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Abstract Details

Quantitative Assessment of Remyelination by Q-space Myelin Map and its Association With Functionality and Quality of Life in Multiple Sclerosis
Multiple Sclerosis
P8 - Poster Session 8 (11:45 AM-12:45 PM)
19-005

 To assess qMM-derived myelin changes and their relationship with therapy initiation, clinical outcomes, and quality of life in relapsing remitting multiple sclerosis (RRMS).

Remyelination in multiple sclerosis (MS) is a key repair process that may help restore neural conduction and protect against progressive neurodegeneration. Conventional MRI, however, cannot reliably distinguish remyelinated tissue from chronic demyelination, limiting in vivo assessment of myelin repair. The q-Space Myelin Map (qMM) is a diffusion-based MRI technique sensitive to myelin content, allowing noninvasive quantification of remyelination.
We conducted a 6-month observational study using qMM in 21 RRMS patients who initiated or switched to natalizumab or other disease-modifying therapies (DMTs). We examined whether qMM-detected myelin increases were associated with clinical improvement and quality-of-life outcomes. Participants underwent baseline and 6-month brain MRI with qMM to quantify myelin within lesions and normal-appearing white matter (NAWM), alongside clinical assessments (EDSS, MSFC, MSQOL-54). 
Among 1,125 lesions analyzed, approximately one-third (34.1%) showed increased myelin content consistent with remyelination, with 71.4% of these lesions occurring in natalizumab-treated patients. Overall remyelination rates after 6 months were comparable between treatment groups. Remyelination was more frequent in male patients (OR 6.44, p = 0.03), in gadolinium-enhancing lesions at baseline (OR 31.9, p < 0.0001), and in those with confirmed EDSS improvement (OR 11.33, p = 0.02). Higher NAWM myelin content correlated with better baseline physical quality-of-life, and greater lesional myelin gains predicted higher MSFC Z-scores at follow-up.
 In summary, qMM appears to be a promising noninvasive biomarker of remyelination. Imaging evidence of myelin restoration was associated with improved disability and quality-of-life measures, supporting the potential of qMM to inform clinical decision-making and advance myelin repair research.
Authors/Disclosures
Vitória Pimentel, MD
PRESENTER 		Dr. Pimentel has nothing to disclose.
Daissy Mora, MD (Residencia Medica Neurologia Hospital Moinhos De Vento) Dr. Mora has nothing to disclose.
Rafael C. Sommer, Sr., MD Dr. Sommer has nothing to disclose.
Alessandra J. Gallo Miss Gallo has nothing to disclose.
Pedro R. Neves, Mr Mr. Neves has nothing to disclose.
Douglas K. Sato, MD Dr. Sato has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra-Zeneca. The institution of Dr. Sato has received research support from Biogen. The institution of Dr. Sato has received research support from Merck.