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Iron-Insensitive Quantitative Assessment of Subcortical Gray Matter Demyelination in Multiple Sclerosis Using the

V L Yarnykh1,2, E P Krutenkova2, G Aitmagambetova2

  • 1From the Department of Radiology (V.L.Y.), University of Washington, Seattle, Washington yarnykh@uw.edu.

AJNR. American Journal of Neuroradiology
|February 14, 2018
PubMed
Abstract

Insights

Macromolecular proton fraction mapping accurately measures demyelination in multiple sclerosis (MS) brain structures, independent of iron levels. This myelin loss correlates with disease severity and disability.

Area of Science:

  • Neuroimaging
  • Quantitative MRI
  • Demyelinating Diseases

Background:

  • Multiple Sclerosis (MS) involves myelin damage in the brain.
  • Assessing demyelination in subcortical gray matter (GM) is crucial for understanding MS progression.
  • Fast macromolecular proton fraction (MPF) mapping offers a novel quantitative MRI approach for myelin assessment.

Purpose of the Study:

  • To evaluate MPF as a measure of demyelination in subcortical GM structures in MS.
  • To investigate the relationship between demyelination (assessed by MPF) and iron deposition (assessed by T2* mapping) in MS.

Main Methods:

  • MPF and T2* maps were acquired using 3T MRI in 12 healthy controls, 18 relapsing-remitting MS (RRMS) patients, and 12 secondary-progressive MS (SPMS) patients.
  • MPF and T2* values were analyzed in the caudate nucleus, globus pallidus, putamen, substantia nigra, and thalamus.
  • Parameter values were compared between groups and correlated with clinical disability scores.

Main Results:

  • MPF significantly decreased across groups from controls to RRMS to SPMS in all studied subcortical structures.
  • T2* also decreased in the globus pallidus, putamen, and caudate nucleus across these groups.
  • MPF showed significant correlations with clinical measures of disability (EDSS, MSFC, 9-Hole Peg Test), indicating association with disease severity and nigrostriatal pathway damage.

Conclusions:

  • MPF is an iron-insensitive quantitative MRI marker for demyelination in subcortical GM in MS.
  • Myelin loss in these structures is not associated with excess iron deposition.
  • Subcortical GM demyelination severity in MS is more strongly linked to disease phenotype and disability than to iron overload.

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