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Magnetization transfer ratio measurement in multiple sclerosis normal-appearing brain tissue: limited differences with controls but relationships with clinical and MR measures of disease

Department of Radiology, MR Center for MS Research, VU University Medical Center, Amsterdam, The Netherlands, h.vrenken{at}vumc.nl

P.J.W. Pouwels

Department of Physics and Medical Technology, MR Center for MS Research, VU University Medical Center, Amsterdam, The Netherlands

S. Ropele

MR Research Unit and Department of Neurology, Medical University Graz, Graz, Austria

D.L. Knol

Department of Clinical Epidemiology and Biostatistics, MR Center for MS Research, VU University Medical Center, Amsterdam, The Netherlands

J.J.G. Geurts

Department of Radiology, MR Center for MS Research, VU University Medical Center, Amsterdam, The Netherlands

C.H. Polman

Department of Neurology, MR Center for MS Research, VU University Medical Center, Amsterdam, The Netherlands

F. Barkhof

Department of Radiology, MR Center for MS Research, VU University Medical Center, Amsterdam, The Netherlands

J.A. Castelijns

Department of Radiology, MR Center for MS Research, VU University Medical Center, Amsterdam, The Netherlands

We investigated the magnetization transfer ratio (MTR) of normal-appearing white (NAWM) and grey matter (NAGM) in a relatively large group of multiple sclerosis (MS) patients, and the relations of MTR changes with clinical disability. MTR was measured in 66 MS patients (12 PP, 35 RR, 19 SP) and 23 healthy controls, using a whole-brain 3D-FLASH technique corrected post-hoc for B₁-induced variation. Histogram parameters of conservatively selected NAWM and cortical NAGM were analysed using Bonferroni-corrected ANOVA with age as covariate. Additionally, manually outlined regions of interest were analysed using a multilevel method. Lesions had low MTR (mean 22.7±6.9%), but NAWM exhibited limited changes: MTR histogram peak position was 32.8±1.0% in controls and 32.4±0.9% in MS patients, with a significant decrease compared to controls only in SPMS patients (31.9±1.1%, p=0.045). Cortical NAGM histograms did not differ significantly between patients and controls. In SPMS, regional mean MTR was significantly decreased in corpus callosum and hippocampus. MTR histogram parameters of NAGM and NAWM were correlated with EDSS and MSFC scores, with lesion volume and with normalized brain volume. We conclude that disease-induced MTR changes were small in MS NAWM and NAGM, but did correlate with clinical decline, lesion volume and overall cerebral atrophy. Multiple Sclerosis 2007; 13: 708-716. http://msj.sagepub.com

Key Words: B1 correction • magnetization transfer • multiple sclerosis • normal-appearing brain tissue

This version was published on July 1, 2007

Multiple Sclerosis, Vol. 13, No. 6, 708-716 (2007)
DOI: 10.1177/1352458506075521


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