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Updated: May 28, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Determinants of brain iron in multiple sclerosis: a quantitative 3T MRI study
M Khalil1, C Langkammer, S Ropele
1Department of Neurology, Medical University of Graz, Graz, Austria.
Objectives:
Abnormal high cerebral iron deposition may be implicated in chronic neurologic disorders, including multiple sclerosis (MS). R2* relaxometry has been recently validated in a postmortem study to indicate brain iron accumulation in a quantitative manner. We used this technique to assess brain iron levels in different stages of MS and healthy controls (HC) and determined their relation with demographic, clinical, neuropsychological, and other imaging variables.
Methods:
We studied 113 consecutive patients (35 clinically isolated syndrome [CIS], 78 MS) and 35 HC with 3 T MRI and clinical and neuropsychological examination. Iron deposition in subcortical gray matter structures was assessed by automated, regional calculation of R2* rates.
Results:
Basal ganglia (BG) R2* levels were significantly increased in MS compared to CIS (p < 0.001) and HC (p < 0.005). They were correlated with age (r = 0.5, p < 0.001), disease duration (r = 0.5, p < 0.001), Expanded Disability Status Scale (r = 0.3, p < 0.005), and the z values of mental processing speed (r = -0.3, p < 0.01). Stepwise linear regression analysis revealed gray matter atrophy as the strongest independent predictor of BG R2* levels (p < 0.001), followed by age (p < 0.001) and T2 lesion load (p < 0.005).
Conclusion:
BG iron accumulation in MS occurs with advancing disease and is related to the extent of morphologic brain damage, which argues for iron deposition as an epiphenomenon. The absence of increased iron levels in patients with CIS indicates that iron accumulation does not precede the development of MS.
Insights
Brain iron deposition increases with multiple sclerosis (MS) progression and is linked to brain damage, not preceding the disease. This finding suggests iron accumulation is a consequence of MS pathology.
Area of Science:
- Neuroimaging
- Neurology
- Biomarkers
Background:
- Abnormal cerebral iron deposition is implicated in chronic neurological disorders like multiple sclerosis (MS).
- R2* relaxometry quantifies brain iron accumulation, validated in postmortem studies.
- Assessing brain iron levels in MS stages can elucidate disease mechanisms.
Purpose of the Study:
- To evaluate brain iron levels in different stages of multiple sclerosis (MS) and healthy controls (HC) using R2* relaxometry.
- To determine the relationship between brain iron deposition and demographic, clinical, neuropsychological, and imaging variables in MS.
- To investigate whether iron accumulation precedes or follows MS development.
Main Methods:
- 113 patients (35 clinically isolated syndrome [CIS], 78 MS) and 35 HC underwent 3 Tesla MRI.
- Automated, regional R2* rates quantified iron deposition in subcortical gray matter structures.
- Clinical and neuropsychological examinations were performed.
Main Results:
- Basal ganglia (BG) R2* levels were significantly higher in MS patients compared to CIS and HC.
- BG R2* levels correlated with age, disease duration, disability (Expanded Disability Status Scale), and processing speed.
- Gray matter atrophy, age, and T2 lesion load were independent predictors of BG R2* levels.
Conclusions:
- Basal ganglia iron accumulation in MS increases with disease progression and correlates with morphologic brain damage.
- Iron deposition in MS appears to be an epiphenomenon, a consequence of disease-related brain damage.
- The lack of increased iron in CIS suggests iron accumulation does not precede MS onset.
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01:24Magnetic Resonance Imaging
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These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).