Macroscopic white matter (WM) lesion volume has been extensively used to predict disability progression in multiple sclerosis (MS). However, currently used lesion-related metrics fail to capture the complexity of WM-lesion spatial distribution. Here we used geostatistics, an emerging approach to model spatial data projected onto a common coordinate space, to characterise the spatial distributional features of WM lesions of patients with their first MS attack, the clinical relevance of lesion distributional properties and their microstructural correlates, through diffusion MRI. We conclude that WM-lesion spatial distributional features reveal novel aspects of MS pathology, are clinically relevant and possess specific microstructural features.
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