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Increased deep gray matter iron is present in clinically isolated syndromes
Matthew P Quinn1, Joseph S Gati2, Martyn L Klassen2
1Department of Medical Biophysics, The University of Western Ontario, Canada; Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, Canada.
Multiple Sclerosis and Related Disorders
|April 17, 2015
Summary
Iron accumulates in the deep gray matter of patients with clinically isolated syndromes (CIS), indicating early Multiple Sclerosis (MS) pathology. Thalamic iron increases correlate with disability, while white matter changes suggest early damage.
Area of Science:
- Neuroimaging
- Neurodegeneration
- Multiple Sclerosis (MS) Research
Background:
- Abnormal iron accumulation is a known hallmark in Multiple Sclerosis (MS).
- The role of iron accumulation as a cause or consequence of MS pathology remains debated.
- Clinically Isolated Syndromes (CIS) represent an early stage of MS.
Purpose of the Study:
- To investigate iron concentration in the brains of patients with CIS, a potential early indicator of MS.
- To determine if iron accumulation occurs early in the MS disease course.
- To explore the relationship between iron levels, clinical status, and potential venous abnormalities.
Main Methods:
- 3T MRI scans were performed on 22 CIS patients and 16 controls.
- R2* values, a measure of iron concentration, were analyzed throughout the brain.
- Correlations between R2* and clinical parameters (EDSS, age, disease duration) and internal jugular vein (IJV) cross-sectional area (CSA) were assessed.
Main Results:
- Significantly increased R2* (iron) was observed in the globus pallidus, thalamus, right pulvinar, and cortical areas of CIS patients.
- Thalamic R2* showed a positive correlation with the Extended Disability Status Scale (EDSS).
- Decreased white matter R2* was detected in CIS patients, suggesting diffuse damage.
Conclusions:
- Iron accumulation is present in deep gray matter during CIS, indicating early MS pathology.
- Increased thalamic iron is associated with greater clinical disability in early MS.
- Observed white matter R2* changes may represent early, diffuse damage, and venous abnormalities do not appear to drive iron accumulation or white matter damage in CIS.

