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MRI T2 shortening ('black T2') in multiple sclerosis: frequency, location, and clinical correlation
R Bakshi1, Z A Shaikh, V Janardhan
1Imaging Services-Kaleida Health, State University of New York, Buffalo 14203, USA.
Abstract:
Abnormal iron deposition occurs in the brains of patients with multiple sclerosis (MS) and may cause MRI T2 shortening ('black T2'; BT2). The frequency, distribution and clinical significance of BT2 in MS is unknown. Analysis of brain MRI scans of 114 MS patients showed BT2 in thalamus (n = 65; 57%), putamen (n = 48; 42%), caudate (n = 27; 24%) and Rolandic cortex (n = 9; 8%). BT2 was significantly related to longer disease duration and advancing neurological disability. Wheelchair-bound patients had worse BT2 in thalamus (p < 0.05), putamen (p < 0.001) and Rolandic cortex (p < 0.05). Patients with secondary progressive disease (n = 34) had worse BT2 in thalamus, putamen and caudate (all p < 0.05) than those with relapsing remitting disease (n = 80). BT2 is proposed as a clinically relevant finding relating to neuronal degeneration in MS.
Insights
Abnormal brain iron deposition, seen as black T2 (BT2) on MRI, is common in multiple sclerosis (MS). This finding correlates with longer disease duration and increased neurological disability in MS patients.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Abnormal iron deposition in the brain is observed in multiple sclerosis (MS) patients.
- This iron deposition can manifest as MRI T2 shortening, termed 'black T2' (BT2).
- The prevalence, location, and clinical relevance of BT2 in MS are not well understood.
Purpose of the Study:
- To investigate the frequency, distribution, and clinical significance of black T2 (BT2) findings in the brains of multiple sclerosis (MS) patients.
- To determine the relationship between BT2 and disease duration, disability level, and disease subtype in MS.
Main Methods:
- Analysis of brain MRI scans from 114 individuals diagnosed with multiple sclerosis.
- Systematic assessment for the presence and location of black T2 (BT2) lesions.
- Statistical analysis to correlate BT2 findings with clinical data, including disease duration, disability status (e.g., wheelchair-bound), and MS subtype (secondary progressive vs. relapsing-remitting).
Main Results:
- Black T2 (BT2) was detected in 57% of patients in the thalamus, 42% in the putamen, 24% in the caudate nucleus, and 8% in the Rolandic cortex.
- BT2 presence and severity were significantly associated with longer disease duration and greater neurological disability.
- Wheelchair-bound patients exhibited worse BT2 in the thalamus, putamen, and Rolandic cortex.
- Patients with secondary progressive MS showed more pronounced BT2 in the thalamus, putamen, and caudate compared to those with relapsing-remitting MS.
Conclusions:
- Black T2 (BT2) is a frequent finding in the brains of multiple sclerosis patients.
- BT2 is clinically relevant, indicating a relationship with advanced neurological degeneration in MS.
- MRI-detectable iron deposition may serve as a biomarker for disease progression and severity in MS.