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Quantitative assessment of brain iron by R₂* relaxometry in patients with clinically isolated syndrome and relapsing–remitting multiple sclerosis

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria

C Enzinger

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria

C Langkammer

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria

M Tscherner

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria

M Wallner-Blazek

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria

M Jehna

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria

S Ropele

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria

S Fuchs

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria

F Fazekas

Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austriafranz.fazekas{at}medunigraz.at

Background

Increased iron deposition has been implicated in the pathophysiology of multiple sclerosis (MS), based on visual analysis of signal reduction on T₂-weighted images. R₂* relaxometry allows to assess brain iron accumulation quantitatively.

Objective

To investigate regional brain iron deposition in patients with a clinically isolated syndrome (CIS) or relapsing–remitting MS (RRMS) and its associations with demographical, clinical, and conventional magnetic resonance imaging (MRI) parameters.

Methods

We studied 69 patients (CIS, n = 32; RRMS, n = 37) with 3T MRI and analyzed regional R₂* relaxation rates and their correlations with age, disease duration, disability, T₂ lesion load, and normalized brain volumes.

Results

Basal ganglia R₂* relaxation rates increased in parallel with age (r = 0.3–0.6; P < 0.01) and were significantly higher in RRMS than in CIS (P < 0.05). Using multivariate linear regression analysis, the rate of putaminal iron deposition was independently predicted by the patients’ age, disease duration, and gray matter atrophy.

Conclusions

Quantitative assessment by R₂* relaxometry suggests increased iron deposition in the basal ganglia of MS patients, which is associated with disease duration and brain atrophy. This technique together with long-term follow-up thus appears suited to clarify whether regional iron accumulation contributes to MS morbidity or merely reflects an epiphenomenon.

Key Words: 3T MRI • brain atrophy • deep gray matter • iron deposition • multiple sclerosis • R2* mapping

This version was published on September 1, 2009

Multiple Sclerosis, Vol. 15, No. 9, 1048-1054 (2009)
DOI: 10.1177/1352458509106609


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