Amide proton transfer weighted signal of multiple sclerosis lesions and normal appearing white matter

Motivation: Monitoring disease progression in people with relapsing-remitting multiple sclerosis (pw-RRMS) presents a substantial clinical challenge. Conventional MRI often fails to provide molecular biomarkers for pathophysiological changes like myelin protein accumulation indicative of demyelination. Goal(s): The study aimed to validate whether amide proton transfer weighted (APTw) imaging could be a sensitive molecular marker for detecting demyelination in MS lesions. Approach: We conducted APTw imaging at 3T on 24 pw-RRMS, evaluating the signal intensity within MS lesions compared to contralateral normal-appearing white matter (cNAWM) regions. Results: The investigation revealed a statistically significant increase in APTw signal intensity in MS lesions compared to cNAWM regions. Impact: Elevated APTw signal intensity could serve as a non-invasive molecular biomarker for demyelination, potentially aiding in the more accurate monitoring of MS disease progression and treatment efficacy.