title: MRI brain T1 relaxation time changes in MS patients increase over time in both the white matter and the cortex.
abstract: OBJECTIVE
  To test the sensitivity of whole-brain T1 relaxometry to the evolution of pathological changes in multiple sclerosis (MS).
  
  
  BACKGROUND
  T1-weighted hypointense lesion load in the brains of patients with MS is associated with axonal loss. Other work has shown that T1 measurements may provide information complementary to existing imaging techniques, such as magnetization transfer imaging.
  
  
  METHODS
  The authors studied 14 MS patients twice over a median time interval of 19.5 months (range, 14-22 months). Structural images and whole-brain T1 maps using a novel rapid-scanning technique (3 min/study) were performed at 3 T. Analysis focused on defining changes separately in the lesional and normal-appearing white matter (NAWM) and in the cortical gray matter.
  
  
  RESULTS
  At baseline, there was an inverse relationship between disease duration and the NAWM T1 histogram peak height (r = -0.75, P = .03). The total white matter T1 histogram peak height decreased over time (P < .001). This could be accounted for by changes in the NAWM (P < .03). There also was a decrease (6%) in the mean (11 of 14 patients, P = .004) and in the median (7%) (13 of 14 patients, P < .001) neocortical gray matter T1 over the follow-up period.
  
  
  CONCLUSIONS
  Brain T1 maps can be generated quickly and are sensitive to pathological changes over time. T1 values in both the gray and the white matter at the baseline visit were related to disease duration, suggesting that the T1 changes are clinically relevant. Although the absolute values will be different, it is likely that similar changes will be able to be detected at 1.5 T. The role of T1 measurement as a magnetic resonance imaging outcome measure in clinical trials now should be explored.
authors.affiliation: Centre for Functional Magnetic Resonance Imaging of the Brain, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Parry
authors.forename: S
authors.initials: S
authors.lastname: Clare
authors.forename: M
authors.initials: M
authors.lastname: Jenkinson
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Palace
authors.forename: P M
authors.initials: PM
authors.lastname: Matthews
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D012680:Sensitivity and Specificity; D013997:Time Factors