Brain Advance Access originally published online on September 2, 2006
Brain 2006 129(10):2620-2627; doi:10.1093/brain/awl208
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Magnetization transfer MRI metrics predict the accumulation of disability 8 years later in patients with multiple sclerosis
1 Neuroimaging Research Unit, San Raffaele Scientific Institute Milan, Italy 2 Department of Neurology, San Raffaele Scientific Institute Milan, Italy
Correspondence to: Dr Massimo Filippi, Neuroimaging Research Unit, Department of Neurology, San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy E-mail: filippi.massimo{at}hsr.it
In multiple sclerosis, the relationship between conventional MRI findings and the clinical evolution of the disease is weak. Magnetization transfer (MT) MRI can provide markers reflecting the more disabling features of multiple sclerosis pathology. The aim of the present study was to assess the value of MT MRI quantities and their short-term changes in predicting the long-term accumulation of disability in multiple sclerosis patients. Conventional and MT MRI scans of the brain were obtained at baseline and after 12 months in 73 patients, who were followed prospectively with clinical visits for a median period of 8 years. At baseline and at 12 months, T2-hyperintense and T1-hypointense lesion volume, normalized brain volume [with grey (GM) and white matter (WM) fractions] and average lesion MT ratio (MTR) were measured. At the two time points, metrics derived from the MTR histograms of the whole-brain parenchyma, GM and normal-appearing WM were also computed. A multivariate analysis, adjusted for follow-up duration, was performed to establish which variables were significant predictors of long-term neurological deterioration. At the end of follow-up, 44 patients (60%) showed a significant disability worsening. A multivariable model included baseline GM MTR histogram peak height [P = 0.029, odds ratio (OR) = 0.97], and average lesion MTR percentage change after 12 months (P = 0.016, OR = 0.88) as independent predictors of disability worsening at 8 years (r2 = 0.28). The discriminating ability of such a model in predicting the individual patients' outcome was 66%. MT MRI provides useful prognostic markers for the prediction of the long-term evolution of multiple sclerosis. This study also suggests that GM damage is one of the key factors associated with disability accumulation in this ‘white matter’ condition.
Key Words: disability; grey matter damage; multiple sclerosis; magnetic resonance imaging; magnetization transfer MRI
Abbreviations: BPF, brain parenchymal fraction; CIS, clinically isolated syndrome; cMRI, conventional magnetic resonance imaging; EDSS, Expanded Disability Status Scale; GM, grey matter; GMF, grey matter fraction; LV, lesion volume; MT, magnetization transfer; MTR, magnetization transfer ratio; NAWM, normal-appearing white matter; OR, odds ratio; PD, proton density; RR, relapsing–remitting; SP, secondary progressive; WM, white matter; WMF, white matter fraction
Received April 3, 2006. Revised June 7, 2006. Accepted July 10, 2006.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A Minneboo, B Jasperse, F Barkhof, B M J Uitdehaag, D L Knol, V de Groot, C H Polman, and J A Castelijns Predicting short-term disability progression in early multiple sclerosis: added value of MRI parameters J. Neurol. Neurosurg. Psychiatry, August 1, 2008; 79(8): 917 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D Bar-Zohar, F Agosta, D Goldstaub, and M Filippi Magnetic resonance imaging metrics and their correlation with clinical outcomes in multiple sclerosis: a review of the literature and future perspectives Multiple Sclerosis, July 1, 2008; 14(6): 719 - 727. [Abstract] [PDF]
|
|
|
|
|
|
J Petkau, S. Reingold, U Held, G. Cutter, T. Fleming, M. Hughes, D. Miller, H. McFarland, and J. Wolinsky Magnetic resonance imaging as a surrogate outcome for multiple sclerosis relapses Multiple Sclerosis, July 1, 2008; 14(6): 770 - 778. [Abstract] [PDF]
|
|
|
|
|
|
M. Rovaris, E. Judica, J. Sastre-Garriga, A. Rovira, M. Pia Sormani, B. Benedetti, T. Korteweg, N. De Stefano, Z. Khaleeli, X. Montalban, et al. Large-scale, multicentre, quantitative MRI study of brain and cord damage in primary progressive multiple sclerosis Multiple Sclerosis, May 1, 2008; 14(4): 455 - 464. [Abstract] [PDF]
|
|
|
|
|
|
Z Khaleeli, J Sastre-Garriga, O Ciccarelli, D H Miller, and A J Thompson Magnetisation transfer ratio in the normal appearing white matter predicts progression of disability over 1 year in early primary progressive multiple sclerosis J. Neurol. Neurosurg. Psychiatry, October 1, 2007; 78(10): 1076 - 1082. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Agosta, E. Pagani, D. Caputo, and M. Filippi Associations Between Cervical Cord Gray Matter Damage and Disability in Patients With Multiple Sclerosis Arch Neurol, September 1, 2007; 64(9): 1302 - 1305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Pulizzi, M. Rovaris, E. Judica, M. P. Sormani, V. Martinelli, G. Comi, and M. Filippi Determinants of Disability in Multiple Sclerosis at Various Disease Stages: A Multiparametric Magnetic Resonance Study Arch Neurol, August 1, 2007; 64(8): 1163 - 1168. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Zivadinov Can imaging techniques measure neuroprotection and remyelination in multiple sclerosis? Neurology, May 29, 2007; 68(22_suppl_3): S72 - S82. [Abstract] [Full Text] [PDF]
|
|