Abnormalities seen on clinical MRIs in the brain and spinal cord of multiple sclerosis (MS) patients lack specificity to myelin. Thus, efficacy of new treatments that aim to protect or remyelinate cannot be fully captured. Quantitative MR metrics, such as R2* and quantitative susceptibility mapping (QSM), have demonstrated good sensitivity to myelin and iron-related tissue changes, but the clinical relevance of such changes has not yet been assessed. We showed that R2* provides good group-wise distinction of MS patients and controls, while QSM values reflected clinically meaningful variations in upper and lower motor function as well as cognitive processing speed.
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