Neurite orientation dispersion and density imaging discloses early changes in the normal-appearing white matter in paediatric multiple sclerosis

Introduction

Paediatric multiple sclerosis (pedMS) brain is known to be impacted by heightened inflammation and axonal degeneration.1 Structural changes in the normal-appearing white matter (NAWM) of pedMS have been disclosed by diffusion tensor imaging, further emphasising that MRI visible white matter (WM) lesions do not capture the full extent of tissue damage in MS.2 Understanding of the complexity of early brain pathology in pedMS can help to better characterise the relationship between inflammation and neurodegeneration in MS.

Neurite orientation dispersion and density imaging (NODDI), a multicompartment model of diffusion MRI, is a clinically feasible method for better capturing brain microstructural complexity in vivo.3 Specifically, NODDI provides quantitative measures including the neurite density index (NDI), considered a measure of neurites (ie, axons and dendrites) volume and orientation dispersion index (ODI), reflecting neurite orientation variability.

In this exploratory study, we applied NODDI to investigate the presence of early…

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