{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:27:07Z","timestamp":1784042827970,"version":"3.55.0"},"reference-count":54,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"King Salman Center for Disability Research","award":["KSRG-2024-197"],"award-info":[{"award-number":["KSRG-2024-197"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Quantitative intravoxel incoherent motion (IVIM) imaging, incorporating both diffusion- and perfusion-derived metrics, offers a promising non-invasive approach for assessing tissue microstructure and clinical disability in multiple sclerosis (MS). This study aimed to investigate the correlation and predictive values of the IVIM apparent diffusion coefficient (ADC), true diffusion coefficient (D), and perfusion-derived pseudo-diffusion coefficient (D*) and perfusion fraction (f) parameters with disability status, measured using the Expanded Disability Status Scale (EDSS), in relapsing\u2013remitting MS patients. Methods: This cross-sectional study retrospectively analyzed MRI data from 197 MS patients. Quantitative IVIM parameters were extracted from scans obtained using a 1.5 T MRI scanner. Clinical data were also obtained, including age, disease duration, number of relapses, disease-modifying therapy (DMT) status, and need for mobility assistance. Bivariate analyses were conducted to compare mean values across subgroups. Pearson correlation was used to examine associations between EDSS score and imaging\/clinical variables. Multiple linear regression was applied to identify independent predictors of EDSS score. Results: The bivariate analyses revealed that ADC, D, D*, and EDSS values were higher in patients over 50 years old, those with a longer disease duration, and those who required mobility assistance. f was higher in females and DMT-treated patients, but it had no effect on EDSS score. Patients with longer disease duration and limited mobility had a higher number of MS lesions and relapses. EDSS score exhibited positive Pearson correlations with ADC, D, D*, the number of MS lesions, and the number of relapses (p-value &lt; 0.001). In the multivariate regression analysis, only the number of MS lesions and relapses emerged as independent predictors of EDSS score (p-value &lt; 0.001). Other variables, including ADC, D, D*, f, age, and disease duration, were not independently associated with EDSS score (p-value &gt; 0.05). Conclusions: This study demonstrates the utility of IVIM parameters in detecting microstructural alterations associated with MS impairment. Despite relapse frequency and lesion count being the strongest predictors of EDSS score, IVIM metrics showed meaningful clinical correlations. The findings support combining IVIM biomarkers with clinical data for better disability assessment.<\/jats:p>","DOI":"10.3390\/diagnostics15162113","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T14:46:04Z","timestamp":1755787564000},"page":"2113","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Utility of Intravoxel Incoherent Motion Metrics in Assessing Disability in Relapsing\u2013Remitting Multiple Sclerosis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9769-2514","authenticated-orcid":false,"given":"Othman I.","family":"Alomair","sequence":"first","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"},{"name":"King Salman Centre for Disability Research, Riyadh 11614, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6404-8762","authenticated-orcid":false,"given":"Sami A.","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6608-6922","authenticated-orcid":false,"given":"Abdullah H.","family":"Abujamea","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, King Saud University Medical City & College of Medicine, King Saud University, Riyadh 7805, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0138-7924","authenticated-orcid":false,"given":"Salman","family":"Aljarallah","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, King Saud University, P.O. Box 145111, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1992-0654","authenticated-orcid":false,"given":"Nuha M.","family":"Alkhawajah","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, King Saud University, P.O. Box 145111, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-384X","authenticated-orcid":false,"given":"Mohammed S.","family":"Alshuhri","sequence":"additional","affiliation":[{"name":"Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Adulaziz University, AlKharj 11942, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0857-524X","authenticated-orcid":false,"given":"Yazeed I.","family":"Alashban","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6340-182X","authenticated-orcid":false,"given":"Nyoman D.","family":"Kurniawan","sequence":"additional","affiliation":[{"name":"Australian Institute for Bioengineering and Nanotechnology, Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/S1474-4422(08)70259-X","article-title":"Cognitive impairment in multiple sclerosis","volume":"7","author":"Chiaravalloti","year":"2008","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1212\/WNL.0000000000000560","article-title":"Defining the clinical course of multiple sclerosis","volume":"83","author":"Lublin","year":"2014","journal-title":"Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Mart\u00ednez-Lapiscina, E.H., Fraga-Pumar, E., Gabilondo, I., Mart\u00ednez-Heras, E., Torres-Torres, R., Ortiz-P\u00e9rez, S., Llufriu, S., Tercero, A., Andorra, M., and Roca, M.F. 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