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Abstract

The optic nerve is frequently involved in multiple sclerosis (MS). However, MRI of the optic nerve is considered optional in the differential diagnosis of optic neuropathy symptoms either at presentation or in established MS. In addition, unlike spinal cord imaging in comparable scenarios, no role is currently recommended for optic nerve MRI in patients presenting with optic neuritis for its confirmation, to plan therapeutic strategy, within the MS diagnostic framework, nor for the detection of subclinical activity in established MS. In this article, evidence related to these 3 aspects will be summarized and gaps in knowledge will be highlighted, including (1) the acquisition challenges and novel sequences that assess pathologic changes within the anterior visual pathways; (2) the clinical implications of quantitative magnetic resonance studies of the optic nerve, focusing on atrophy measures, magnetization transfer, and diffusion tensor imaging; and (3) the relevant clinical studies performed to date. Finally, an algorithm for the application of optic nerve MRI will be proposed to guide future studies aimed at addressing our knowledge gaps.

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References

1.
Toosy AT, Mason DF, Miller DH. Optic neuritis. Lancet Neurol. 2014;13(1):83-99.
2.
Wattjes MP, Ciccarelli O, Reich DS, et al. 2021 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis. Lancet Neurol. 2021;20(8):653-670.
3.
Toussaint D. Perivenous sheathing in multiple sclerosis. Bull Soc Belge Ophtalmol. 1983;208(Pt 1):369-374.
4.
Balcer LJ, Frohman EM. Evaluating loss of visual function in multiple sclerosis as measured by low-contrast letter acuity. Neurology. 2010;74(suppl 3):S16-S23.
5.
Miller DH, Newton MR, van der Poel JC, et al. Magnetic resonance imaging of the optic nerve in optic neuritis. Neurology. 1988;38(2):175-179.
6.
Biousse V, Danesh-Meyer HV, Saindane AM, Lamirel C, Newman NJ. Imaging of the optic nerve: technological advances and future prospects. Lancet Neurol. 2022;21(12):1135-1150.
7.
Hodel J, Outteryck O, Bocher AL, et al. Comparison of 3D double inversion recovery and 2D STIR FLAIR MR sequences for the imaging of optic neuritis: pilot study. Eur Radiol. 2014;24(12):3069-3075.
8.
Riederer I, Muhlau M, Hoshi MM, Zimmer C, Kleine JF. Detecting optic nerve lesions in clinically isolated syndrome and multiple sclerosis: double-inversion recovery magnetic resonance imaging in comparison with visually evoked potentials. J Neurol. 2019;266(1):148-156.
9.
London F, Zephir H, Hadhoum N, et al. Optic nerve double inversion recovery hypersignal in patients with clinically isolated syndrome is associated with asymptomatic gadolinium-enhanced lesion. Mult Scler. 2019;25(14):1888-1895.
10.
Davion JB, Lopes R, Drumez E, et al. Asymptomatic optic nerve lesions: an underestimated cause of silent retinal atrophy in MS. Neurology. 2020;94(23):e2468-e2478.
11.
Patel S, Dimaandal I, Kuhns T, et al. Double inversion recovery to detect cervical spinal cord multiple sclerosis lesions. J Neuroimaging. 2023;33(4):521-526.
12.
Aiken AH, Mukherjee P, Green AJ, Glastonbury CM. MR imaging of optic neuropathy with extended echo-train acquisition fluid-attenuated inversion recovery. AJNR Am J Neuroradiol. 2011;32(2):301-305.
13.
Davion JB, Jougleux C, Lopes R, Leclerc X, Outteryck O. Relation between retina, cognition and brain volumes in MS: a consequence of asymptomatic optic nerve lesions. J Neurol. 2023;270(1):240-249.
14.
Denis M, Woillez JP, Smirnov VM, et al. Optic nerve lesion length at the acute phase of optic neuritis is predictive of retinal neuronal loss. Neurol Neuroimmunol Neuroinflamm. 2022;9(2):e1135.
15.
Hadhoum N, Hodel J, Defoort-Dhellemmes S, et al. Length of optic nerve double inversion recovery hypersignal is associated with retinal axonal loss. Mult Scler. 2016;22(5):649-658.
16.
Pravata E, Roccatagliata L, Sormani MP, et al. Dedicated 3D-T2-STIR-ZOOMit imaging improves demyelinating lesion detection in the anterior visual pathways of patients with multiple sclerosis. AJNR Am J Neuroradiol. 2021;42(6):1061-1068.
17.
Trip SA, Wheeler-Kingshott C, Jones SJ, et al. Optic nerve diffusion tensor imaging in optic neuritis. Neuroimage. 2006;30(2):498-505.
18.
Kolbe S, Chapman C, Nguyen T, et al. Optic nerve diffusion changes and atrophy jointly predict visual dysfunction after optic neuritis. Neuroimage. 2009;45(3):679-686.
19.
Hickman SJ, Toosy AT, Jones SJ, et al. Serial magnetization transfer imaging in acute optic neuritis. Brain. 2004;127(Pt 3):692-700.
20.
Hickman SJ, Brierley CM, Brex PA, et al. Continuing optic nerve atrophy following optic neuritis: a serial MRI study. Mult Scler. 2002;8(4):339-342.
21.
Yiannakas MC, Toosy AT, Raftopoulos RE, Kapoor R, Miller DH, Wheeler-Kingshott CA. MRI acquisition and analysis protocol for in vivo intraorbital optic nerve segmentation at 3T. Invest Ophthalmol Vis Sci. 2013;54(6):4235-4240.
22.
Inglese M, Ghezzi A, Bianchi S, et al. Irreversible disability and tissue loss in multiple sclerosis: a conventional and magnetization transfer magnetic resonance imaging study of the optic nerves. Arch Neurol. 2002;59(2):250-255.
23.
Trip SA, Schlottmann PG, Jones SJ, et al. Optic nerve magnetization transfer imaging and measures of axonal loss and demyelination in optic neuritis. Mult Scler. 2007;13(7):875-879.
24.
Wang Y, van der Walt A, Paine M, et al. Optic nerve magnetisation transfer ratio after acute optic neuritis predicts axonal and visual outcomes. PLoS One. 2012;7(12):e52291.
25.
Naismith RT, Xu J, Tutlam NT, Trinkaus K, Cross AH, Song SK. Radial diffusivity in remote optic neuritis discriminates visual outcomes. Neurology. 2010;74(21):1702-1710.
26.
Naismith RT, Xu J, Tutlam NT, et al. Diffusion tensor imaging in acute optic neuropathies: predictor of clinical outcomes. Arch Neurol. 2012;69(1):65-71.
27.
van der Walt A, Kolbe SC, Wang YE, et al. Optic nerve diffusion tensor imaging after acute optic neuritis predicts axonal and visual outcomes. PLoS One. 2013;8(12):e83825.
28.
Vidal-Jordana A, Rovira A, Calderon W, et al. Adding the optic nerve in multiple sclerosis diagnostic criteria: a longitudinal, prospective, multicenter study. Neurology. 2024;102(1):e200805.
29.
Petzold A, Fraser CL, Abegg M, et al. Diagnosis and classification of optic neuritis. Lancet Neurol. 2022;21(12):1120-1134.
30.
Bennett JL, Costello F, Chen JJ, et al. Optic neuritis and autoimmune optic neuropathies: advances in diagnosis and treatment. Lancet Neurol. 2023;22(1):89-100.
31.
Stunkel L, Kung NH, Wilson B, McClelland CM, Van Stavern GP. Incidence and causes of overdiagnosis of optic neuritis. JAMA Ophthalmol. 2018;136(1):76-81.
32.
Onofrj M, Tartaro A, Thomas A, et al. Long echo time STIR sequence MRI of optic nerves in optic neuritis. Neuroradiology. 1996;38(1):66-69.
33.
Beck RW, Cleary PA, Anderson MM Jr., et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992;326(9):581-588.
34.
Petzold A, Braithwaite T, van Oosten BW, et al. Case for a new corticosteroid treatment trial in optic neuritis: review of updated evidence. J Neurol Neurosurg Psychiatry. 2020;91(1):9-14.
35.
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.
36.
Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162-173.
37.
Brownlee WJ, Miszkiel KA, Tur C, Barkhof F, Miller DH, Ciccarelli O. Inclusion of optic nerve involvement in dissemination in space criteria for multiple sclerosis. Neurology. 2018;91(12):e1130-e1134.
38.
Vidal-Jordana A, Rovira A, Arrambide G, et al. Optic nerve topography in multiple sclerosis diagnosis: the utility of visual evoked potentials. Neurology. 2021;96(4):e482-e490.
39.
Ruggieri S, Prosperini L, Petracca M, et al. The added value of spinal cord lesions to disability accrual in multiple sclerosis. J Neurol. 2023;270(10):4995-5003.
40.
Kallenbach K, Simonsen H, Sander B, et al. Retinal nerve fiber layer thickness is associated with lesion length in acute optic neuritis. Neurology. 2010;74(3):252-258.

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Information

Published In

Neurology®
Volume 103Number 3August 13, 2024
PubMed: 39018513

Publication History

Received: February 15, 2024
Accepted: May 17, 2024
Published online: July 17, 2024
Published in print: August 13, 2024

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Disclosure

J. Sastre-Garriga has received consulting fees and speaking honoraria from BMS, Sanofi, Merck, Janssen, Novartis, and Roche, is scientific director of Revista de Neurología, receives an honorarium as a member of the editorial committee of Multiple Sclerosis Journal, and has received research support from Fondo de Investigación en Salud (PI19/00950 and PI22/00750) from Instituto de Salud Carlos III, Spain. A. Vidal-Jordana has received support from contracts Juan Rodes (JR16/00024) and Fondo de Investigación en Salud (PI17/02162 and PI22/01589) from Instituto de Salud Carlos III, Spain, and has received consulting fees and/or speaker honoraria from Roche, Novartis, and Merck. A. Toosy has received speaker honoraria from Biomedia, Sereno Symposia International Foundation, and Bayer, has received meeting expenses from Biogen Idec and Novartis, was the UK PI for 2 clinical trials sponsored by MEDDAY pharmaceutical company (MD1003 in optic neuropathy [MS-ON - NCT02220244] and progressive MS [MS-SPI2 - NCT02936037]), has been supported by grants from the MRC (MR/S026088/1), NIHR BRC (541/CAP/OC/818837), and RoseTrees Trust (A1332 and PGL21/10079), is an associate editor for Frontiers in Neurology, and is an editorial board member of Neurology and Multiple Sclerosis Journal. C. Enzinger has received travel and speaker honoraria from Biogen, Bayer Schering, Merck Serono, Novartis, Shire, Genzyme, and Teva Pharmaceutical Industries Ltd./Sanofi-Aventis; has received research support from Merck Serono, Biogen, and Teva Pharmaceutical Industries Ltd./Sanofi-Aventis; and has served on scientific advisory boards for Bayer Schering, Biogen, Celgene, Merck Serono, Novartis, Roche and Teva Pharmaceutical Industries Ltd./Sanofi-Aventis. C. Granziera is employed by the University Hospital Basel (USB), has received advisory board and consulting fees from Actelion, Genzyme-Sanofi, Novartis, Jannsen, Merck, Teva, GeNeuro, and Hoffmann La Roche, has received speaker honoraria from Genzyme-Sanofi, Novartis, Jannsen, Merck, Teva, GeNeuro, and Hoffmann La Roche, has received research support from Siemens, GeNeuro, Biogen, Novartis, Hoffmann La Roche, the Swiss National Science Foundation (SNSF) grant PP00P3_206151, the Stiftung zur Förderung der gastroenterologischen und allgemeinen klinischen Forschung, and EUROSTAR E!113682 HORIZON2020. J. Frederiksen has served on scientific advisory boards for and has received travel expenses and speaker honoraria from Merck Serono, Sanofi-Aventis, Roche, Novartis, and Chiesi. O. Ciccareli is an NIHR Research Professor (RP-2017-08-ST2-004), has been a member of independent DSMB for Novartis, has received a speaker honorarium from Merck, has contributed to an advisory board for Biogen; receives an honorarium as Deputy Editor of Neurology, and has received research support from the MS Society of Great Britain and Northern Ireland, the NIHR UCLH Biomedical Research Centre, the Rosetree Trust, the National MS Society, and the NIHR-HTA. M. Filippi is Editor-in-Chief of the Journal of Neurology, is an Associate Editor of Human Brain Mapping, Neurologic Sciences, and Radiology; has received consulting fees from Alexion, Almirall, Biogen, Merck, Novartis, Roche, and Sanofi, has received speaker honoraria from Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA, has been an advisory board member for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, and Takeda, has provided scientific direction of educational events for Biogen, Merck, Roche, Celgene, Bristol-Myers Squibb, Lilly, Novartis, and Sanofi-Genzyme, and receives research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla. X. Montalban has received consulting fees (paid to institution) from AbbVie, Actelion, Alexion, Biogen, Bristol Myers Squibb/Celgene, EMD Serono, Genzyme, Hoffmann-La Roche, Immunic, Janssen Pharmaceuticals, MedDay, Merck, Mylan, Nervgen, Novartis, Sandoz, Sanofi Genzyme, Teva, and TG Therapeutics, has received travel expenses for scientific meeting participation (paid to institution) from the National MS Society and the MS International Federation, and has received research support (funded through institution) from Biogen, Bristol Myers Squibb/Celgene, Hoffmann-La Roche, Sanofi Genzyme, Merck, and Novartis. M. Tintoré has received consulting fees, speaker honoraria, and research support from Almirall, Bayer Schering Pharma, Biogen-Idec, Genzyme, Janssen, Merck-Serono, Novartis, Roche, Sanofi-Aventis, Viela Bio and Teva Pharmaceuticals, and has served on data safety monitoring boards for Parexel and UCB Biopharma. D. Pareto has received research grants from Biogen Idec and Fondo de Investigaciones Sanitarias (PI18/00823, PI22/01709), cofunded by the European Union. À. Rovira has served on scientific advisory boards for Novartis, Sanofi-Genzyme, Synthetic MR, Roche, and Biogen, has received speaker honoraria from Bayer, Sanofi-Genzyme, Merck-Serono, Teva Pharmaceutical Industries Ltd, Novartis, Roche, Bristol-Myers, and Biogen, is CMO and cofounder of TensorMedical, and receives research support from Fondo de Investigación en Salud (PI19/00950 and PI22/01589) from Instituto de Salud Carlos III, Spain. The other authors report no relevant disclosures. Go to Neurology.org/N for full disclosures.

Study Funding

The authors report no targeted funding.

Authors

Affiliations & Disclosures

Jaume Sastre-Garriga, MD, PhD https://orcid.org/0000-0002-1589-2254
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Served on a scientific advisory board - Merck (2) Served on a scientific advisory board - BMS (3) Served as an associate editor - Multiple Sclerosis Journal (4) Served as a journal editor - Revista de Neurologia (5) Received speaker honoraria - BMS (6) Received speaker honoraria - Roche (7) Received speaker honoraria - Universidad Católica de Murcia (8) Received speaker honoraria - Universidad Autónoma de Madrid (9) Received speaker honoraria - Sociedad Española de Neurología (10) Received speaker honoraria - Janssen (11) Received speaker honoraria - Universidad Internacional Menéndez Pelayo (12) Received speaker honoraria - Merck (13) Served on a scientific advisory board - Medscape
Research Support:
1.
(1) Governmental - Fondo de Investigación Sanitaria (PI19/00950): Follow-up of patients with acute optic neuritis (2) Governmental - Fondo de Investigación Sanitaria (PI22/00750): CNS reserve definition
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
Angela Vidal-Jordana, MD, PhD https://orcid.org/0000-0002-7270-5507
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) CONSULTATNT / SPEAKER - Roche, Merck, and Sanofi
Research Support:
1.
(1) GOVERNMENTAL ENTITY - Fondo de Investigación en Salud, Instituto de Salud Carlos III, Spain (PI17/02162): National grant to conduct research study (2) GOVERNMENTAL ENTITY - Fondo de Investigación en Salud, Instituto de Salud Carlos III, Spain (PI22/01589): National grant to conduct research study
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Associate Editor - Frontiers in Neurology (2) Editorial Board Member - Neurology journal (3) Editorial Board Member - Multiple Sclerosis Journal
Research Support:
1.
(1) Governmental entity - Medical Research Council (MR/S026088/1): Research Grant (2) Society - Rosetrees Trust (PGL21/10079): Research Grant (3) Society - Rosetrees Trust (A1332): Research Grant
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
Christian Enzinger, MD, PhD https://orcid.org/0000-0001-9764-7617
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
NONE
Research Support:
1.
NONE
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
Cristina Granziera, MD, PhD https://orcid.org/0000-0002-4917-8761
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Research grant - Biogen (2) Research grants - Hoffman La Roche (3) Research grant - Genzyme Sanofi (4) Research grant - Novartis (5) Speaker fees (Institution - not personal) - Hoffman La Roche, Genzyme-Sanofi, Novartis, Teva, Jannsen, Merck
Research Support:
1.
(1) Swiss National Foundation - SNF Professorship (PP00P3_206151): Imaging axonal damage and repair in multiple sclerosis (2) Horizon 2020 - Eurostar: MS-Connect
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Advisory Board - Alexion (2) Funding for travel and speaker honorario - Sanofi (3) Funding for trsvel - Serono (4) Funding for travel - Roche
Research Support:
1.
(1) Grant - Roche: Study on the role of EBV in MS
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
Olga Ciccarelli, MD, PhD https://orcid.org/0000-0001-7485-1367
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Serve on a data safety monitoring board for Remibrutinib - Novartis (2) Received speaker honoraria - Merck (3) Serve on scientific advisory board - Biogen (4) Serve as Deputy Editor for Neurology - AAN (5) Serves as Editorial Board Member (since 2018) - Multiple Sclerosis Journal Relevant Clinical Procedures: (1) spends 100% effort for Queen Square MS Centre- MRI
Research Support:
1.
(1) Governmental - NIHR (RP-2017-08-ST2-004): Research Professor (2) Governmental - MRC (MR/S026088/1): received funding (3) Academic - NIHR UCLH/UCL Biomedical Research Centre,: received funding (4) Society - National MS Society: received funding (5) Society - MS Society of Great Britain and Northern Ireland: received funding (6) Foundation - Rosetrees Trust: received funding
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
Massimo Filippi, MD, PhD https://orcid.org/0000-0002-5485-0479
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Served as a consultant - Alexion (2) Served as a consultant - Almirall (3) Served as a consultant - Biogen (4) Served as a consultant - Merck (5) Served as a consultant - Novartis (6) Served as a consultant - Roche (7) Served as a consultant - Sanofi (8) received speaker honoraria - Bayer (9) received speaker honoraria - Biogen (10) received speaker honoraria - Celgene (11) received speaker honoraria - Chiesi Italia SpA (12) received speaker honoraria - Eli Lilly (13) received speaker honoraria - Genzyme (14) received speaker honoraria - Janssen (15) received speaker honoraria - Merck-Serono (16) received speaker honoraria - Neopharmed Gentili (17) received speaker honoraria - Novartis (18) received speaker honoraria - Novo Nordisk (19) received speaker honoraria - Roche (20) received speaker honoraria - Sanofi (21) received speaker honoraria - Takeda (22) received speaker honoraria - TEVA (23) Served on a scientific advisory board - Alexion (24) Served on a scientific advisory board - Biogen (25) Served on a scientific advisory board - Bristol-Myers Squibb (26) Served on a scientific advisory board - Merck (27) Served on a scientific advisory board - Novartis (28) Served on a scientific advisory board - Roche (29) Served on a scientific advisory board - Sanofi (30) Served on a scientific advisory board - Sanofi-Aventis (31) Served on a scientific advisory board - Sanofi-Genzyme (32) Served on a scientific advisory board - Takeda (33) Served as a journal editor - Journal of Neurology
Research Support:
1.
(1) Commercial - Biogen Idec: money to my institution (2) Commercial - Merck-Serono: money to my institution (3) Commercial - Novartis: money to my institution (4) Commercial - Roche: money to my institution (5) Governmental - Italian Ministry of Health: money to my institution (6) Foundation - Fondazione Italiana Sclerosi Multipla: money to my institution (7) Governmental - Italian Ministry of University and Research: money to my institution
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
Xavier Montalban, MD, PhD https://orcid.org/0000-0002-0098-9918
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Actelion (2) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Biogen (3) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Bristol Myers Squibb/ Celgene (4) Speaking honoraria & participation on Advisory Board (payments made to the institution) - EMD Serono (5) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Genzyme (6) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Hoffmann-La Roche (7) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Immunic (8) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Janssen Pharmaceuticals (9) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Medday (10) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Merck (11) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Mylan (12) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Nervgen (13) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Novartis (14) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Sandoz (15) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Sanofi-Genzyme (16) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Teva Pharmaceutical (17) Speaking honoraria & participation on Advisory Board (payments made to the institution) - TG Therapeutics (18) Speaking honoraria & participation on Advisory Board (payments made to the institution) - Excemed (19) Travelling expenses for attending meetings - Actelion (20) Travelling expenses for attending meetings - Biogen (21) Travelling expenses for attending meetings - Bristol Myers Squibb/ Celgene (22) Travelling expenses for attending meetings - EMD Serono (23) Travelling expenses for attending meetings - Genzyme (24) Travelling expenses for attending meetings - Hoffmann-La Roche (25) Travelling expenses for attending meetings - Immunic (26) Travelling expenses for attending meetings - Janssen Pharmaceuticals (27) Travelling expenses for attending meetings - Medday (28) Travelling expenses for attending meetings - Merck (29) Travelling expenses for attending meetings - Mylan (30) Travelling expenses for attending meetings - Nervgen (31) Travelling expenses for attending meetings - Novartis (32) Travelling expenses for attending meetings - Sandoz (33) Travelling expenses for attending meetings - Sanofi-Genzyme (34) Travelling expenses for attending meetings - Teva Pharmaceutical (35) Travelling expenses for attending meetings - TG Therapeutics (36) Travelling expenses for attending meetings - Excemed (37) Travelling expenses for attending meetings - MSIF (38) Travelling expenses for attending meetings - National MS Society Relevant Clinical Procedures: (1) spends None% effort for None- None
Research Support:
1.
(1) None - None (None): None
Stock, Stock Options & Royalties:
1.
(1) None - None: None
Legal Proceedings:
1.
(1) None for None in None
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Editorial advisory board member - Multiple Sclerosis Journal (2) Data safety monitoring board - Parexel and UCB pharma (3) Scientific advisory board - Janssen (4) Scientific advisory board - Merck (5) Scientific advisory board - Novartis (6) Scientific advisory board - Genzyme (7) Scientific advisory board - Roche (8) Speaker Honoraria - Iberoamerimed (9) Speaker Honoraria - Viatris (10) Speaker Honoraria - Biogen (11) Speaker Honoraria - Excemed (12) Speaker Honoraria - BMS (13) Relapse adjudication Committee - IMCYSE (14) Speaker Honoraria - XLR8 Health Ltd.
Research Support:
1.
(1) Pharma company - Biogen (Statistical support ): Salary (2) MS research Association - ARSEP (Research grant ): Project (3) National Research Institute - FIS (Research grant ): Project
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
NONE
Research Support:
1.
NONE
Stock, Stock Options & Royalties:
1.
NONE
Legal Proceedings:
1.
NONE
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Disclosure
Financial Disclosure:
1.
Personal Compensation: (1) Personal compensation - Brystol (2) Personal compensation - Novartis (3) Personal compensation - Sanofi (4) Personal compensation - Roche (5) Personal compensation - Biogen (6) Personal compensation - Merck (7) Personal compensation - Bayer
Research Support:
1.
(1) Governmental - Instituto de salud Carlos III (PI22_01589): Structural and functional characterization of the anterior visual pathway in patients with early multiple sclerosis
Stock, Stock Options & Royalties:
1.
(1) Stock options - Tensor Medical S.L.: CNN tool for automated assessment of multiple sclerosis lesions
Legal Proceedings:
1.
NONE
for the MAGNIMS Study Group
From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.

Notes

Correspondence Dr. Sastre-Garriga [email protected]
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was Editor-in-Chief José Merino, MD, MPhil, FAAN.

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