Cronin, Alicia E.; Zhang, Xinyu; Combes, Anna; Vandekar, Simon; Dunay, Gabriella L.; Narisetti, Lipika; Sweeney, Grace; Prock, Logan; Houston, Delaney; Salakhov, Aimee; Schilling, Kurt G.; Stubblefield, Seth; McKnight, Colin D.; Bagnato, Francesca; Sriram, Subramaniam; Smith, Seth A.; O鈥橤rady, Kristin P. (2026).听.听Imaging Neuroscience, 4, IMAG.a.1296.听
People with聽multiple sclerosis (MS)聽often experience problems with walking, sensation, and automatic body functions such as bladder control, but these symptoms do not always match the amount of damage seen on conventional聽magnetic resonance imaging (MRI). This study explored whether聽diffusion tensor imaging (DTI), an advanced MRI technique that measures the microscopic structure of tissue, could provide additional insights by examining the聽lumbosacral spinal cord鈥攖he lower portion of the spinal cord that helps control the legs and pelvic organs. The researchers compared MRI scans from 29 people with mild聽relapsing-remitting MS聽and 27 healthy volunteers. They found that healthy participants showed natural differences in DTI measurements across different spinal cord regions, highlighting the importance of analyzing these areas separately. Overall, people with MS did not show significant differences from healthy participants in normal-appearing spinal cord tissue. However, among participants with MS, higher聽fractional anisotropy (FA)聽values in the back (dorsal) portion of the spinal cord were associated with poorer mobility and sensation. These findings suggest that higher FA in the lower spinal cord may not necessarily indicate healthier tissue in people with MS and underscore the need for region-specific analyses and larger studies that include patients with more advanced disease.
Fig 1
Example data for one healthy control (A, 26-year-old female) and one person with multiple sclerosis (B, 42-year-old female). Shown are the anatomical multi-echo, gradient echo (mFFE) images, image with no diffusion-sensitizing gradients (b = 0), mean diffusion-weighted image (DWI), three DWI slices averaged with good gray matter (GM) contrast without (left) and with (right) GM, white matter columns, and lesions overlaid, and the fractional anisotropy (FA) and axial diffusivity (AD) quantitative maps. All images are shown for three slices corresponding to spinal levels throughout the lumbar enlargement. Lesions are highlighted by the yellow area on the anatomical slices.