NAWM is the beginning of MS and can be seen with special MRI

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DTI (Diffusion Tensor Imaging MRI) shows the most early tissue injury in MS, when atrophy and lesions are not yet detectable (non lesional damage, NAWM). In patients with CIS it might indicate an active disease stage that predicts conversion from CIS into definite MS.

Non-lesional cerebellar damage in patients with clinically isolated syndrome: DTI measures predict early conversion into clinically definite multiple sclerosis

https://www.sciencedirect.com/science/a ... 8218301372

This article highlights:

• Convincing evidence for hidden active disease processes in patients with CIS
• Widespread alterations of cerebellar white matter FA in NAWM
• Decreased cerebellar FA indicated shorter conversion time into MS
• New spotlight to the time point of diagnosis of multiple sclerosis

Conclusion

DTI seems to reflect early tissue injury in beginning MS, when atrophy and lesions are not yet detectable. Decreased cerebellar FA in patients with CIS might indicate an active and unstable disease stage, resulting in a shorter conversion time into MS.