Multimodal imaging assessment of neurodegeneration and neuroplasticity in multiple sclerosis

Tavazzi, Eleonora (2022) Multimodal imaging assessment of neurodegeneration and neuroplasticity in multiple sclerosis. Doctoral thesis, University of East Anglia.

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Background The advent of advanced magnetic resonance imaging (MRI) techniques has allowed to study multiple sclerosis (MS) evolution over time, providing qualitative information and quantitative measures related to tissue damage. However some relevant questions remain unanswered, mainly concerning a better definition of structural and functional features of disease progression as well as the identification of causal factors for disease evolution over time

Aims to characterize different aspects of disease progression, by applying a multimodal imaging approach.

Methods Together with traditional measures of lesion volumes, such as T1-weighted and T2-weighted lesion loads, and of global and regional brain volumes, we applied: quantitative susceptibility mapping (QSM) to quantify iron; diffusion tensor imaging (DTI) to analyze microstructural tissue properties; functional MRI (fMRI) to analyze activity pattern in response to a motor task; resting state fMRI to analyze functional connectivity within regions of interest; optical coherence tomography (OCT) to evaluate the usefulness of an alternative imaging technique in the study of neuroaxonal damage

Results We showed that disease progression is related to iron dyshomeostasis in deep grey matter structures. We confirmed the usefulness of a novel MRI marker such as atrophied T2-LV, reflecting both lesion accrual and simultaneously occurring irreversible tissue loss. Moreover, we confirmed the role of sNfL and OCT measures as markers reflective of neuroaxonal degeneration. Finally, we analyzed the effect of motor rehabilitation on clinical and MRI markers, supporting its usefulness as a non-pharmacological treatment able to impact on disability.

Discussion/Conclusions The findings here reported highlight that MS disease progression cannot be properly characterized using conventional radiological imaging, or even a single advanced neuroimaging modality. Only the combination of structural and functional MRI techniques investigating complementary aspects of MS-related pathogenetic mechanisms can lead to a better understanding of disease progression.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: Kitty Laine
Date Deposited: 15 Feb 2023 14:56
Last Modified: 15 Feb 2023 14:56

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