![]() ![]() Even though APTw imaging can detect signal changes in MS lesions, it is yet unknown how the APTw signal varies at different clinical phases. Furthermore, MS lesions and WM hyperintensities of small vessel disease were distinguished by using APTw imaging, but its histogram parameters only provided poor diagnostic performance, implying that more advanced amide proton transfer (APT) signal analysis may be required to help further distinguish MS lesion and WM hyperintensities ( Sartoretti et al., 2019). APTw signals in normal-appearing white matter (NAWM) of spinal cord in MS patients were significantly different from those in healthy controls (HCs), except for WM lesions in the brain, which can provide information regarding biochemical components of spinal cord lesions and disease progression ( By et al., 2018). (2011) found that the APTw signal value of WM lesions were higher than that of healthy brain tissues, and that there was significant variability between individual MS lesions. A recent study using APTw MRI to detect microscopic changes in normally appearing tissue in a mouse model of experimental autoimmune encephalomyelitis (EAE) at early stage suggests that changes in the inflammatory environment may lead to changes in APTw signals, which have the potential to serve as imaging biomarkers ( Liu et al., 2019). APTw MRI has been used to investigate brain/abdominal tumors, ischemic stroke, and MS ( Heo et al., 2019 Joo et al., 2019 Kamimura et al., 2019 Momosaka et al., 2020 Meng et al., 2021 Sartoretti et al., 2021). However, conventional MRI was unable of quantifying protein weighted information and microstructural cerebral abnormalities, which are essential for the early detection, diagnosis, and treatment of MS ( Brownlee et al., 2017).Īmide proton transfer-weighted (APTw) imaging is a kind of chemical exchange saturation transfer (CEST) that detects the exchange rate of protons in amide in free proteins or polypeptide molecules in the body and protons in water to reflect changes in tissue protein content and pH ( Zhou et al., 2019). ![]() Utilizing MRI, a variety of morphological information, including focal white matter (WM) lesions, brain volume reduction, gray matter atrophy, and the size and location of MS brain lesions were evaluated ( Granziera et al., 2021). Magnetic resonance imaging (MRI) is an important technique for diagnosing and differentiating MS, as well as monitoring therapeutic outcomes. Within 15 to 20 years, 50 to 60 percent of relapsing-remitting MS patients would advance to secondary progressive form if not effectively treated ( Noseworthy et al., 2000). Although myelin regeneration may repair demyelinating nerve cell lesions in the early stages of MS, self-repair is no longer able to compensate for nerve cell damage and loss as the area of damage expands, resulting in the secondary progressive MS stage. In its early stages, MS has an alternating relapse-remitting clinical course, with relapses typically characterized by acute episodes of neurological impairments, depending on the location of the lesion and the severity of the inflammatory process ( Compston and Coles, 2008 Marisa et al., 2021). Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) that primarily affects young and middle-aged individuals, resulting in a high incidence of neurological impairment and imposing an enormous personal and economic burden on patients, their families, and society ( Brownlee et al., 2017 Thompson et al., 2018b). ![]()
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