Reduced myelin integrity is associated with axonal damage at diagnosis in people with relapsing-remitting multiple sclerosis (RRMS). The magnetic resonance imaging (MRI)-derived g-ratio could be a useful tool in assessing lesion severity and extent of axonal damage at diagnosis.
Why this matters
It is well-known that demyelination and axonal damage are associated in people with established RRMS, and that axonal damage is a key factor in long-term disability. However, it is unclear whether this association exists in early or newly diagnosed RRMS and could therefore be leveraged at the earliest opportunity for treatment.
Using sensitive techniques for identifying early demyelination (MRI-derived g-ratios) and axonal damage (plasma neurofilament ELISA) in newly diagnosed RRMS could help to clarify this relationship.