{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:50:55Z","timestamp":1792687855667,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["HE 9297\/1\u20101"],"award-info":[{"award-number":["HE 9297\/1\u20101"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Time\u2010efficient phase\u2010cycled balanced steady\u2010state free precession (pc\u2010bSSFP) imaging is a novel microstructure\u2010 and myelin\u2010sensitive approach for multi\u2010parametric brain tissue characterization not yet evaluated in demyelinating diseases such as multiple sclerosis (MS).<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To evaluate quantitative relaxometry metrics in white matter (WM) and gray matter (GM) of relapsing\u2010remitting multiple sclerosis (RRMS) and healthy control (HC) cohorts using a multi\u2010parametric pc\u2010bSSFP framework.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Prospective and retrospective, observational.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n Twenty RRMS patients (34.5\u2009\u00b1\u20095.9\u2009years, female 15\/20) and 10 HC subjects (33.4\u2009\u00b1\u20096.9\u2009years, female 5\/10).<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n \n 3\u2009T;\n T<\/jats:italic>\n 1<\/jats:sub>\n \u2010weighted magnetization\u2010prepared rapid gradient\u2010echo,\n T<\/jats:italic>\n 2<\/jats:sub>\n \u2010weighted fluid\u2010attenuated inversion recovery, pc\u2010bSSFP,\n B<\/jats:italic>\n 1<\/jats:sub>\n +<\/jats:sup>\n mapping, single\u2010shot spin\u2010echo echo\u2010planar\u2010imaging diffusion tensor imaging (DTI).\n <\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n \n R<\/jats:italic>\n 1<\/jats:sub>\n ,\n R<\/jats:italic>\n 2<\/jats:sub>\n , and the bSSFP asymmetry index (AI) were compared between RRMS and HC across selected WM and GM regions of interest (ROIs). DTI\u2010derived fiber\u2010to\u2010field angle, number of fiber orientations, and fractional anisotropy were used for parameter anisotropy analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Linear mixed\u2010effects models tested group, ROI, and group\u2010by\u2010ROI effects for each metric. Anisotropy differences between cohorts were assessed with two\u2010sided\n t<\/jats:italic>\n \u2010tests. ROI and anisotropy tests employed false discovery rate correction with significance set at\n p<\/jats:italic>\n \n corr<\/jats:italic>\n <\/jats:sub>\n <\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Significant group, ROI, and group\u2010by\u2010ROI effects were found for\n R<\/jats:italic>\n 1<\/jats:sub>\n (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.16) and\n R<\/jats:italic>\n 2<\/jats:sub>\n (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22122.84). The ROI effect was significant for AI while the group (\n p<\/jats:italic>\n \u2009=\u20090.450) and group\u2010by\u2010ROI (\n p<\/jats:italic>\n \u2009=\u20090.747) effects were non\u2010significant. Age and sex covariates did not reach significance (Age:\n p<\/jats:italic>\n \u2009=\u2009[0.563, 0.705, 0.591], Gender:\n p<\/jats:italic>\n \u2009=\u2009[0.839, 0.822, 0.179], for [\n R<\/jats:italic>\n 1<\/jats:sub>\n ,\n R<\/jats:italic>\n 2<\/jats:sub>\n , AI]). Fourteen of 16 ROIs showed significantly lower\n R<\/jats:italic>\n 1<\/jats:sub>\n and\n R<\/jats:italic>\n 2<\/jats:sub>\n (\n d<\/jats:italic>\n \u2009=\u2009\u22124.25 to \u22120.85) in RRMS than HC. All ROIs remained non\u2010significant for AI.\n R<\/jats:italic>\n 2<\/jats:sub>\n (\n p<\/jats:italic>\n \n corr<\/jats:italic>\n <\/jats:sub>\n \u2265\u20090.055) and AI (\n p<\/jats:italic>\n \n corr<\/jats:italic>\n <\/jats:sub>\n \u2265\u20090.108) anisotropy comparison between RRMS and HC groups did not reach significance.\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n Phase\u2010cycled bSSFP relaxometry showed WM\u2010predominant differences in RRMS, with additional whole\u2010brain assessment including gray matter.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 2.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 1.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70594","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:27:22Z","timestamp":1792646842000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Multi\u2010Parametric Phase\u2010Cycled Balanced Steady\u2010State Free Precession Brain Tissue Characterization in Relapsing\u2010Remitting Multiple Sclerosis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0860-3570","authenticated-orcid":false,"given":"Florian","family":"Birk","sequence":"first","affiliation":[{"name":"High\u2010Field Magnetic Resonance Max Planck Institute for Biological Cybernetics T\u00fcbingen Germany"},{"name":"Department of Biomedical Magnetic Resonance University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3205-4631","authenticated-orcid":false,"given":"Benjamin","family":"Bender","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamzeh","family":"Tesh","sequence":"additional","affiliation":[{"name":"High\u2010Field Magnetic Resonance Max Planck Institute for Biological Cybernetics T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anagha","family":"Deshmane","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maris M.","family":"Fabian","sequence":"additional","affiliation":[{"name":"Department of Neurology & Stroke University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1389-5539","authenticated-orcid":false,"given":"Markus C.","family":"Kowarik","sequence":"additional","affiliation":[{"name":"Department of Neurology & Stroke University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"Hertie\u2010Institute for Clinical Brain Research University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Lindig","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Ernemann","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Scheffler","sequence":"additional","affiliation":[{"name":"High\u2010Field Magnetic Resonance Max Planck Institute for Biological Cybernetics T\u00fcbingen Germany"},{"name":"Department of Biomedical Magnetic Resonance University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4589-6483","authenticated-orcid":false,"given":"Rahel","family":"Heule","sequence":"additional","affiliation":[{"name":"High\u2010Field Magnetic Resonance Max Planck Institute for Biological Cybernetics T\u00fcbingen Germany"},{"name":"Department of Biomedical Magnetic Resonance University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"Center for MR Research University Children's Hospital Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/jon.12945","article-title":"Diffusely Abnormal White Matter in Multiple Sclerosis","volume":"32","author":"Cairns J.","year":"2022","journal-title":"Journal of Neuroimaging"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/S1474-4422(25)00270-4","article-title":"Diagnosis of Multiple Sclerosis: 2024 Revisions of the McDonald Criteria","volume":"24","author":"Montalban X.","year":"2025","journal-title":"Lancet Neurology"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0095161","article-title":"Normal Appearing and Diffusely Abnormal White Matter in Patients With Multiple Sclerosis Assessed With Quantitative MR","volume":"9","author":"West J.","year":"2014","journal-title":"PLoS 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