PT  - JOURNAL ARTICLE
AU  - Ana C. Londoño
AU  - Carlos A. Mora
TI  - Nonconventional MRI biomarkers for in vivo monitoring of pathogenesis in multiple sclerosis
AID  - 10.1212/NXI.0000000000000045
DP  - 2014 Dec 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e45
VI  - 1
IP  - 4
4099  - http://nn.neurology.org/content/1/4/e45.short
4100  - http://nn.neurology.org/content/1/4/e45.full
SO  - Neurol Neuroimmunol Neuroinflamm2014 Dec 01; 1
AB  - To date, biomarkers based on nonconventional MRI have not been standardized for diagnosis and follow-up of patients with multiple sclerosis (MS). The sequential monitoring of pathogenesis in MS by imaging of the normal appearing brain tissue is an important research tool in understanding the early stages of MS. In this review, we focus on the importance of deciphering the physiopathogenesis of the disease cascade in vivo based on imaging biomarkers that allow a correlation with immunohistochemistry and molecular biology findings in order to provide earlier clinical diagnosis and better individualization of treatment and follow-up in patients with MS. Among the nonconventional imaging techniques available, we remark on the importance of proton magnetic resonance spectroscopy imaging because of its ability to assist in the simultaneous evaluation of different events in the pathogenesis of MS that cannot be determined by conventional MRI. Nonconventional MRI and the use of novel contrast agents are expected to elucidate the process of neuroinflammation and excitotoxicity in vivo that characterizes MS, thus leading to more specific neuroprotective and immunomodulatory therapies and reducing progression toward disability.1H-MRSI=proton magnetic resonance spectroscopy imaging; AD=Alzheimer disease; BBB=blood-brain barrier; CIS=clinically isolated syndrome; cMRI=conventional MRI; CR=creatine; DTI=diffusion tensor imaging; EDSS=Expanded Disability Status Scale; GLX=glutamate-glutamine complex; mI=myo-inositol; MS=multiple sclerosis; NAA=N-acetylaspartate; NABT=normal appearing brain tissue; NAWM=normal appearing white matter; NMO=neuromyelitis optica; PPMS=primary progressive multiple sclerosis; RIS=radiologically isolated syndrome; RRMS=relapsing-remitting multiple sclerosis; SPMS=secondary progressive multiple sclerosis; SWI=susceptibility-weighted imaging; TNF-α=tumor necrosis factor α