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Updated: Jul 9, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Detecting macromolecular differences of the CSF in low disability multiple sclerosis using quantitative MT MRI at 3T
Richard D Lawless1,2, Colin D McKnight3, Kristin P O'Grady4
1Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA.
Background:
Imaging investigation of cerebrospinal fluid (CSF) in multiple sclerosis (MS) is understudied. Development of noninvasive methods to detect pathological CSF changes would have a profound effect on MS diagnosis and would offer insight into MS pathophysiology and mechanisms of neurological impairment.
Objective:
We propose magnetization transfer (MT) MRI as a tool to detect macromolecular changes in spinal CSF.
Methods:
MT and quantitative MT (qMT) data were acquired in the cervical region in 27 people with relapsing-remitting multiple sclerosis (pwRRMS) and 38 age and sex-matched healthy controls (HCs). MT ratio (MTR), the B1, B0, and R1 corrected qMT-derived pool size ratio (PSR) were quantified in the spinal cord and CSF of each group.
Results:
Both CSF MTR and CSF qMT-derived PSR were significantly increased in pwRRMS compared to HC (p = 0.027 and p = 0.020, respectively). CSF PSR of pwRRMS was correlated to Expanded Disability Status Scale Scores (p = 0.045, R = 0.352).
Conclusion:
Our findings demonstrate increased CSF macromolecular content in pwRRMS and link CSF macromolecular content with clinical impairment. This highlights the potential role of CSF in processing products of demyelination.
Insights
Magnetization transfer MRI reveals increased macromolecular content in the cerebrospinal fluid (CSF) of people with multiple sclerosis (MS). This finding links CSF changes to clinical impairment, suggesting CSF’s role in demyelination.
Area of Science:
- Neuroimaging
- Biomarkers
- Multiple Sclerosis Pathophysiology
Background:
- Cerebrospinal fluid (CSF) imaging in multiple sclerosis (MS) is underexplored.
- Noninvasive methods for detecting pathological CSF changes are needed for MS diagnosis and understanding disease mechanisms.
- Macromolecular changes in spinal CSF may offer insights into neurological impairment.
Purpose of the Study:
- To propose and evaluate magnetization transfer (MT) MRI as a tool for detecting macromolecular changes in spinal CSF.
- To investigate differences in CSF macromolecular content between people with relapsing-remitting MS (pwRRMS) and healthy controls (HCs).
Main Methods:
- MT and quantitative MT (qMT) MRI data were acquired in the cervical spinal cord and CSF.
- 27 pwRRMS and 38 HCs participated in the study.
- Quantified metrics included MT ratio (MTR) and qMT-derived pool size ratio (PSR).
Main Results:
- CSF MTR and CSF qMT-derived PSR were significantly elevated in pwRRMS compared to HCs (p=0.027 and p=0.020).
- CSF PSR in pwRRMS showed a correlation with Expanded Disability Status Scale Scores (p=0.045, R=0.352).
Conclusions:
- Findings demonstrate increased CSF macromolecular content in pwRRMS.
- Elevated CSF macromolecular content is linked to clinical impairment in MS.
- This suggests a potential role for CSF in processing demyelination products.
