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T2 hypointensity in the deep gray matter of patients with benign multiple sclerosis

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

M Filippi

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italym.filippi{at}hsr.it

M Neema

Department of Neurology, Brigham and Women’s Hospital, Laboratory for Neuroimaging Research, Boston, MA, USA

A Arora

Department of Neurology, Brigham and Women’s Hospital, Laboratory for Neuroimaging Research, Boston, MA, USA

P Valsasina

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

MA Rocca

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

BC Healy

Department of Neurology, Brigham and Women’s Hospital, Laboratory for Neuroimaging Research, Boston, MA, USA; Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

R Bakshi

Department of Neurology, Brigham and Women’s Hospital, Laboratory for Neuroimaging Research, Boston, MA, USA; Department of Radiology, Brigham and Women’s Hospital, Laboratory for Neuroimaging Research, Boston, MA, USA

Background

Gray matter (GM) magnetic resonance imaging (MRI) T2 hypointensity, a putative marker of iron deposition, commonly occurs in multiple sclerosis (MS). However, GM T2 hypointensity in benign MS (BMS) has not yet been characterized.

Objective

To determine the presence of deep GM T2 hypointensity in BMS, compare it to secondary progressive (SP) MS and assess its association with clinical and diffusion tensor (DT) MRI measures.

Methods

Thirty-five cognitively unimpaired BMS, 26 SPMS patients, and 25 healthy controls were analyzed for normalized T2-intensity in the basal ganglia and thalamus, global T2 hyperintense lesion volume, global atrophy, and white matter and GM DT metrics.

Results

BMS and SPMS patients showed deep GM T2 hypointensity compared with controls. T2 hypointensity was similar in both MS subgroups and moderately correlated (r = –0.45 to 0.42) with DT MRI metrics. GM T2 hypointensity in BMS showed a weak to moderate correlation (r = –0.44 to –0.35) with disability.

Conclusions

GM in BMS is not spared from structural change including iron deposition. However, while T2 hypointensity is related to global tissue disruption reflected in DT MRI, the expression of benign versus non-benign MS is likely related to other factors.

Key Words: benign multiple sclerosis • diffusion tensor • EDSS • gray matter T2 hypointensity • iron deposition • magnetic resonance imaging

Multiple Sclerosis, Vol. 15, No. 6, 678-686 (2009)
DOI: 10.1177/1352458509103611


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				A. Ceccarelli, M. A Rocca, M. Neema, V. Martinelli, A. Arora, S. Tauhid, A. Ghezzi, G. Comi, R. Bakshi, and M. Filippi Deep gray matter T2 hypointensity is present in patients with clinically isolated syndromes suggestive of multiple sclerosis Multiple Sclerosis, January 1, 2010; 16(1): 39 - 44. [Abstract] [PDF]