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Exploring in vivo multiple sclerosis brain microstructural damage through T1w/T2w ratio: a multicentre study.

Monica Margoni1, Elisabetta Pagani1, Alessandro Meani1

  • 1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.

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|May 17, 2022
PubMed
Summary
This summary is machine-generated.

The T1w/T2w ratio, a marker of brain tissue changes, is altered in multiple sclerosis (MS) patients, showing lower values in lesions and normal-appearing white matter but higher values in specific deep grey matter areas. This ratio may indicate demyelination, neurodegeneration, and iron accumulation in MS.

Keywords:
MRIT1w/T2w-ratiomultiple sclerosis

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Area of Science:

  • Neuroimaging
  • Radiology
  • Neurology

Background:

  • Multiple Sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
  • Understanding tissue changes in MS is crucial for diagnosis and monitoring.
  • The T1-weighted/T2-weighted (T1w/T2w) ratio is a potential imaging biomarker.

Purpose of the Study:

  • To evaluate the T1w/T2w ratio in white matter and grey matter of healthy controls and MS patients.
  • To investigate the association between T1w/T2w ratio and clinical disability in MS.

Main Methods:

  • Cross-sectional study of 270 healthy controls and 434 MS patients from 7 European sites.
  • Retrospective analysis of brain T1w and T2w MRI scans.
  • Intensity calibration using eyes and temporal muscle to obtain T1w/T2w ratio.

Main Results:

  • In healthy controls, T1w/T2w ratio increased with age until 50-60 years.
  • MS patients showed significantly lower T1w/T2w ratio in white matter lesions, normal-appearing white matter, and cortex compared to controls.
  • Conversely, MS patients exhibited a significantly higher T1w/T2w ratio in the striatum and pallidum.
  • T1w/T2w ratio alterations correlated with disease duration, disability (EDSS), lesion volume, and brain volume.

Conclusions:

  • The T1w/T2w ratio may serve as a clinically relevant imaging marker in multiple sclerosis.
  • This ratio is sensitive to demyelination, neurodegeneration, and iron accumulation.
  • T1w/T2w ratio patterns vary across different MS phenotypes and disease stages.