Multiple Sclerosis and Other Demyelinating Diseases

  • Yongmei Li


White matter demyelinating diseases in the central nervous system (CNS) are characterized as myelin loss with relative preservation of axons. Traditionally, demyelinating disorders are classified as primary or as secondary. In this chapter, the neuroimaging findings of multiple sclerosis (MS) and other demyelinating diseases were described.


Demyelinating diseases Multiple sclerosis Neuromyelitis optica Acute disseminated encephalomyelitis Progressive multifocal leukoencephalopathy 


  1. 1.
    Berer K, Krishnamoorthy G. Microbial view of central nervous system autoimmunity. FEBS Lett. 2014;588(22):4207–13.PubMedCrossRefGoogle Scholar
  2. 2.
    Frohman EM, Racke MK, Raine CS. Multiple sclerosis—the plaque and its pathogenesis. N Engl J Med. 2006;354(9):942–55.PubMedCrossRefGoogle Scholar
  3. 3.
    Milo R, Miller A. Revised diagnostic criteria of multiple sclerosis. Autoimmun Rev. 2014;13(4-5):518–24.PubMedCrossRefGoogle Scholar
  4. 4.
    Krupp LB, Banwell B, Tenembaum S. Consensus definitions proposed for pediatric multiple sclerosis and related disorders. Neurology. 2007;68(16 Suppl 2):S7–12.PubMedCrossRefGoogle Scholar
  5. 5.
    Milo R, Kahana E. Multiple sclerosis: geoepidemiology, genetics and the environment. Autoimmun Rev. 2010;9(5):A387–94.PubMedCrossRefGoogle Scholar
  6. 6.
    Compston A, Coles A. Multiple sclerosis. Lancet. 2008;372(9648):1502–17.PubMedCrossRefGoogle Scholar
  7. 7.
    Lublin FD, Reingold SC. National Multiple Sclerosis Society Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Defining the clinical course of multiple sclerosis: results of an international survey. Neurology. 1996;46(4):907–11.PubMedCrossRefGoogle Scholar
  8. 8.
    Miller D, Barkhof F, Montalban X, et al. Clinically isolated syndromes suggestive of multiple sclerosis, part I: natural history, pathogenesis, diagnosis, and prognosis. Lancet Neurol. 2005;4(5):281–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Okuda DT, Mowry EM, Beheshtian A, et al. Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome. Neurology. 2009;72(9):800–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Tsang BK, Macdonell R. Multiple sclerosis-diagnosis, management and prognosis. Aust Fam Physician. 2011;40(12):948–55.PubMedGoogle Scholar
  11. 11.
    Dawson JW. XVIII.–the histology of disseminated sclerosis. Trans R Soc Edinb. 1914;50:517–740.CrossRefGoogle Scholar
  12. 12.
    Swanton JK, Fernando K, Dalton CM, et al. Modification of MRI criteria for multiple sclerosis in patients with clinically isolated syndromes. J Neurol Neurosurg Psychiatry. 2006;77(7):830–3.PubMedCrossRefGoogle Scholar
  13. 13.
    Polman CH, Reingold SC, Edan G, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald criteria”. Ann Neurol. 2005;58(6):840–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292–302.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Montalban X, Tintoré M, Swanton J, et al. MRI criteria for MS in patients with clinically isolated syndromes. Neurology. 2010;74(5):427–34.PubMedCrossRefGoogle Scholar
  16. 16.
    Filippi M, Rocca MA, Ciccarelli O, et al. MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines. Lancet Neurol. 2016;15(3):292–303.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Caucheteux N, Maarouf A, Genevray M, et al. Criteria improving multiple sclerosis diagnosis at the first MRI. J Neurol. 2015;262(4):979–87.PubMedCrossRefGoogle Scholar
  18. 18.
    Sombekke MH, Wattjes MP, Balk LJ, et al. Spinal cord lesions in patients with clinically isolated syndrome: a powerful tool in diagnosis and prognosis. Neurology. 2013;80(1):69–75.PubMedCrossRefGoogle Scholar
  19. 19.
    Kelly SB, Kinsella K, Duggan M, et al. A proposed modification to the McDonald 2010 criteria for the diagnosis of primary progressive multiple sclerosis. Mult Scler. 2013;19(8):1095–100.PubMedCrossRefGoogle Scholar
  20. 20.
    Cañellas AR, Gols AR, Izquierdo JR, et al. Idiopathic inflammatory-demyelinating diseases of the central nervous system. Neuroradiology. 2007;49(5):393–409.PubMedCrossRefGoogle Scholar
  21. 21.
    Sastregarriga J, Rovira A, Río J, et al. Clinically definite multiple sclerosis after radiological Schilder-like onset. J Neurol. 2003;250(7):871.CrossRefGoogle Scholar
  22. 22.
    Gharagozloo AM, Poe LB, Collins GH. Antemortem diagnosis of Balo concentric sclerosis: correlative MR imaging and pathologic features. Radiology. 1994;191(3):817–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Jeong IH, Kim SH, Hyun JW, et al. Tumefactive demyelinating lesions as a first clinical event: clinical, imaging, and follow-up observations. J Neurol Sci. 2015;358(1-2):118–24.PubMedCrossRefGoogle Scholar
  24. 24.
    Mabray MC, Cohen BA, Villanueva-Meyer JE, et al. Performance of apparent diffusion coefficient values and conventional MRI features in differentiating tumefactive demyelinating lesions from primary brain neoplasms. AJR Am J Roentgenol. 2015;205(5):1075–85.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Srinivasan R, Sailasuta N, Hurd R, et al. Evidence of elevated glutamate in multiple sclerosis using magnetic resonance spectroscopy at 3 T. Brain. 2005;128(Pt 5):1016–25.PubMedCrossRefGoogle Scholar
  26. 26.
    Khan O, Shen Y, Caon C, et al. Axonal metabolic recovery and potential neuroprotective effect of glatiramer acetate in relapsing-remitting multiple sclerosis. Mult Scler. 2005;11(6):646–51.PubMedCrossRefGoogle Scholar
  27. 27.
    Wolff SD, Balaban RS. Magnetization transfer imaging: practical aspects and clinical applications. Radiology. 1994;192(3):593–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Filippi M, Iannucci G, Tortorella C, et al. Comparison of MS clinical phenotypes using conventional and magnetization transfer MRI. Neurology. 1999;52(3):588–94.PubMedCrossRefGoogle Scholar
  29. 29.
    Filippi M, Rocca MA. Magnetization transfer magnetic resonance imaging of the brain, spinal cord, and optic nerve. Neurotherapeutics. 2007;4(3):401–13.PubMedCrossRefGoogle Scholar
  30. 30.
    Filippi M, Agosta F. Magnetization transfer MRI in multiple sclerosis. J Neuroimaging. 2007;17(S1):22S–6S.PubMedCrossRefGoogle Scholar
  31. 31.
    Henry RG, Joonmi O, Nelson SJ, et al. Directional diffusion in relapsing-remitting multiple sclerosis: a possible in vivo signature of Wallerian degeneration. J Magn Reson Imaging. 2003;18(4):420–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Yu HJ, Christodoulou C, Bhise V, et al. Multiple white matter tract abnormalities underlie cognitive impairment in RRMS. NeuroImage. 2012;59(4):3713–22.PubMedCrossRefGoogle Scholar
  33. 33.
    Bakshi R, Thompson AJ, Rocca MA, et al. MRI in multiple sclerosis: current status and future prospects. Lancet Neurol. 2008;7(7):615–25.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Haacke EM, Xu Y, Cheng YC, Reichenbach JR. Susceptibility weighted imaging in MRI. Magn Reson Med. 2004;52(3):612–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Haacke EM, Makki MY. Characterizing iron deposition in multiple sclerosis lesions using susceptibility weighted imaging. J Magn Reson Imaging. 2009;29(3):537–44.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Rocca MA, Pagani E, Absinta M, et al. Altered functional and structural connectivities in patients with MS: a 3-T study. Neurology. 2007;69(23):2136–45.PubMedCrossRefGoogle Scholar
  37. 37.
    Sicotte NL, Voskuhl RR, Bouvier S, et al. Comparison of multiple sclerosis lesions at 1.5 and 3.0 Tesla. Investig Radiol. 2003;38(7):423–7.Google Scholar
  38. 38.
    Kollia K, Maderwald S, Putzki N, et al. First clinical study on ultra-high-field MR imaging in patients with multiple sclerosis: comparison of 1.5T and 7T. AJNR Am J Neuroradiol. 2009;30(4):699–702.PubMedCrossRefGoogle Scholar
  39. 39.
    Wattjes MP, Harzheim M, Kuhl CK, et al. Does high-field MR imaging have an influence on the classification of patients with clinically isolated syndromes according to current diagnostic mr imaging criteria for multiple sclerosis? AJNR Am J Neuroradiol. 2006;27(8):1794–8.PubMedGoogle Scholar
  40. 40.
    Calabrese M, Battaglini M, Giorgio A, et al. Imaging distribution and frequency of cortical lesions in patients with multiple sclerosis. Neurology. 2010;75(14):1234–40.PubMedCrossRefGoogle Scholar
  41. 41.
    Menge T, Hemmer B, Nessler S, et al. Acute disseminated encephalomyelitis: an update. JAMA Neurol. 2005;62(11):1673–80.Google Scholar
  42. 42.
    Tenembaum S, Chitnis T, Ness J, et al. Acute disseminated encephalomyelitis. Neurology. 2007;68(16 Suppl 2):S23–36.PubMedCrossRefGoogle Scholar
  43. 43.
    Dale RC, Branson JA. Acute disseminated encephalomyelitis or multiple sclerosis: can the initial presentation help in establishing a correct diagnosis? Arch Dis Child. 2005;90(6):636–9.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Bennetto L, Scolding N. Inflammatory/post-infectious encephalomyelitis. J Neurol Neurosurg Psychiatry. 2004;75(Suppl 1):i22–8.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Hartung HP. ADEM: distinct disease or part of the MS spectrum? Neurology. 2001;56(10):1257–60.PubMedCrossRefGoogle Scholar
  46. 46.
    Ghezzi A, Bergamaschi R, Martinelli V, et al. Clinical characteristics, course and prognosis of relapsing Devic’s Neuromyelitis Optica. J Neurol. 2004;251(1):47–52.PubMedCrossRefGoogle Scholar
  47. 47.
    Pittock SJ, Weinshenker BG, Lucchinetti CF, et al. Neuromyelitis optica brain lesions localized at sites of high aquaporin 4 expression. Arch Neurol. 2006;63(7):964–8.PubMedCrossRefGoogle Scholar
  48. 48.
    Rovaris M, Viti B, Ciboddo G, et al. Brain involvement in systemic immune mediated diseases: magnetic resonance and magnetisation transfer imaging study. J Neurol Neurosurg Psychiatry. 2000;68(2):170–7.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    Joseph FG, Scolding NJ. Sarcoidosis of the nervous system. Pract Neurol. 2007;7(4):234–44.PubMedCrossRefGoogle Scholar
  50. 50.
    Karussis D, Weiner HL, Abramsky O. Multiple sclerosis vs Lyme disease: a case presentation to a discussant and a review of the literature. Mult Scler. 1999;5(6):395–402.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Yongmei Li
    • 1
  1. 1.Department of RadiologyFirst Hospital of Chongqing Medical UniversityChongqingChina

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