NEURAL TISSUE STRUCTURAL EVOLUTION IN AGGRESSIVE FORMS OF MULTIPLE SCLEROSIS AFTER AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION: AN MRI STUDY

Multiple sclerosis (MS) is a chronic, inflammatory and neurodegenerative disease of the central nervous system (CNS). Magnetic resonance imaging (MRI) revolutionalized MS evaluation in these last decades, and both conventional and nonconventional measures are regularly used in monitoring disease activity, guiding treatment decision and predicting MS evolution. Nevertheless, little is known about the structural neural response to acute damage in MS, its persistence along time and its repair mechanism. In this context, those patients with aggressive, highly-active, forms of MS, for which treatment with autologous hematopoietic stem cell transplantation (aHSCT) has been progressively endorsed as “standard of care”, might be of peculiar interest. In particular, the observation of tissue structural evolution through non-conventional MRI, and diffusion weighted imaging (DWI) in particular, and its evolution after aHSCT might sustain for the first time from a “neuroanatomical point of view” the confirmed long-term efficacy of intense immunosuppression followed by aHSCT demonstrated at the present time mainly from clinical and conventional MRI measures.