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Updated: Apr 11, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Magnetization transfer ratio in lesions rather than normal-appearing brain relates to disability in patients with
Michael Amann1, Athina Papadopoulou, Michaela Andelova
1Department of Neurology, University Hospital Basel, Basel, Switzerland.
Abstract:
Magnetization transfer ratio (MTR) is a semi-quantitative measure that seems to correlate with the degree of myelin loss and generally tissue destruction in multiple sclerosis (MS). Our objective was to comprehensively assess the MTR of lesions and normal appearing (NA) tissue separately in the white matter (WM), the cortex, the thalamus and the basal ganglia (BG) and determine their relative contribution to disability. In this cross-sectional study 71 patients were included (59 with relapsing-remitting MS, 12 with secondary progressive MS). We used a three-dimensional MTR sequence with high spatial resolution, based on balanced steady-state free precession. Mean MTR was calculated for lesions and NA tissue separately for each tissue type. Lesional MTR was lower than normal-appearing MTR in WM, cortex and thalamus. In the regression analysis, MTR of cortical lesions (β = -0.23, p = 0.05) and MTR of WML (β = -0.21, p = 0.08) were related by trend to the expanded disability status scale. MTR of WML significantly predicted the paced auditory serial-addition test (β = 0.35, p = 0.004). MTR of normal-appearing tissue did not relate to any outcome. Our results suggest that MTR of lesions in the white matter and cortex rather than of normal-appearing tissue relates to disability in patients with MS.
Insights
Magnetization transfer ratio (MTR) in multiple sclerosis (MS) lesions, particularly in white matter and cortex, correlates with patient disability. MTR in normal-appearing tissue did not show a significant relationship with disability outcomes.
Area of Science:
- Neuroimaging
- Biomarkers
- Multiple Sclerosis Research
Background:
- Magnetization transfer ratio (MTR) is a neuroimaging technique used to assess tissue integrity.
- MTR is believed to correlate with myelin loss and tissue damage in neurological conditions like multiple sclerosis (MS).
- Understanding the relationship between MTR in different brain regions and disability is crucial for MS patient management.
Purpose of the Study:
- To comprehensively evaluate MTR in both MS lesions and normal-appearing (NA) brain tissue.
- To analyze MTR in specific regions: white matter (WM), cortex, thalamus, and basal ganglia (BG).
- To determine the contribution of MTR in these areas to patient disability.
Main Methods:
- A cross-sectional study involving 71 MS patients (59 relapsing-remitting, 12 secondary progressive).
- Utilized a high-resolution, three-dimensional MTR sequence based on balanced steady-state free precession.
- Calculated mean MTR for both lesional and NA tissue across different brain regions.
Main Results:
- Lesional MTR was consistently lower than NA tissue MTR in WM, cortex, and thalamus.
- MTR of cortical lesions and white matter lesions (WML) showed a trend towards association with the Expanded Disability Status Scale (EDSS).
- WML MTR significantly predicted performance on the Paced Auditory Serial Addition Test (PASAT).
- MTR of NA tissue did not correlate with any measured disability outcomes.
Conclusions:
- MTR of MS lesions in the white matter and cortex, not NA tissue, is related to disability in MS patients.
- MTR of lesions may serve as a valuable imaging biomarker for assessing disability progression in MS.
- These findings highlight the importance of lesion MTR in understanding MS pathophysiology and its impact on patients.
