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

Mult Scler. 2014 Sep;20(10):1322-30. doi: 10.1177/1352458514522537. Epub 2014 Feb 19.

Abstract

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) 1×1×1mm(3) 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.

Keywords: Multiple sclerosis; cortical grey matter; magnetization transfer ratio.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cerebral Cortex / metabolism
  • Cerebral Cortex / pathology*
  • Disability Evaluation
  • Disease Progression
  • Female
  • Gray Matter / metabolism
  • Gray Matter / pathology*
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Multiple Sclerosis, Chronic Progressive / diagnosis*
  • Multiple Sclerosis, Chronic Progressive / metabolism
  • Multiple Sclerosis, Chronic Progressive / pathology
  • Multiple Sclerosis, Relapsing-Remitting / diagnosis*
  • Multiple Sclerosis, Relapsing-Remitting / metabolism
  • Multiple Sclerosis, Relapsing-Remitting / pathology
  • Myelin Sheath / metabolism
  • Neurons / metabolism
  • Neurons / pathology*
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Young Adult