Focal and diffuse cervical spinal cord damage in patients with early relapsing–remitting MS: A multicentre magnetisation transfer ratio study

2018 ◽  
Vol 25 (8) ◽  
pp. 1113-1123 ◽  
Author(s):  
Benoît Combès ◽  
Anne Kerbrat ◽  
Jean Christophe Ferré ◽  
Virginie Callot ◽  
Josefina Maranzano ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Magnetisation Transfer ◽  
Phase Sensitive Inversion Recovery ◽  
Magnetisation Transfer Ratio ◽  
Transfer Ratio ◽  
Relapsing Remitting ◽  
Phase Sensitive ◽  
Relapsing Remitting Multiple Sclerosis

Background: Studies including patients with well-established multiple sclerosis (MS) have shown a significant and disability-related reduction in the cervical spinal cord (SC) magnetisation transfer ratio (MTR). Objectives: The objectives are to (1) assess whether MTR reduction is already measurable in the SC of patients with early relapsing–remitting multiple sclerosis (RRMS) and (2) describe its spatial distribution. Methods: We included 60 patients with RRMS <12  months and 34 age-matched controls at five centres. Axial T2*w, sagittal T2w, sagittal phase-sensitive inversion recovery (PSIR), 3DT1w, and axial magnetisation transfer (MT) images were acquired from C1 to C7. Lesions were manually labelled and mean MTR values computed both for the whole SC and for normal-appearing SC in different regions of interest. Results: Mean whole SC MTR was significantly lower in patients than controls (33.7 vs 34.9  pu, p  =  0.00005), even after excluding lesions (33.9  pu, p  =  0.0003). We observed a greater mean reduction in MTR for vertebral levels displaying the highest lesion loads (C2–C4). In the axial plane, we observed a greater mean MTR reduction at the SC periphery and barycentre. Conclusion: Cervical SC tissue damage measured using MTR is not restricted to macroscopic lesions in patients with early RRMS and is not homogeneously distributed.

Magnetisation transfer ratio measurement in the cervical spinal cord: a preliminary study in multiple sclerosis

1997 ◽  
Vol 39 (6) ◽  
pp. 441-445 ◽  
Author(s):  
N. C. Silver ◽  
G. J. Barker ◽  
N. A. Losseff ◽  
M. L. Gawne-Cain ◽  
D. G. MacManus ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Magnetisation Transfer ◽  
Magnetisation Transfer Ratio ◽  
Ratio Measurement ◽  
Transfer Ratio ◽  
Preliminary Study

Investigation of outer cortical magnetisation transfer ratio abnormalities in multiple sclerosis clinical subgroups

2014 ◽  
Vol 20 (10) ◽  
pp. 1322-1330 ◽  
Author(s):  
Rebecca S Samson ◽  
Manuel J Cardoso ◽  
Nils Muhlert ◽  
Varun Sethi ◽  
Claudia AM Wheeler-Kingshott ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Three Dimensional ◽  
Neuronal Loss ◽  
Magnetisation Transfer ◽  
Magnetisation Transfer Ratio ◽  
Outer Cortex ◽  
Transfer Ratio ◽  
Relapsing Remitting ◽  
Healthy Control

Background: Pathological abnormalities including demyelination and neuronal loss are reported in the outer cortex in multiple sclerosis (MS). Objective: We investigated for in vivo evidence of outer cortical abnormalities by measuring the magnetisation transfer ratio (MTR) in MS patients of different subgroups. Methods: Forty-four relapsing–remitting (RR) (mean age 41.9 years, median Expanded Disability Status Scale (EDSS) 2.0), 25 secondary progressive (SP) (54.1 years, EDSS 6.5) and 19 primary progressive (PP) (53.1 years, EDSS 6.0) MS patients and 35 healthy control subjects (mean age 39.2 years) were studied. Three-dimensional (3D) 1×1×1mm3 T1-weighted images and MTR data were acquired. The cortex was segmented, then subdivided into outer and inner bands, and MTR values were calculated for each band. Results: In a pairwise analysis, mean outer cortical MTR was lower than mean inner cortical MTR in all MS groups and controls ( p<0.001). Compared with controls, outer cortical MTR was decreased in SPMS ( p<0.001) and RRMS ( p<0.01), but not PPMS. Outer cortical MTR was lower in SPMS than PPMS ( p<0.01) and RRMS ( p<0.01). Conclusions: Lower outer than inner cortical MTR in healthy controls may reflect differences in myelin content. The lowest outer cortical MTR was seen in SPMS and is consistent with more extensive outer cortical (including subpial) pathology, such as demyelination and neuronal loss, as observed in post-mortem studies of SPMS patients.

Early diffuse demyelinating lesion in the cervical spinal cord predicts a worse prognosis in relapsing—remitting multiple sclerosis

2010 ◽  
Vol 16 (8) ◽  
pp. 935-941 ◽  
Author(s):  
F. Coret ◽  
I. Bosca ◽  
L. Landete ◽  
MJ Magraner ◽  
A. Navarré ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Long Term Outcome ◽  
Relapsing Remitting ◽  
Group A ◽  
Remitting Multiple Sclerosis ◽  
Group B ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Worse Prognosis

Objective: To study the long-term outcome and persistence of two patterns of cervical spinal cord abnormality in early relapsing—remitting multiple sclerosis (RRMS). Methods: RRMS patients with a spinal cord MRI performed during the first 3 years of the disease, a control MRI 5 years later and who have been followed up at least 10 years were included. Patients were grouped according the T2 spinal cord MRI into: (A) nodular pattern, if one or more focal lesions were present; and (B) diffuse pattern, defined as a poorly demarcated high signal area. The end point was defined as the time to reach an Expanded Disability Status Score (EDSS) of 4.0. Results: Twenty-five patients were included; 12 in group A and 13 in group B. Three patients in group A and 9 in group B reached EDSS 4, in a mean time of 11 years in group A and 7 years in group B (log rank 10.3, p = 0.001). Multivariate Cox regression analysis assessing the risk of EDSS 4.0 including sex, age, number of relapses in the first 2 years, number of T2 brain lesions and spinal cord pattern showed higher risk for the diffuse pattern (hazard ratio 7.2, 95% confidence interval 1.4—36.4). Control MRI showed the persistence of the diffuse pattern in all patients, and the development of diffuse pattern in two patients with basal nodular lesions. Conclusions: The diffuse abnormality in cervical spinal cord at the beginning of the disease is persistent and predicts a worse prognosis in RRMS patients.

scholarly journals Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio

2021 ◽  
Vol 12 ◽  
Author(s):  
Ratthaporn Boonsuth ◽  
Rebecca S. Samson ◽  
Carmen Tur ◽  
Marco Battiston ◽  
Francesco Grussu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Nervous System ◽  
Magnetic Resonance ◽  
Sciatic Nerve ◽  
Lumbar Plexus ◽  
Imaging Biomarker ◽  
Magnetisation Transfer ◽  
Magnetisation Transfer Ratio ◽  
Transfer Ratio ◽  
Relapsing Remitting

Background: Multiple sclerosis (MS) has traditionally been regarded as a disease confined to the central nervous system (CNS). However, neuropathological, electrophysiological, and imaging studies have demonstrated that the peripheral nervous system (PNS) is also involved, with demyelination and, to a lesser extent, axonal degeneration representing the main pathophysiological mechanisms.Aim: The purpose of this study was to assess PNS damage at the lumbar plexus and sciatic nerve anatomical locations in people with relapsing-remitting MS (RRMS) and healthy controls (HCs) in vivo using magnetisation transfer ratio (MTR), which is a known imaging biomarker sensitive to alterations in myelin content in neural tissue, and not previously explored in the context of PNS damage in MS.Method: Eleven HCs (7 female, mean age 33.6 years, range 24-50) and 15 people with RRMS (12 female, mean age 38.5 years, range 30-56) were recruited for this study and underwent magnetic resonance imaging (MRI) investigations together with clinical assessments using the expanded disability status scale (EDSS). Magnetic resonance neurography (MRN) was first used for visualisation and identification of the lumbar plexus and the sciatic nerve and MTR imaging was subsequently performed using identical scan geometry to MRN, enabling straightforward co-registration of all data to obtain global and regional mean MTR measurements. Linear regression models were used to identify differences in MTR values between HCs and people with RRMS and to identify an association between MTR measures and EDSS.Results: MTR values in the sciatic nerve of people with RRMS were found to be significantly lower compared to HCs, but no significant MTR changes were identified in the lumbar plexus of people with RRMS. The median EDSS in people with RRMS was 2.0 (range, 0-3). No relationship between the MTR measures in the PNS and EDSS were identified at any of the anatomical locations studied in this cohort of people with RRMS.Conclusion: The results from this study demonstrate the presence of PNS damage in people with RRMS and support the notion that these changes, suggestive of demyelination, maybe occurring independently at different anatomical locations within the PNS. Further investigations to confirm these findings and to clarify the pathophysiological basis of these alterations are warranted.

Sign in / Sign up

Export Citation Format

Share Document