Longitudinal analysis of T1w/T2w ratio in patients with multiple sclerosis from first clinical presentation

Cooper, Graham; Chien, Claudia; Zimmermann, Hanna; Bellmann‐Strobl, Judith; Ruprecht, Klemens; Kuchling, Joseph; Asseyer, Susanna; Brandt, Alexander U.; Scheel, Michael; Finke, Carsten; Paul, Friedemann

doi:10.1177/13524585211003479

Cited by 14 publications

(23 citation statements)

References 36 publications

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“…In the NAWM, compared with HC, T1w/T2w ratio was significantly lower already from mild disability levels and in patients with RRMS and SPMS, but not in those with CIS and PPMS. Although in contrast with some previous reports,11 16 our results in patients with RRMS are consistent with other studies,12–14 18 showing no significant differences in the early phases of the disease but only in patients with a longer disease duration. Discrepancies among studies may be explained by heterogeneities in the cohorts of patients with MS investigated, often with small sample sizes and short disease duration, and in the methods applied to quantify T1w/T2w ratio.…”

Section: Discussionsupporting

confidence: 83%

“…T1w/T2w ratio values were found significantly lower in the NAWM of early relapsing-remitting (RR) MS compared with healthy controls (HC) 12 14 18. However, this was not confirmed in other studies where no difference was detected in patients with MS compared with HC 11 13 16. Some studies found a significantly lower cortical T1w/T2w ratio in patients with RRMS and progressive MS,6 17 but not in the early phases of the disease 16.…”

Section: Introductionmentioning

confidence: 93%

“…At present, a few studies have investigated in vivo T1w/T2w ratio in patients with MS with conflicting results 6 11–18. T1w/T2w ratio values were found significantly lower in the NAWM of early relapsing-remitting (RR) MS compared with healthy controls (HC) 12 14 18.…”

Section: Introductionmentioning

confidence: 99%

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Exploring in vivo multiple sclerosis brain microstructural damage through T1w/T2w ratio: a multicentre study

Margoni

Pagani

Meani

et al. 2022

J Neurol Neurosurg Psychiatry

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ObjectivesTo evaluate white matter and grey matter T1-weighted (w)/T2w ratio (T1w/T2w ratio) in healthy controls and patients with multiple sclerosis, and its association with clinical disability.MethodsIn this cross-sectional study, 270 healthy controls and 434 patients with multiple sclerosis were retrospectively selected from 7 European sites. T1w/T2w ratio was obtained from brain T2w and T1w scans after intensity calibration using eyes and temporal muscle.ResultsIn healthy controls, T1w/T2w ratio increased until 50–60 years both in white and grey matter. Compared with healthy controls, T1w/T2w ratio was significantly lower in white matter lesions of all multiple sclerosis phenotypes, and in normal-appearing white matter and cortex of patients with relapsing-remitting and secondary progressive multiple sclerosis (p≤0.026), but it was significantly higher in the striatum and pallidum of patients with relapsing-remitting, secondary progressive and primary progressive multiple sclerosis (p≤0.042). In relapse-onset multiple sclerosis, T1w/T2w ratio was significantly lower in white matter lesions and normal-appearing white matter already at Expanded Disability Status Scale (EDSS) <3.0 and in the cortex only for EDSS ≥3.0 (p≤0.023). Conversely, T1w/T2w ratio was significantly higher in the striatum and pallidum for EDSS ≥4.0 (p≤0.005). In primary progressive multiple sclerosis, striatum and pallidum showed significantly higher T1w/T2w ratio beyond EDSS=6.0 (p≤0.001). In multiple sclerosis, longer disease duration, higher EDSS, higher brain lesional volume and lower normalised brain volume were associated with lower lesional and cortical T1w/T2w ratio and a higher T1w/T2w ratio in the striatum and pallidum (β from −1.168 to 0.286, p≤0.040).ConclusionsT1w/T2w ratio may represent a clinically relevant marker sensitive to demyelination, neurodegeneration and iron accumulation occurring at the different multiple sclerosis phases.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 93%

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Exploring in vivo multiple sclerosis brain microstructural damage through T1w/T2w ratio: a multicentre study

Margoni

Pagani

Meani

et al. 2022

J Neurol Neurosurg Psychiatry

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“…In contrast, another work did not show any significant associations between T1-w/T2-w and EDSS, although the sample size was much smaller (26 patients) ( Granberg et al, 20172017 ). A recent longitudinal work ( Cooper et al, 2021 ) in CIS and early MS patients showed that T1-w/T2-w in NAWM is associated with increasing lesion volume and disease activity in the first 2 years of disease after first clinical presentation.…”

Section: Discussionmentioning

confidence: 99%

T1/T2-weighted ratio in multiple sclerosis: A longitudinal study with clinical associations

Boaventura¹,

Sastre‐Garriga²,

García-Vidal

et al. 2022

NeuroImage: Clinical

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“…Preprocessing included white and grey matter brain masking 13 for brain extraction, N4-bias field correction 14 and linear, rigid body registration of FLAIR images to MPRAGE images. 15 MPRAGE and FLAIR scans were longitudinally co-registered as described in Cooper et al 16 Cerebral Gd- and T2-hyperintense lesions were segmented manually and saved as binary masks using ITK-SNAP ( www.itksnap.org ) by two expert MRI technicians (greater than 10 years of experience). Longitudinally co-registered MPRAGEs were lesion-filled ( https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/lesion_filling ) and used for whole brain, white and grey matter and CSF normalised volume extraction.…”

Section: Methodsmentioning

confidence: 99%

Prediction of high and low disease activity in early MS patients using multiple kernel learning identifies importance of lateral ventricle intensity

Chien

Seiler²,

Eitel

et al. 2022

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Lack of easy-to-interpret disease activity prediction methods in early MS can lead to worse patient prognosis. Objectives Using machine learning (multiple kernel learning – MKL) models, we assessed the prognostic value of various clinical and MRI measures for disease activity. Methods Early MS patients ( n = 148) with at least two associated clinical and MRI visits were investigated. T2-weighted MRIs were cropped to contain mainly the lateral ventricles (LV). High disease activity was defined as surpassing NEDA-3 Criteria more than once per year. Clinical demographic, MRI-extracted image-derived phenotypes (IDP), and MRI data were used as inputs for separate kernels to predict future disease activity with MKL. Model performance was compared using bootstrapped effect size analysis of mean differences. Results A total of 681 visits were included, where 81 (55%) patients had high disease activity in a combined end point measure using all follow-up visits. MKL model discrimination performance was moderate (AUC ≥ 0.62); however, modelling with combined clinical and cropped LV kernels gave the highest prediction performance (AUC = 0.70). Conclusions MRIs contain valuable information on future disease activity, especially in and around the LV. MKL techniques for combining different data types can be used for the prediction of disease activity in a relatively small MS cohort.

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Longitudinal analysis of T1w/T2w ratio in patients with multiple sclerosis from first clinical presentation

Cited by 14 publications

References 36 publications

Exploring in vivo multiple sclerosis brain microstructural damage through T1w/T2w ratio: a multicentre study

Exploring in vivo multiple sclerosis brain microstructural damage through T1w/T2w ratio: a multicentre study

T1/T2-weighted ratio in multiple sclerosis: A longitudinal study with clinical associations

Prediction of high and low disease activity in early MS patients using multiple kernel learning identifies importance of lateral ventricle intensity

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