Grey matter magnetization transfer ratio independently correlates with neurological deficit in secondary progressive multiple sclerosis

2009 ◽  
Vol 256 (3) ◽  
pp. 427-435 ◽  
Author(s):  
T. Hayton ◽  
J. Furby ◽  
K. J. Smith ◽  
D. R. Altmann ◽  
R. Brenner ◽  
...  
2009 ◽  
Vol 15 (6) ◽  
pp. 687-694 ◽  
Author(s):  
J Furby ◽  
T Hayton ◽  
D Altmann ◽  
R Brenner ◽  
J Chataway ◽  
...  

Background Although MRI measures of grey matter abnormality correlate with clinical disability in multiple sclerosis, it is uncertain whether grey matter abnormality measured on MRI is entirely due to a primary grey matter process or whether it is partly related to disease in the white matter. Methods To explore potential mechanisms of grey matter damage we assessed the relationship of white matter T2 lesion volume, T1 lesion volume, and mean lesion magnetisation transfer ratio (MTR), with MRI measures of tissue atrophy and MTR in the grey matter in 117 subjects with secondary progressive multiple sclerosis. Results Grey matter fraction and mean grey matter MTR were strongly associated with lesion volumes and lesion MTR mean ( r = ±0.63–0.72). In contrast, only weak to moderate correlations existed between white matter and lesion measures. In a stepwise regression model, T1 lesion volume was the only independent lesion correlate of grey matter fraction and accounted for 52% of the variance. Lesion MTR mean and T2 lesion volume were independent correlates of mean grey matter MTR, accounting for 57% of the variance. Conclusions Axonal transection within lesions with secondary degeneration into the grey matter may explain the relationship between T1 lesions and grey matter fraction. A parallel accumulation of demyelinating lesions in white and grey matter may contribute to the association of T2 lesion volume and lesion MTR with grey matter MTR.


2007 ◽  
Vol 13 (4) ◽  
pp. 483-489 ◽  
Author(s):  
B. Audoin ◽  
G. Davies ◽  
W. Rashid ◽  
L. Fisniku ◽  
A.J. Thompson ◽  
...  

Previous studies using magnetization transfer ratio (MTR) histogram analysis have demonstrated the existence of global grey matter (GM) abnormalities in patients with early relapsing-remitting multiple sclerosis (RRMS). However, MTR histogram analysis does not provide any information on the localization of the morphological changes within the GM. The aim of this study was to investigate the localization of GM injury in early RRMS, performing voxel-based analysis of GM MTR maps. Statistical mapping analysis of GM MTR maps was performed in a group of 38 patients with early RRMS and 45 healthy controls. Between-group comparisons (P<0.05, corrected for multiple comparisons) demonstrated significant GM MTR decrease in patients located in the bilateral lenticular nuclei, the bilateral insula, the left posterior cingulate cortex, and the right orbitofrontal cortex. To limit the potential confounding effect of regional GM atrophy, the percentages of GM were assessed in the regions showing significant MTR decrease, and no GM atrophy was evidenced in these regions. This study demonstrates that several GM regions are commonly affected in patients with early RRMS. Predominant involvement of these structures may be partly related to their vulnerability to anterograde or retrograde degeneration from transected axons in the white matter and/or to the predominant localization of GM demyelinating lesions in such regions. Multiple Sclerosis 2007; 13: 483-489. http://msj.sagepub.com


Brain ◽  
2021 ◽  
Author(s):  
Matteo Pardini ◽  
J William L Brown ◽  
Roberta Magliozzi ◽  
Richard Reynolds ◽  
Declan T Chard

Abstract While multiple sclerosis can affect any part of the CNS, it does not do so evenly. In white matter it has long been recognized that lesions tend to occur around the ventricles, and grey matter lesions mainly accrue in the outermost (subpial) cortex. In cortical grey matter, neuronal loss is greater in the outermost layers. This cortical gradient has been replicated in vivo with magnetization transfer ratio and similar gradients in grey and white matter magnetization transfer ratio are seen around the ventricles, with the most severe abnormalities abutting the ventricular surface. The cause of these gradients remains uncertain, though soluble factors released from meningeal inflammation into the CSF has the most supporting evidence. In this Update, we review this ‘surface-in’ spatial distribution of multiple sclerosis abnormalities and consider the implications for understanding pathogenic mechanisms and treatments designed to slow or stop them.


PLoS ONE ◽  
2011 ◽  
Vol 6 (9) ◽  
pp. e24969 ◽  
Author(s):  
Lydie Crespy ◽  
Wafaa Zaaraoui ◽  
Mathias Lemaire ◽  
Audrey Rico ◽  
Anthony Faivre ◽  
...  

2009 ◽  
Vol 15 (6) ◽  
pp. 668-677 ◽  
Author(s):  
LK Fisniku ◽  
DR Altmann ◽  
M Cercignani ◽  
DJ Tozer ◽  
DT Chard ◽  
...  

Background In multiple sclerosis, grey matter (GM) damage appears more clinically relevant than either white matter damage or lesion load. Objective We investigated if normal-appearing white matter (NAWM) and grey matter tissue changes assessed by magnetization transfer ratio were associated with long-term disability. Methods Sixty-nine people were assessed 20 years after presentation with a clinically isolated syndrome (CIS) [28 still CIS, 31 relapsing-remitting multiple sclerosis, 10 secondary progressive multiple sclerosis], along with 19 healthy subjects. Mean magnetization transfer ratio, peak height (PH) and peak location of the normalized magnetization transfer ratio histograms were determined in NAWM and grey matter, as well as, white matter and GM Fraction (GMF) and T2-weighted lesion load. Results Median expanded disability status scale for multiple sclerosis patients was 2.5 (range 1–8). GM-PH, and less so, NAWM mean and peak location, were lower in multiple sclerosis patients ( P = 0.009) versus controls, relapsing-remitting multiple sclerosis versus CIS ( P = 0.008) and secondary progressive multiple sclerosis versus relapsing-remitting multiple sclerosis ( P = 0.002). GM-PH (as well as GMF) correlated with expanded disability status scale ( rs = −0.49; P = 0.001) and multiple sclerosis functional score ( rs = 0.51; P = 0.001). GM-PH independently predicted disability with similar strength to the associations of GMF with clinical measures. Conclusion Grey matter damage was related to long-term disability in multiple sclerosis cohort with a relatively low median expanded disability status scale. Markers of intrinsic grey matter damage (magnetization transfer ratio) and tissue loss offer clinically relevant information in multiple sclerosis.


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