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Updated: Mar 20, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
White Matter Tract Injury is Associated with Deep Gray Matter Iron Deposition in Multiple Sclerosis
Niels Bergsland1,2,3, Eleonora Tavazzi4, Maria Marcella Laganà1
1MR Research Laboratory, IRCCS, Don Gnocchi Foundation ONLUS, Milan, Italy.
Background And Purpose:
With respect to healthy controls (HCs), increased iron concentrations in the deep gray matter (GM) and decreased white matter (WM) integrity are common findings in multiple sclerosis (MS) patients. The association between these features of the disease remains poorly understood. We investigated the relationship between deep iron deposition in the deep GM and WM injury in associated fiber tracts in MS patients.
Methods:
Sixty-six MS patients (mean age 50.0 years, median Expanded Disability Status Scale 5.25, mean disease duration 19.1 years) and 29 HCs, group matched for age and sex were imaged on a 1.5T scanner. Susceptibility-weighted imaging and diffusion tensor imaging (DTI) were used for assessing high-pass filtered phase values in the deep GM and normal appearing WM (NAWM) integrity in associated fiber tracts, respectively. Correlation analyses investigated the associations between filtered phase values (suggestive of iron content) and WM damage.
Results:
Areas indicative of increased iron levels were found in the left and right caudates as well as in the left thalamus. MS patients presented with decreased DTI-derived measures of tissue integrity in the associated WM tracts. Greater mean, axial and radial diffusivities were associated with increased iron levels in all three GM areas (r values .393 to .514 with corresponding P values .003 to <.0001). Global NAWM diffusivity measures were not related to mean filtered phase values within the deep GM.
Conclusions:
Increased iron concentration in the deep GM is associated with decreased tissue integrity of the connected WM in MS patients.
Insights
In multiple sclerosis (MS), increased deep gray matter (GM) iron is linked to reduced white matter (WM) integrity. This study confirms that higher iron levels in the caudate and thalamus correlate with white matter damage in MS patients.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Multiple sclerosis (MS) is characterized by increased iron in deep gray matter (GM) and reduced white matter (WM) integrity in patients compared to healthy controls (HCs).
- The relationship between deep GM iron deposition and associated WM damage in MS is not well understood.
Purpose of the Study:
- To investigate the association between deep GM iron deposition and WM injury in connected fiber tracts in MS patients.
Main Methods:
- Sixty-six MS patients and 29 HCs underwent 1.5T MRI scans.
- Susceptibility-weighted imaging assessed deep GM iron levels (filtered phase values).
- Diffusion tensor imaging (DTI) evaluated normal-appearing WM (NAWM) integrity in associated fiber tracts, with correlation analyses performed.
Main Results:
- Increased iron concentrations were observed in the left and right caudates and left thalamus of MS patients.
- MS patients showed decreased DTI-derived measures of tissue integrity in associated WM tracts.
- Higher mean, axial, and radial diffusivities in WM tracts correlated significantly with increased iron levels in the caudate and thalamus.
Conclusions:
- Increased deep GM iron concentration is associated with compromised tissue integrity in connected WM in MS.
- These findings highlight a link between iron accumulation and white matter damage in multiple sclerosis.
