Magnetisation transfer ratio abnormalities in primary and secondary progressive multiple sclerosis

Author:

Brown James William L1ORCID,Chowdhury Azmain2,Kanber Baris3,Prados Carrasco Ferran4,Eshaghi Arman2,Sudre Carole H5,Pardini Matteo6,Samson Rebecca S2ORCID,van de Pavert Steven HP2,Wheeler-Kingshott Claudia Gandini7,Chard Declan T8ORCID

Affiliation:

1. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK

2. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK

3. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, UK/National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals (UCLH), London, UK/Department of Clinical and Experimental Epilepsy, UCL Queen Square...

4. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, UK/eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain

5. Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, UK/Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK/School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK

6. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, and IRCCS AOU San Martino-IST, Genoa, Italy

7. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Brain MRI 3T Mondino Research Center, IRCCS Mondino Foundation, Pavia, Italy/Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

8. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals (UCLH), London, UK

Abstract

Background: In relapse-onset multiple sclerosis (MS), tissue abnormality – as assessed with magnetisation transfer ratio (MTR) imaging – is greater in the outer cortical and inner periventricular layers. The cause of this remains unknown but meningeal inflammation has been implicated, particularly lymphoid follicles, which are seen in secondary progressive (SP) but not primary progressive (PP) MS. Cortical and periventricular MTR gradients might, therefore, differ in PPMS and SPMS if these follicles are responsible. Objective: We assessed cortical and periventricular MTR gradients in PPMS, and compared gradients between people with PPMS and SPMS. Methods: Using an optimised processing pipeline, periventricular normal-appearing white matter and cortical grey-matter MTR gradients were compared between 51 healthy controls and 63 people with progressive MS (28 PPMS, 35 SPMS). Results: The periventricular gradient was significantly shallower in healthy controls (0.122 percentage units (pu)/band) compared to PPMS (0.952 pu/band, p < 0.0001) and SPMS (1.360 pu/band, p < 0.0001). The cortical gradient was also significantly shallower in healthy controls (−2.860 pu/band) compared to PPMS (−3.214 pu/band, p = 0.038) and SPMS (−3.328 pu/band, p = 0.016). Conclusion: Abnormal periventricular and cortical MTR gradients occur in both PPMS and SPMS, suggesting comparable underlying pathological processes.

Funder

Multiple Sclerosis Society

Publisher

SAGE Publications

Subject

Clinical Neurology,Neurology

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