Robert J. Fox1, Daniel Ontaneda1, Xiofeng Wang2, Ken Sakaie3, Jian Lin3, Mark J. Lowe3, Michael D. Phillips3
1Mellen Center for MS, Cleveland Clinic, Cleveland, OH, United States; 2Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States; 3Radiology, Cleveland Clinic, Cleveland, OH, United States
We used HARDI DTI in a longitudinal study of multiple sclerosis patients to identify changes in brain tissue prior to the development of acute inflammation (gadolinium enhancement). We found significantly decreased fractional anisotropy (FA) up to 10 months prior to the development of gadolinium-enhancing lesions. Changes in FA were driven an increase in transverse diffusivity, while longitudinal diffusivity remained unchanged. This study provides evidence for impaired myelin integrity up to 10 months prior to development of gadolinium enhancement.