Periventricular gradient of T₁ tissue alterations in multiple sclerosis

Area of Science:

• Neuroimaging
• Neurology
• Biomarker Discovery

Background:

• Multiple sclerosis (MS) pathology is unevenly distributed, with greater severity observed in areas near cerebrospinal fluid (CSF).
• A
• This study investigates the presence and significance of this gradient in MS.

Purpose of the Study:

• To determine if the
• To compare this gradient between early and progressive MS.
• To assess if gradient-derived MRI metrics correlate better with disability than conventional metrics.

Main Methods:

• Included 47 early MS, 52 progressive MS patients, and 92 controls.
• Utilized 3T 3D T1 relaxometry (Magnetization-Prepared 2 Rapid Acquisition Gradient Echoes) to create normative T1 atlases.
• Analyzed periventricular T1 relaxation time z-scores and correlated them with the Expanded Disability Status Scale (EDSS).

Main Results:

• Both early and progressive MS patients showed a periventricular T1 relaxation time z-score gradient.
• In progressive MS, gradient metrics in normal-appearing white matter (NAWM) correlated more strongly with disability (rho=0.374) than lesion volume (rho=0.189) or count (rho=0.21).
• In early MS, baseline NAWM gradient (z-scores > 2) predicted disability at 2-year follow-up.

Conclusions:

• The
• Periventricular gradients correlate with clinical disability.
• NAWM periventricular gradients show promise as early biomarkers for monitoring MS activity across all phenotypes.