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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Iron deposition in the gray matter in patients with relapse-remitting multiple sclerosis: A longitudinal study using
Silin Du1, Shambhu K Sah1, Chun Zeng1
1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China.
Purpose:
To investigate the relationship between the iron content by magnetic resonance imaging (MRI) and clinic correlation in patients with relapse-remitting multiple sclerosis (RRMS) over a two-year period.
Methods:
Thirty RRMS patients and 30 healthy control subjects were examined twice, two years apart, by undergoing brain conventional MRI and three-dimensional (3D)-enhanced T2*-weighted angiography (ESWAN) sequences at 3.0T. Quantitative differences in iron content in deep gray matter (GM) nuclei and precentral gyrus GM between patients and control subjects with repeated-measures the mean phase values (MPVs) for ESWAN-filtered phase images. Spearman's rank correlation coefficient analysis was used to evaluate correlations of the MPVs, both 2-year-difference and single-time measurements, to disease duration, expanded disability status scale (EDSS) and times of recurrence.
Results:
The RRMS patients had higher GM iron concentration than that of the healthy control subjects in both single-time measurements, but only the substantia nigra (SN), and the precentral gyrus GM (PGM) showed a significant statistical difference (p<0.05). Using the paired samples t test, we found that there were significant differences in two-year-difference measurements of the MPVs in the putamen (PUT), the globus pallidus (GP), the head of the caudate nucleus (HCN), the thalamus (THA), SN, the red nucleus (RN), the dentate nucleus (DN) and PGM, especially in SN (t=2.92, p=0.007) in RRMS patients. The MPVs of the PUT, GP, HCN, THA, SN, RN, DN and PGM for the subgroup with RRMS patients in times of recurrence less than twice were similar to the healthy controls. There was no significant difference in all regions of interests (ROIs). However, there were significant differences in all ROIs except THA and GP for the other subgroup with RRMS patients in times of recurrence more than and equal to twice. Spearman's rank correlation coefficient analysis showed there were significant negative correlations between disease duration and the MPVs in the HCN (r=-0.516, p=0.004), DN (r=-0.468, p=0.009) and PGM (r=-0.84, p=0). However, no correlations were found between the EDSS scores and the MPVs.
Conclusions:
Iron content in the GM can be measurable using MRI and our results confirmed that iron concentration was increasing in the GM of MS patients during two-year period compared to healthy controls. Furthermore, this study had also shown significant and substantial correlation of iron concentration with disease severity.
Insights
Iron accumulation in the gray matter (GM) of patients with relapse-remitting multiple sclerosis (RRMS) increases over two years, detectable by magnetic resonance imaging (MRI). This iron concentration correlates with disease severity, offering insights into multiple sclerosis progression.
Area of Science:
- Neuroimaging
- Neurology
- Biomarkers
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
- Iron accumulation in deep gray matter (GM) nuclei is implicated in neurodegeneration in MS.
- Longitudinal assessment of iron content in MS is crucial for understanding disease progression.
Purpose of the Study:
- To investigate the relationship between iron content in the brain's GM, measured by MRI, and clinical correlations in patients with relapse-remitting MS (RRMS) over a two-year period.
- To assess changes in iron concentration in specific brain regions of RRMS patients compared to healthy controls.
- To evaluate the correlation between iron levels and disease duration, disability status, and recurrence frequency.
Main Methods:
- Thirty RRMS patients and 30 healthy controls underwent brain MRI, including conventional and 3D-enhanced T2*-weighted angiography (ESWAN) sequences, at baseline and two-year follow-up.
- Quantitative iron content was assessed using mean phase values (MPVs) from ESWAN-filtered phase images in deep GM nuclei and the precentral gyrus.
- Spearman's rank correlation was used to analyze relationships between MPVs and clinical parameters (disease duration, EDSS, recurrence times).
Main Results:
- RRMS patients showed higher GM iron concentration than controls, with significant differences in substantia nigra (SN) and precentral gyrus GM (PGM).
- Over two years, significant increases in MPVs were observed in multiple deep GM nuclei (putamen, globus pallidus, caudate nucleus, thalamus, SN, red nucleus, dentate nucleus) and PGM in RRMS patients.
- Significant negative correlations were found between disease duration and MPVs in the caudate nucleus, dentate nucleus, and PGM, but no correlation with EDSS scores.
Conclusions:
- Iron content in the GM is measurable using MRI and increases in RRMS patients over a two-year period compared to controls.
- This study confirms increasing iron concentration in the GM of MS patients over time.
- Iron concentration in the GM shows a significant correlation with disease severity, suggesting its potential as a biomarker for MS progression.
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