Abstract #0630

Accelerated mI/tNAA Increase in Normal-Appearing WM of RRMS with Paramagnetic Rim Lesions: A 7T MR Spectroscopic Imaging 2-year Follow-Up Study

Anna Zöchner^1,2, Wolfgang Bogner^1,2, Assunta Dal-Bianco³, Bernhard Strasser¹, Gilbert Hangel^1,4,5, Paulus Rommer³, and Eva Niess¹

¹High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria, ²Christian Doppler Laboratory for MR Imaging Biomarkers (BIOMAK), Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria, ³Department of Neurology, Medical University of Vienna, Vienna, Austria, ⁴Functional Imaging Laboratory, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom, ⁵Department of Neurosurgery, Medical University of Vienna, Vienna, Austria

Synopsis

Keywords: Multiple Sclerosis, Multiple Sclerosis

Motivation: Investigating normal-appearing white matter (NAWM) in relapsing-remitting multiple sclerosis (RRMS) with paramagnetic rim lesions (PRLs) using magnetic resonance spectroscopy imaging (MRSI) may clarify shift from RRMS to progressive MS and identify mI/tNAA as biomarker for MS progression.

Goal(s): Examine mI/tNAA levels in NAWM over two years and how they are impacted by presence of PRLs using ultra-high-resolution 7T MRSI.

Approach: Annually measured mI/tNAA in NAWM was compared across groups (RRMS with >1 PRL and ≤1 PRL, and secondary progressive MS) using linear mixed-effect models.

Results: RRMS patients showed rising mI/tNAA, with larger increases in those with multiple PRLs, while SPMS patients remained stable.

Impact: Results revealed faster increase in mI/tNAA in the NAWM of patients with >1 PRL, which may indicate elevated inflammation. This could explain the transition from relapsing-remitting MS to progressive forms and identify mI/tNAA as potential biomarker for MS progression.

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