Prediction of Longitudinal Brain Atrophy in Multiple Sclerosis by Gray Matter Magnetic Resonance Imaging T2 Hypointensity

Abstract

Background: Gray matter magnetic resonance imaging T2 hypointensity, a marker of iron deposition, is associated with clinical impairment and brain atrophy in cross-sectional studies of multiple sclerosis. Treatment with intramuscular interferon beta-1a limits brain atrophy in the second year of treatment. Objective: To test whether T2 hypointensity predicts brain atrophy and whether interferon affects this relationship.

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

“…SPMS showed left versus right differences in all these regions (caudate nucleus, P = 0.001; globus pallidus, P = 0.032; putamen, P = 0.019; thalamus, P = 0.036). For all significant differences, except the thalamus in BMS patients, we found more significant GM T2 hypointensity in the left side, consistent with findings shown in previous MRI studies in MS [7,26,43]. Because of these laterality differences, the GM T2 hypointensity for each hemisphere was retained as a variable in each statistical comparison.…”

“…Our findings are in agreement with previous studies showing that GM T2 hypointensity is linked to measures of disease severity [19][20][21][22][23][24][25][26][27]45]. In the present study, we found a moderate correlation with EDSS score in BMS patients.…”

“…The presence of MRI-based evidence of GM iron deposition in MS versus HC in our study is in agreement with several other studies, which have used T2 hypointensity [19][20][21][22]24], magnetic field correlation [23], or phase imaging [44]. Previous studies have raised the possibility that GM T2 hypointensity may be a clinically relevant biological marker of brain injury and brain dysfunction [19][20][21][22][23][24][25][26][27]45]. However, unlike previous studies [19][20][21] that have showed more prominent deep GM T2 hypointensity in SPMS when compared with RRMS, we found no differences in GM T2 hypointensity between BMS and SPMS.…”

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

“…SPMS showed left versus right differences in all these regions (caudate nucleus, P = 0.001; globus pallidus, P = 0.032; putamen, P = 0.019; thalamus, P = 0.036). For all significant differences, except the thalamus in BMS patients, we found more significant GM T2 hypointensity in the left side, consistent with findings shown in previous MRI studies in MS [7,26,43]. Because of these laterality differences, the GM T2 hypointensity for each hemisphere was retained as a variable in each statistical comparison.…”

“…Our findings are in agreement with previous studies showing that GM T2 hypointensity is linked to measures of disease severity [19][20][21][22][23][24][25][26][27]45]. In the present study, we found a moderate correlation with EDSS score in BMS patients.…”

“…The presence of MRI-based evidence of GM iron deposition in MS versus HC in our study is in agreement with several other studies, which have used T2 hypointensity [19][20][21][22]24], magnetic field correlation [23], or phase imaging [44]. Previous studies have raised the possibility that GM T2 hypointensity may be a clinically relevant biological marker of brain injury and brain dysfunction [19][20][21][22][23][24][25][26][27]45]. However, unlike previous studies [19][20][21] that have showed more prominent deep GM T2 hypointensity in SPMS when compared with RRMS, we found no differences in GM T2 hypointensity between BMS and SPMS.…”

Deep gray matter T2 hypointensity is present in patients with clinically isolated syndromes suggestive of multiple sclerosis

“…12,19 However, it is worth noting that, in comparison with other quantitative MR-based techniques, the assessment of T2 intensity changes is relatively time saving, since it does not require the acquisition of an additional MR sequence during patients' examinations. In line with previous quantitative 34,38 and volumetric 47,48 studies, we found a left versus right difference in the basal ganglia of CIS patients. Such an asymmetry may relate to normal brain structural variability 49 or a relatively small sample size.…”

Quantitative assessment of brain iron by R 2 * relaxometry in patients with clinically isolated syndrome and relapsing–remitting multiple sclerosis

“…This needs to be investigated further. Another major finding is the link between iron deposition and brain atrophy, which has been suggested earlier by correlations between T 2 hypointensity and brain atrophy [7,8,10] and which is now corroborated by our quantitative R 2 * measurements. In this context, it is important to note that local R 2 * changes do not only reflect changes in brain iron load.…”

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

“…SPMS showed left versus right differences in all these regions (caudate nucleus, P = 0.001; globus pallidus, P = 0.032; putamen, P = 0.019; thalamus, P = 0.036). For all significant differences, except the thalamus in BMS patients, we found more significant GM T2 hypointensity in the left side, consistent with findings shown in previous MRI studies in MS [7,26,43]. Because of these laterality differences, the GM T2 hypointensity for each hemisphere was retained as a variable in each statistical comparison.…”

“…Our findings are in agreement with previous studies showing that GM T2 hypointensity is linked to measures of disease severity [19][20][21][22][23][24][25][26][27]45]. In the present study, we found a moderate correlation with EDSS score in BMS patients.…”

“…The presence of MRI-based evidence of GM iron deposition in MS versus HC in our study is in agreement with several other studies, which have used T2 hypointensity [19][20][21][22]24], magnetic field correlation [23], or phase imaging [44]. Previous studies have raised the possibility that GM T2 hypointensity may be a clinically relevant biological marker of brain injury and brain dysfunction [19][20][21][22][23][24][25][26][27]45]. However, unlike previous studies [19][20][21] that have showed more prominent deep GM T2 hypointensity in SPMS when compared with RRMS, we found no differences in GM T2 hypointensity between BMS and SPMS.…”

Deep gray matter T2 hypointensity is present in patients with clinically isolated syndromes suggestive of multiple sclerosis

“…12,19 However, it is worth noting that, in comparison with other quantitative MR-based techniques, the assessment of T2 intensity changes is relatively time saving, since it does not require the acquisition of an additional MR sequence during patients' examinations. In line with previous quantitative 34,38 and volumetric 47,48 studies, we found a left versus right difference in the basal ganglia of CIS patients. Such an asymmetry may relate to normal brain structural variability 49 or a relatively small sample size.…”

Quantitative assessment of brain iron by R 2 * relaxometry in patients with clinically isolated syndrome and relapsing–remitting multiple sclerosis

“…This needs to be investigated further. Another major finding is the link between iron deposition and brain atrophy, which has been suggested earlier by correlations between T 2 hypointensity and brain atrophy [7,8,10] and which is now corroborated by our quantitative R 2 * measurements. In this context, it is important to note that local R 2 * changes do not only reflect changes in brain iron load.…”

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

“…SPMS showed left versus right differences in all these regions (caudate nucleus, P = 0.001; globus pallidus, P = 0.032; putamen, P = 0.019; thalamus, P = 0.036). For all significant differences, except the thalamus in BMS patients, we found more significant GM T2 hypointensity in the left side, consistent with findings shown in previous MRI studies in MS [7,26,43]. Because of these laterality differences, the GM T2 hypointensity for each hemisphere was retained as a variable in each statistical comparison.…”

“…Our findings are in agreement with previous studies showing that GM T2 hypointensity is linked to measures of disease severity [19][20][21][22][23][24][25][26][27]45]. In the present study, we found a moderate correlation with EDSS score in BMS patients.…”

“…The presence of MRI-based evidence of GM iron deposition in MS versus HC in our study is in agreement with several other studies, which have used T2 hypointensity [19][20][21][22]24], magnetic field correlation [23], or phase imaging [44]. Previous studies have raised the possibility that GM T2 hypointensity may be a clinically relevant biological marker of brain injury and brain dysfunction [19][20][21][22][23][24][25][26][27]45]. However, unlike previous studies [19][20][21] that have showed more prominent deep GM T2 hypointensity in SPMS when compared with RRMS, we found no differences in GM T2 hypointensity between BMS and SPMS.…”

Deep gray matter T2 hypointensity is present in patients with clinically isolated syndromes suggestive of multiple sclerosis

“…12,19 However, it is worth noting that, in comparison with other quantitative MR-based techniques, the assessment of T2 intensity changes is relatively time saving, since it does not require the acquisition of an additional MR sequence during patients' examinations. In line with previous quantitative 34,38 and volumetric 47,48 studies, we found a left versus right difference in the basal ganglia of CIS patients. Such an asymmetry may relate to normal brain structural variability 49 or a relatively small sample size.…”

Quantitative assessment of brain iron by R 2 * relaxometry in patients with clinically isolated syndrome and relapsing–remitting multiple sclerosis

“…This needs to be investigated further. Another major finding is the link between iron deposition and brain atrophy, which has been suggested earlier by correlations between T 2 hypointensity and brain atrophy [7,8,10] and which is now corroborated by our quantitative R 2 * measurements. In this context, it is important to note that local R 2 * changes do not only reflect changes in brain iron load.…”