Brain Advance Access originally published online on February 22, 2006
Brain 2006 129(4):1031-1039; doi:10.1093/brain/awl039
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Selective magnetization transfer ratio decrease in the visual cortex following optic neuritis
1 NMR Research Unit, Departments of 2 Neuroinflammation and 3 Headache, Rehabilitation and Brain Injury, Institute of Neurology, University College London, 4 Neuro-ophthalmology Service, Moorfields Eye Hospital, London, UK and 5 Centre de Résonance Magnétique Biologique et Médicale (CRMBM) and Service de Neurologie, Hôpital de la Timone, Marseille, France
Correspondence to: Professor D. H. Miller, NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, Queen Square, London WC1N 3BG, UK E-mail: d.miller{at}ion.ucl.ac.uk
Patients with clinically isolated syndromes suggestive of multiple sclerosis have evidence for abnormality in normal appearing grey matter detected using the magnetization transfer ratio (MTR), a quantitative MRI measure. One potential mechanism for the decreased grey matter MTR (GM MTR) observed is trans-synaptic morphological abnormality secondary to demyelinating lesions that are in an anatomically linked pathway but remote location. We investigated this potential association by studying the location of abnormalities using voxel-based analysis of GM MTR maps in a group of 80 patients studied within 6 months of presenting with isolated optic neuritis and compared the findings with those seen in 50 age- and sex-matched healthy controls. Occipital cortex and whole brain analysis comparing all optic neuritis patients and controls revealed a selective decrease of MTR bilaterally in the visual cortex in patients [Brodmann area (BA) 17]. Whole brain analysis of patients fulfilling the McDonald criteria for multiple sclerosis (n = 20) showed a lower MTR compared to controls bilaterally in the visual cortex (BA 17/18), left hippocampus, bilateral superior temporal gyrus, bilateral lenticular nuclei and the right cerebellum. There was no significant difference in the percentage of grey matter between patients and controls in the regions of abnormal MTR detected in the visual cortex. The intrinsic MTR decrease seen in patients suggests that there are structural changes in the visual cortex following an attack of optic neuritis. Potential mechanisms for this include trans-synaptic neuronal degeneration and cortical synaptic morphological changes; such abnormalities may also contribute to MTR abnormalities observed in the normal appearing grey matter in multiple sclerosis.
Key Words: MTR; CIS; optic neuritis; multiple sclerosis; visual cortex
Abbreviations: BA = Brodmann area; CIS = clinically isolated syndrome; EDSS = Expanded Disability Status Scale; GM MTR = grey matter MTR; MR = magnetic resonance; MTI = magnetization transfer imaging; MTR = magnetization transfer ratio; nGM MTR = normalized grey matter MTR; SVC = small volume correction
Received October 3, 2005. Revised December 20, 2005. Accepted January 24, 2006.
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