Evolution of peripheral nerve changes in early multiple sclerosis-a longitudinal MR neurography study.

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system. Increasing evidence indicates additional peripheral nerve involvement in early and chronic disease stages. To investigate the evolution of peripheral nerve changes in patients first diagnosed with MS using quantitative MR neurography. This prospective study included 19 patients with newly diagnosed MS according to the revised McDonald criteria (16 female, mean 30.2 ± 7.1 years) and 19 age-/sex-matched healthy volunteers. High-resolution 3 T MR neurography of the sciatic nerve using a quantitative T2-relaxometry sequence was performed, which yielded the biomarkers of T2 relaxation time (T2app) and proton spin density (PSD). Follow-up scans of patients were performed after median of 12 months (range 7-16). Correlation analyses considered clinical symptoms, intrathecal immunoglobulin synthesis, nerve conduction study, and lesion load on brain and spine MRI. Patients showed increased T2app and decreased PSD compared to healthy controls at initial diagnosis and follow-up ( Peripheral nerve involvement in MS appears at initial diagnosis and continues to evolve within 1 year follow-up with individual dynamics. Quantitative MRN provides non-invasive biomarkers to detect and monitor peripheral nerve changes in MS.

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Copyright © 2024 Foesleitner, Hayes, Weiler, Sam, Wildemann, Wick, Bendszus, Heiland and Jäger.

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The author(s) declare financial support was received for the research, authorship, and/or publication of this article. OF was supported by the Rahel Goitein-Straus research grant and the Physician-Scientist fellowship of the Medical Faculty of the University of Heidelberg. SH and GS (SFB 1118), MB (SFB 1158), and BW (FOR 2289) were supported by the German Research Council. MB reports personal fees from Novartis, Seagen, Springer, NeuroScios and Boehringer-Ingelheim, as well as grants from the DFG, European Union and Novartis. JH received a research grant, personal fees, lecture honoraria and financial support for conference attendance from Alnylam Pharmaceuticals, and lecture and advisory honoraria from Horizon Therapeutics. MW is a member of the European Reference Network for Neuromuscular Diseases (ERN EURO-NMD). BW received grants from the German Ministry of Education and Research, Dietmar Hopp Foundation, Klaus Tschira Foundation, grants and personal fees from Merck and Novartis, and personal fees from Alexion, INSTAND, Roche, none related to this work. WW reports to be inventor and patent-holder on “Peptides for use in treating or diagnosing IDH1R132H positive cancers” (EP2800580B1) and “Cancer therapy with an oncolytic virus combined with a checkpoint inhibitor” (US11027013B2). He consulted for Apogenix, Astra Zeneca, Bayer, Enterome, MSD and Roche/Genentech with honoraria paid to the Medical Faculty at the University of Heidelberg. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.