Perspectives and experiences with COVID-19 vaccines in people with MS

[摘要] Background: Susac Syndrome (SuS) is an autoimmune endotheliopathy impacting the brain, retina andcochlea that can clinically mimic multiple sclerosis (MS).Objective: To evaluate non-lesional white matter demyelination changes in SuS compared to MS andhealthy controls (HC) using quantitative MRI.Methods: 3T MRI including myelin water imaging and diffusion basis spectrum imaging were acquiredfor 7 SuS, 10 MS and 10 HC participants. Non-lesional white matter was analyzed in the corpus callosum(CC) and normal appearing white matter (NAWM). Groups were compared using ANCOVA with Tukeycorrection.Results: SuS CC myelin water fraction (mean 0.092) was lower than MS(0.11, p=0.01) and HC(0.11, p=0.04). Another myelin marker, radial diffusivity, was increased in SuS CC(0.27μm2/ms) compared toHC(0.21μm2/ms, p=0.008) and MS(0.23μm2/ms, p=0.05). Fractional anisotropy was lower in SuSCC(0.82) than HC(0.86, p=0.04). Fiber fraction (reflecting axons) did not differ from HC or MS. InNAWM, radial diffusivity and apparent diffusion coefficient were significantly increased in SuS comparedto HC(p < 0.001 for both measures) and MS(p=0.003, p < 0.001 respectively).Conclusions: Our results provided evidence of myelin damage in SuS, particularly in the CC, and moreextensive microstructural injury in NAWM, supporting the hypothesis that there are widespread microstructural changes in SuS syndrome including diffuse demyelination.

[关键词] Susac syndrome;MRI;neuroimaging;multiple sclerosis;myelin water imaging;diffusion basis spectrum imaging;demyelination