Visualizing Peripheral Nerve Involvement in MS With Magnetic Resonance Neurography

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Compared with controls, MS patients had higher nerve proton-spin-density.
Compared with controls, MS patients had higher nerve proton-spin-density.

HealthDay News — Patients with multiple sclerosis (MS) have peripheral nerve involvement that can be visualized and quantified by high-resolution magnetic resonance neurography (MRN), according to a study published online in the Annals of Neurology.

Johann M.E. Jende, MD, from Heidelberg University Hospital in Germany, and colleagues compared 36 patients diagnosed with MS with and without disease-modifying treatment to 35 healthy age- and sex-matched volunteers. All patients underwent detailed neurological and electrophysiological examinations, and 3 Tesla MRN was performed.

The researchers found that all MS patients had T2w-hyperintense nerve lesions, with a mean lesion number at thigh level of 151.5±5.7 vs 19.1±2.4 in controls. Compared with controls, MS patients had higher nerve proton-spin-density (tibial/peroneal: 371.8±7.7/368.9±8.2 vs 266±11/276.8±9.7). 

Controls had significantly higher T2-relaxation time (tibial/peroneal: 82±2.1/78.3±1.7 vs 64.3±1/61.2±0.9). Compared with controls, MS patients had higher proximal tibial (52.4±2.1 vs 45.2±1.4 mm²) and peroneal nerve caliber (25.4±1.3 vs  21.3±0.7 mm²).

"Peripheral nerve lesions could be visualized and quantified in MS in vivo by high-resolution MRN," the authors write. "By showing involvement of the peripheral nervous system in MS, this proof-of-concept study may offer new insights into the pathophysiology and treatment of MS."

Alnylam Pharmaceuticals partially funded the study, and one author disclosed financial ties to Siemens Healthcare.

Reference

Jende JME, Hauck GH, Diem R, et al. Peripheral nerve involvement in multiple sclerosis: Demonstration by magnetic resonance neurography [published online Ocotber 10, 2017]. Ann Neurol. doi:10.1002/ana.25068



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