scholarly journals Magnetisation transfer ratio abnormalities in primary and secondary progressive multiple sclerosis

2019 ◽  
Vol 26 (6) ◽  
pp. 679-687 ◽  
Author(s):  
James William L Brown ◽  
Azmain Chowdhury ◽  
Baris Kanber ◽  
Ferran Prados Carrasco ◽  
Arman Eshaghi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
Healthy Controls ◽  
Magnetisation Transfer ◽  
Magnetisation Transfer Ratio ◽  
Transfer Ratio ◽  
Secondary Progressive ◽  
Normal Appearing White Matter ◽  
Meningeal Inflammation ◽  
Cortical Grey Matter

Background: In relapse-onset multiple sclerosis (MS), tissue abnormality – as assessed with magnetisation transfer ratio (MTR) imaging – is greater in the outer cortical and inner periventricular layers. The cause of this remains unknown but meningeal inflammation has been implicated, particularly lymphoid follicles, which are seen in secondary progressive (SP) but not primary progressive (PP) MS. Cortical and periventricular MTR gradients might, therefore, differ in PPMS and SPMS if these follicles are responsible. Objective: We assessed cortical and periventricular MTR gradients in PPMS, and compared gradients between people with PPMS and SPMS. Methods: Using an optimised processing pipeline, periventricular normal-appearing white matter and cortical grey-matter MTR gradients were compared between 51 healthy controls and 63 people with progressive MS (28 PPMS, 35 SPMS). Results: The periventricular gradient was significantly shallower in healthy controls (0.122 percentage units (pu)/band) compared to PPMS (0.952 pu/band, p < 0.0001) and SPMS (1.360 pu/band, p < 0.0001). The cortical gradient was also significantly shallower in healthy controls (−2.860 pu/band) compared to PPMS (−3.214 pu/band, p = 0.038) and SPMS (−3.328 pu/band, p = 0.016). Conclusion: Abnormal periventricular and cortical MTR gradients occur in both PPMS and SPMS, suggesting comparable underlying pathological processes.

Cortical lesion load correlates with diffuse injury of multiple sclerosis normal appearing white matter

2013 ◽  
Vol 20 (2) ◽  
pp. 227-233 ◽  
Author(s):  
Niraj Mistry ◽  
Rasha Abdel-Fahim ◽  
Olivier Mougin ◽  
Christopher Tench ◽  
Penny Gowland ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Cortical Lesion ◽  
Cortical Lesions ◽  
Magnetisation Transfer ◽  
Magnetisation Transfer Ratio ◽  
Lesion Load ◽  
Transfer Ratio ◽  
Normal Appearing White Matter ◽  
Axon Loss

Background:Degeneration of central nervous system normal appearing white matter (NAWM) underlies disability and progression in multiple sclerosis (MS). Axon loss typifies NAWM degeneration.Objective:The objective of this paper is to assess correlation between cortical lesion load and magnetisation transfer ratio (MTR) of the NAWM in MS. This was in order to test the hypothesis that cortical lesions cause NAWM degeneration.Methods:Nineteen patients with MS underwent 7 Tesla magnetisation-prepared-rapid-acquisition-gradient-echo (MPRAGE), and magnetisation transfer ratio (MTR) brain magnetic resonance imaging (MRI). Cortical lesions were identified using MPRAGE and MTR images of cortical ribbons. White matter lesions (WMLs) were segmented using MPRAGE images. WML maps were subtracted from white matter volumes to produce NAWM masks. Pearson correlation was calculated for NAWM MTR vs cortical lesion load, and WML volumes.Results:Cortical lesion volumes and counts all had significant correlation with NAWM mean MTR. The strongest correlation was with cortical lesion volumes obtained using MTR images ( r = −0.6874, p = 0.0006). WML volume had no significant correlation with NAWM mean MTR ( r = −0.08706, p = 0.3615).Conclusion:Our findings are consistent with the hypothesis that cortical lesions cause NAWM degeneration. This implicates cortical lesions in the pathogenesis of NAWM axon loss, which underpins long-term disability and progression in MS.

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.

Magnetisation transfer of normal appearing white matter in primary progressive multiple sclerosis

1999 ◽  
Vol 5 (5) ◽  
pp. 313-316 ◽  
Author(s):  
S M Leary ◽  
N C Silver ◽  
V L Stevenson ◽  
G J Barker ◽  
D H Miller ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Corpus Callosum ◽  
Progressive Multiple Sclerosis ◽  
Primary Progressive Multiple Sclerosis ◽  
Magnetisation Transfer ◽  
Centrum Semiovale ◽  
Primary Progressive ◽  
Normal Appearing White Matter ◽  
Frontal White Matter

Patients with primary progressive multiple sclerosis may develop severe disability despite a paucity of lesions on conventional magnetic resonance imaging, raising the possibility that intrinsic changes in normal appearing white matter (NAWM) contribute to disability. This study has measured magnetisation transfer ratio (MTR), an index of tissue damage, of NAWM in 52 patients with primary progressive multiple sclerosis and 26 healthy controls. Absolute values of MTR were obtained from the genu of the corpus callosum and pons, and mean values were calculated from bilateral regions in the centrum semiovale, frontal white matter, parieto-occipital white matter and posterior limb of the internal capsule. The median MTR was lower in all regions in patients compared to controls. Median values (per cent units) were significantly lower in corpus callosum (39.73 vs 40.63; P=0.01), frontal white matter (39.11 vs 39.59; P=0.01) and centrum semiovale (37.21 vs 37.82; P50.05). This study has demonstrated small but widespread decreases in MTR in NAWM in primary progressive multiple sclerosis supporting the hypothesis that there are intrinsic changes in NAWM which may contribute to disability in this patient group.

T1 relaxation maps allow differentiation between pathologic tissue subsets in relapsing-remitting and secondary progressive multiple sclerosis

2004 ◽  
Vol 10 (5) ◽  
pp. 556-561 ◽  
Author(s):  
A Castriota-Scanderbeg ◽  
F Fasano ◽  
M Filippi ◽  
C Caltagirone
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Relaxation Times ◽  
Brain Regions ◽  
Progressive Multiple Sclerosis ◽  
Clinical Group ◽  
Secondary Progressive ◽  
Normal Appearing White Matter ◽  
Relapsing Remitting ◽  
Normal White Matter

In an attempt to clarify whether T1 relaxation time mapping may assist in characterizing the pathological brain tissue substrate of multiple sclerosis (MS), we compared the T1 relaxation times of lesions, areas of normal-appearing white matter (NAWM) located proximal to lesions, and areas of NAWM located distant from lesions in 12 patients with the relapsing-remitting and 12 with the secondary progressive (SP) subtype of disease. Nine healthy volunteers served as controls. Calculated mean T1 values were averaged across all patients within each clinical group, and comparisons were made by means of the Mann-Whitney U-test. Significant differences were found between all investigated brain regions within each clinical subgroup. Significant differences were also detected for each investigated brain region among clinical subgroups. While T1 values of NAWM were significantly higher in patients with SP disease than in normal white matter (NWM) of controls, no differences were detected when corresponding brain areas of patients with RR MS were compared with NWM of controls. T1 maps identify areas of the brain that are damaged to a different extent in patients with MS, and may be of help in monitoring disease progression.

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