Metabolite changes in radiologically isolated syndrome

Abstract

Conventional structural neuroimaging has revolutionized the field of multiple sclerosis (MS), facilitating an earlier diagnosis1 and enabling the classification of asymptomatic subjects at risk for a seminal symptomatic demyelinating event after identification of incidental anomalies fulfilling spatial or temporal criteria.2 The recent introduction of more advanced imaging techniques in patients with MS has improved our understanding of microarchitecture involvement3 and metabolic change4 related to clinical outcomes. Despite better technology that allows for in vivo characterization of disease, the immediate- and long-term phenotypic contributions of such findings remain a challenge. Improved characterization of early demyelinating disease, even before the development of symptoms, may assist our understanding of the temporal course and may result in strategies to intervene, thus limiting injury.