authors: Filippi, M., Rocca, M. A., Martino, G., Horsfield, M. A., & Comi, G.
Affiliations: University of Milan (IT)
University of Leicester (GB)
Corresponding author: Filippi, Massimo
ORCID: Filippi, Massimo
Rocca, Maria A.
Martino, Gianvito
Horsfield, Mark A.
Venue: Annals of Neurology
Publisher: Wiley
Published: 1998-06
Volume: 43
Issue: 6
Pages: 809-814
ISSN: 0364-5134 (ISSN-L)
1531-8249
DOI: 10.1002/ana.410430616
OpenAlex: W2102993505
Cited by: 395
References: 31
Citations by year: 2026: 3 · 2025: 2 · 2024: 8 · 2023: 11 · 2022: 9 · 2021: 10 · 2020: 10 · 2019: 4 · 2018: 7 · 2017: 11 · 2016: 12 · 2015: 15 · 2014: 14 · 2013: 16 · 2012: 10
FWCI: 18.79
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2321 d)
Locations: Annals of Neurology (publishedVersion)
PubMed (publishedVersion)
Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
Leicester Research Archive (University of Leicester) (submittedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
Keywords: multiple sclerosis, normal-appearing white matter, magnetization transfer ratio, enhancing lesions, lesion progression, relapsing-remitting multiple sclerosis, Gd-DTPA, white matter changes
MeSH terms: Adult, Female, Follow-Up Studies, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Magnetics, Male, Multiple Sclerosis, Myelin Sheath, Nerve Fibers, Protons, Disease Progression

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Magnetization transfer changes in the normal appering white matter precede the appearance of enhancing lesions in patients with multiple sclerosis

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