Evaluation of the effect of highly effective multiple sclerosis disease-modifying drugs on the progression of the disease using diffusion-weighted magnetic resonance imaging with tractography

Peshkin A.N.; Kotov S.V.; Tonia G.T.; Ovchinnikova E.O.

doi:https://doi.org/10.17116/jnevro202512507273

Peshkin A.N.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0009-0009-9726-7679

Kotov S.V.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

SPIN RSCI: 1798-0837
Scopus AuthorID: 7005990035
ResearcherID: E-4451-2017
ORCID: 0000-0002-8706-7317

Tonia G.T.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0009-0003-3973-5362

Ovchinnikova E.O.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0009-0001-1864-2381

Evaluation of the effect of highly effective multiple sclerosis disease-modifying drugs on the progression of the disease using diffusion-weighted magnetic resonance imaging with tractography

Authors:

Peshkin A.N., Kotov S.V., Tonia G.T., Ovchinnikova E.O.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2025;125(7‑2): 73‑78

DOI: 10.17116/jnevro202512507273

Read: 1006 times

Contact the author

Table of contents

To cite this article:

Peshkin AN, Kotov SV, Tonia GT, Ovchinnikova EO. Evaluation of the effect of highly effective multiple sclerosis disease-modifying drugs on the progression of the disease using diffusion-weighted magnetic resonance imaging with tractography. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;125(7‑2):73‑78. (In Russ.)
https://doi.org/10.17116/jnevro202512507273

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски (S.S. Korsakov Journal of Neurology and Psychiatry (special issues))

Использование инфографики авторами научных работ

OBJECTIVE

To study the effect of highly effective multiple sclerosis disease-modifying drugs (ocrelizumab and cladribine) on the course of the disease using diffusion-weighted MRI with tractography.

MATERIALS AND METHODS

The study included 23 patients divided into two groups: Group 1 received cladribine, and Group 2 received ocrelizumab. To assess the severity of damage to the pyramidal tract and the effectiveness of treatment, all patients underwent dynamic brain MRI with tractography before the start of therapy (baseline) and one year after the start of treatment.

RESULTS

The comparison of the results of the examination of the participants of group 1 with the indicators of the control group did not show significant differences in the volume of the pyramidal tract, FA, and ADC. Analysis of results one year after starting ocrelizumab treatment showed a statistically significant increase in ADC, while other parameters showed no significant change.

CONCLUSION

The comparison of the examination results of group 1 patients with those in the control group showed a decrease in the length of the pyramidal tract. However, there was no difference between the values before and after treatment. These results suggest that cladribine therapy contributes to slowing down neurodegenerative processes. Analysis of the results one year after the start of treatment with ocrelizumab showed a slight negative trend, indicating the progression of neurodegenerative processes. The observed results are probably due to more severe baseline impairment of the pyramidal function and ambulation in this group of patients compared to group 1.

Keywords:

cladribine

ocrelizumab

tractography

multiple sclerosis

highly effective multiple sclerosis disease-modifying drugs

Authors:

Peshkin A.N.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0009-0009-9726-7679

Kotov S.V.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

SPIN RSCI: 1798-0837
Scopus AuthorID: 7005990035
ResearcherID: E-4451-2017
ORCID: 0000-0002-8706-7317

Tonia G.T.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0009-0003-3973-5362

Ovchinnikova E.O.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0009-0001-1864-2381

Received:

27.05.2025

Accepted:

29.05.2025

Close metadata

References:

Tae WS, Ham BJ, Pyun SB, et al. Current Clinical Applications of Diffusion-Tensor Imaging in Neurological Disorders. J Clin Neurol. 2018;14(2):129-140. https://doi.org/10.3988/jcn.2018.14.2.129
Hori M, Maekawa T, Kamiya K, et al. Advanced Diffusion MR Imaging for Multiple Sclerosis in the Brain and Spinal Cord. Magn Reson Med Sci. 2022;21(1):58-70. https://doi.org/10.2463/mrms.rev.2021-0091
Cercignani M, Gandini Wheeler-Kingshott C. From micro- to macro-structures in multiple sclerosis: what is the added value of diffusion imaging. NMR Biomed. 2019; 32:e3888. https://doi.org/10.1002/nbm.3888
Filippi M, Iannucci G, Cercignani M, et al. A quantitative study of water diffusion in multiple sclerosis lesions and normal-appearing white matter using echo-planar imaging. Arch Neurol 2000; 57:1017-1021. https://doi.org/10.1001/archneur.57.7.1017
Jang SH, Yeo SS, Choi EB. Diffusion Tensor Tractography Studies on Recovery Mechanisms of Aphasia in Stroke Patients: A Narrative Mini-Review. Healthcare (Basel). 2022;10(10):1927. https://doi.org/10.3390/healthcare10101927
Schlaug G, Marchina S, Norton A. Evidence for plasticity in white-matter tracts of patients with chronic Broca’s aphasia undergoing intense intonation-based speech therapy. Ann N Y Acad Sci. 2009;1169:385-394. https://doi.org/10.1111/j.1749-6632.2009.04587.x
Basser PJ, Pierpaoli C. Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson Bull. 1996;111:209-219. https://doi.org/10.1006/jmrb.1996.0086
Assaf Y, Pasternak O. Diffusion tensor imaging (DTI)-based white matter mapping in brain research: A review. J Mol Neurosci. 2008;34:51-61. https://doi.org/10.1007/s12031-007-0029-0
Kim S, Jang SH. Prediction of aphasia outcome using diffusion tensor tractography for arcuate fasciculus in stroke. Am J Neuroradiol. 2013;34:785-790. https://doi.org/10.3174/ajnr.A3259
Neil JJ. Diffusion imaging concepts for clinicians. J Magn Reson Imaging. 2008;27:1-7. https://doi.org/10.1002/jmri.21087
Seo JP, Kwon YH, Jang SH. Mini-review of studies reporting the repeatability and reproducibility of diffusion tensor imaging. Invest Magn Reson Imaging. 2019;23:26-33. https://doi.org/10.13104/imri.2019.23.1.26
Lee SK, Kim DI, Kim J. Diffusion-tensor MR imaging and fiber tractography: A new method of describing aberrant fiber connections in developmental CNS anomalies—Response. Radiographics. 2005;25:68. https://doi.org/10.1148/rg.251045085
Peshkin AN, Toniya GT, Stepanova EA, et al. Diffusion tensor tomography with tractography in assessment of the pyramidal system in patients with highly active multiple sclerosis. Nevrologiya, Nejropsihiatriya, Psihosomatika. 2024;16(3):31-37. (In Russ.). https://doi.org/10.14412/2074-2711-2024-3-31-37
Parker G, Alexander D. Probabilistic anatomical connectivity derived from the microscopic persistent angular structure of cerebral tissue. Philos Trans R Soc B Biol. Sci. 2005;360:893-902. https://doi.org/10.1098/rstb.2005.1639
Giovannoni G. Cladribine to Treat Relapsing Forms of Multiple Sclerosis. Neurotherapeutics. 2017;14(4):874-887. https://doi.org/10.1007/s13311-017-0573-4
Aung WY, Mar S, Benzinger TL. Diffusion tensor MRI as a biomarker in axonal and myelin damage. Imaging Med. 2013;5(5):427-440.