A quantitative MRI-Based Normative Framework for Personalizing Microstructural Pathology in Multiple Sclerosis

Motivation: Quantitative MRI (qMRI) offers a unique perspective for investigating microstructural pathological changes in multiple sclerosis (MS). This study employs qMRI-based normative modeling for tracking individual MS pathology. Goal(s): To quantify personalized cortical microstructural changes in patients with MS using qMRI-based normative models. Approach: Hierarchical Bayesian Regression-based normative models were developed using quantitative multiparametric (R1, R2*, Quantitative Susceptibility Mapping) data across two centers to quantify regional cortical microstructural changes in people with MS. Results: qMRI-based deviations in cortical microstructure exhibited significant differences across various phenotypes and correlated with clinical measures of MS disability and biofluid measures of neuro-axonal damage. Impact: This qMRI-based normative model enables individualized quantification of multiple sclerosis pathology, which is strongly related to clinical measures and a fluid biomarker of neuroaxonal damage, opening a new perspective for clinical stratification and personalized treatment decisions.