Multimodal quantitative MRI assessment of cortical damage in relapsing-remitting multiple sclerosis

René Maxime Gracien, Alina Jurcoane, Marlies Wagner, Sarah C. Reitz, Christoph Mayer, Steffen Volz, Stephanie Michelle Hof, Vinzenz Fleischer, Amgad Droby, Helmuth Steinmetz, Sergiu Groppa, Elke Hattingen, Ralf Deichmann, Johannes C. Klein

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate magnetization transfer ratio (MTR), T1 relaxation time, and proton density (PD) as indicators of gray matter damage in relapsing-remitting multiple sclerosis (RRMS), reflecting different aspects of microstructural damage and as imaging correlates of clinical disability. We aimed to determine which of these parameters may optimally quantify cortical damage, and serve as an imaging surrogate of clinical disability. In this study, cortical values of MTR, a surrogate for demyelination in MS, of PD, reflecting replacement of neural tissue by water, and of T1, indicating a complex array of microstructural changes, were assessed in a group of RRMS patients in comparison to healthy controls (HC). Materials and Methods: 22 RRMS patients with varying disease duration (4.0 ± 6.54 years) and 10 HC received quantitative 3T magnetic resonance imaging (MRI) with MTR, T1, and PD mapping. We tested for differences in cortical measurements between patients and HC. Additionally, correlation with disability as quantified by the Expanded Disability Status Scale was investigated. Results: Cortical parameter values were significantly altered in the RRMS group, with increased values of T1 (P = 0.008) and PD (P = 0.028) and reduced values of MTR (P = 0.043). Only cortical T1 was correlated with clinical disability measurements (P = 0.001, r = 0.65). Receiver operating characteristic analysis demonstrated the best discriminatory power for T1 (area under the curve 0.79, PD: 0.75, MTR 0.73). Conclusion: Out of the parameters studied, cortical T1 is best suited to detect cortical damage as an imaging surrogate of clinical disability in RRMS. J. Magn. Reson. Imaging 2016;44:1600–1607.

Original languageEnglish
Pages (from-to)1600-1607
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Volume44
Issue number6
DOIs
StatePublished - 1 Dec 2016
Externally publishedYes

Keywords

  • MTR
  • T relaxation time
  • cortical gray matter
  • multiple sclerosis
  • proton density
  • quantitative MRI

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