Feasibility of diffusion kurtosis imaging in evaluating cervical spinal cord injury in multiple sclerosis

Medicine, 2023 · DOI: http://dx.doi.org/10.1097/MD.0000000000034205 · Published: July 21, 2023

Simple Explanation

This study investigates the use of diffusion kurtosis imaging (DKI) to assess spinal cord damage in multiple sclerosis (MS) patients. DKI is a type of MRI that can detect subtle changes in the structure of the spinal cord. The study compares DKI measurements in MS patients with and without visible lesions on standard MRI, as well as with healthy individuals, to see if DKI can identify damage not seen on regular MRI scans. The researchers also looked at whether DKI measurements correlate with the severity of disability in MS patients, as measured by the Expanded Disability Status Scale (EDSS).

Study Duration

January 2018 to October 2019

Participants

78 subjects (48 MS patients, 30 healthy controls)

Evidence Level

Observational Study

Key Findings

1
DKI metrics showed significant differences between MS patients and healthy controls, indicating microstructural damage in the spinal cord of MS patients.
2
Significant differences in DKI metrics were observed between MS patients with and without T2-hyperintense lesions, suggesting that DKI can detect damage even in the absence of visible lesions.
3
The study found correlations between Expanded Disability Status Scale (EDSS) scores and specific DKI metrics, indicating that DKI measurements may reflect the severity of clinical disability in MS patients.

Research Summary

This study assessed the feasibility of using diffusion kurtosis imaging (DKI) to evaluate cervical spinal cord (CSC) injury in multiple sclerosis (MS) patients. The researchers compared DKI metrics in MS patients and healthy controls. The results showed significant differences in DKI metrics between MS patients and healthy controls, as well as between patients with and without T2-hyperintense lesions. This indicates that DKI can detect microstructural changes in the CSC of MS patients, even when standard MRI shows no visible lesions. Furthermore, the study found correlations between DKI metrics and the Expanded Disability Status Scale (EDSS) score, suggesting that DKI can be used to monitor disease progression and therapeutic response in MS patients.

Practical Implications

Improved Diagnosis

DKI can potentially improve the early detection of spinal cord damage in MS, even before visible lesions appear on conventional MRI.

Monitoring Disease Progression

DKI metrics correlate with clinical disability scores, offering a quantitative way to track disease progression and treatment response.

Therapeutic Assessment

Changes in DKI metrics after therapy suggest that DKI can be used to assess the effectiveness of treatments aimed at preserving or restoring spinal cord microstructure.

Study Limitations

1
The number of MS patients was low and not selected according to MS phenotypes.
2
The FA and MD estimated inside DKI framework may be more accurate in Thaler’s study, which is what we need to improve in the future.
3
Future longitudinal studies are warranted to examine whether the current approach could be used to monitor the disease progression of MS.

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