MAGNETIC RESONANCE TECHNIQUES IN MULTIPLE SCLEROSIS – TWENTY-SEVENTH ADVANCED COURSE

RAZIONALE

Multiple Sclerosis (MS) is a complex disorder in which modifiable determinants of brain health play a critical role alongside immune-mediated damage. Lifestyle factors, physical activity, cognitive engagement, and psychosocial well-being influence the balance between tissue injury and the brain’s capacity for resilience, repair, and functional compensation.

The 27^th Advanced Course, Magnetic Resonance Techniques in Multiple Sclerosis, focuses on “Brain Health as a Disease-Modifying Target in MS: From Mechanisms to Measurable Outcomes and Clinical Implementation.” The course aims to bridge knowledge on lifestyle and environmental determinants of brain health with state-of-the-art magnetic resonance imaging (MRI) methodologies capable of capturing their biological impact, supporting more integrated MS management alongside pharmacological therapy. The program opens with the environmental and lifestyle determinants of brain health in MS, including physical activity, diet, smoking, sleep, and other exposures that modulate immune function, neuroinflammation, and neurodegeneration. Particular emphasis will be placed on the biological pathways linking lifestyle factors to CNS resilience or vulnerability with advanced MRI metrics capable of detecting lifestyle-related effects on tissue integrity, network organization, and structural reserve. The second session addresses training-induced resilience, focusing on aerobic exercise and motor rehabilitation. Exercise-driven immunometabolic adaptations, neurotrophic signaling, and neuroplastic remodeling are discussed together with MRI markers that capture adaptive brain reorganization and support the development of personalized rehabilitation strategies. On the second day, attention shifts to cognitive impairment and cognitive resilience, integrating current knowledge of the biological substrates of cognitive dysfunction with concepts of cognitive reserve and compensatory reorganization. MRI-based measures of structural integrity and functional connectivity will be presented as key tools for identifying patients at risk, monitoring cognitive decline, and evaluating cognitive rehabilitation. The final session explores multimodal brain-health interventions, addressing interconnected symptoms such as fatigue, mood disorders, pain, and cognitive impairment that arise from shared network dysfunction. The course will also highlight the growing role of multimodal biomarkers, including advanced MRI, digital health technologies, wearable sensors, and artificial intelligence, in capturing complex treatment effects and enabling more precise outcome measures in clinical trials and clinical practice.