Lesion features on magnetic resonance imaging discriminate multiple sclerosis patients.

TitleLesion features on magnetic resonance imaging discriminate multiple sclerosis patients.
Publication TypeJournal Article
Year of Publication2022
AuthorsRúa SMHurtado, Kaunzner UW, Pandya S, Sweeney E, Tozlu C, Kuceyeski A, Nguyen TD, Gauthier SA
JournalEur J Neurol
Date Published2022 Jan
KeywordsBrain, Humans, Magnetic Resonance Imaging, Multiple Sclerosis, Multiple Sclerosis, Chronic Progressive, Multiple Sclerosis, Relapsing-Remitting, Myelin Sheath

BACKGROUND: Magnetic resonance imaging (MRI) provides insight into various pathological processes in multiple sclerosis (MS) and may provide insight into patterns of damage among patients.

OBJECTIVE: We sought to determine if MRI features have clinical discriminative power among a cohort of MS patients.

METHODS: Ninety-six relapsing remitting and seven progressive MS patients underwent myelin water fraction (MWF) imaging and conventional MRI for cortical thickness and thalamic volume. Patients were clustered based on lesion level MRI features using an agglomerative hierarchical clustering algorithm based on principal component analysis (PCA).

RESULTS: One hundred and three patients with 1689 MS lesions were analyzed. PCA on MRI features demonstrated that lesion MWF and volume distributions (characterized by 25th, 50th, and 75th percentiles) accounted for 87% of the total variability based on four principal components. The best hierarchical cluster confirmed two distinct patient clusters. The clustering features in order of importance were lesion median MWF, MWF 25th, MWF 75th, volume 75th percentiles, median individual lesion volume, total lesion volume, cortical thickness, and thalamic volume (all p values <0.01368). The clusters were associated with patient Expanded Disability Status Scale (EDSS) (n = 103, p = 0.0338) at baseline and at 5 years (n = 72, p = 0.0337).

CONCLUSIONS: These results demonstrate that individual MRI features can identify two patient clusters driven by lesion-based values, and our unique approach is an analysis blinded to clinical variables. The two distinct clusters exhibit MWF differences, most likely representing individual remyelination capabilities among different patient groups. These findings support the concept of patient-specific pathophysiological processes and may guide future therapeutic approaches.

Alternate JournalEur J Neurol
PubMed ID34402140
PubMed Central IDPMC8727028
Grant ListR01 NS104283 / NS / NINDS NIH HHS / United States
R21 NS104634 / NS / NINDS NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States

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