title: Whole-brain T1 mapping in multiple sclerosis: global changes of normal-appearing gray and white matter.
abstract: OBJECTIVE
  To prospectively investigate whether T1 changes in normal-appearing white matter (WM) and normal-appearing gray matter (GM) in multiple sclerosis (MS) are global or regional and their relationship to disease type.
  
  
  METHODS
  The institutional ethics review board approved study; written informed consent was obtained. Whole-brain T1 maps were obtained in 67 patients with MS and 24 healthy control subjects with three-dimensional fast low-angle shot flip angle-array method, with correction for B(1) imperfections. Analysis of variance was performed on T1 histogram parameters of global normal-appearing WM and GM. Regional mean T1 values were analyzed with a multilevel approach. Multiple linear regression analysis was performed to investigate associations with clinical disability and overall atrophy. For patients, T2 lesion load was determined.
  
  
  RESULTS
  T1 histograms of normal-appearing WM had significantly higher peak positions for patients with MS (792 msec +/- 36 in secondary progressive [SP] MS) than for control subjects (746 msec +/- 23) and were significantly broader and lower (all P < .001). Histograms for cortical normal-appearing GM were significantly shifted (peak positions, 1263 msec +/- 44 in control subjects and 1355 msec +/- 62 in patients with SP MS) (P < .001). Histogram peak positions were significantly higher in SP MS than in relapsing-remitting (RR) and primary progressive MS (P < .05). In SP disease, at least 31% of normal-appearing WM and 20% of cortical normal-appearing GM were affected. In MS, T1 was significantly elevated in all normal-appearing WM and cortical normal-appearing GM regions (all P < .01) but was elevated only in the thalamus in deep GM (P < .05). Cortical T1 histogram peak position was associated with clinical disability; T2 lesion load was not.
  
  
  CONCLUSIONS
  Results suggest that a global disease process affects large parts of both normal-appearing WM and GM in MS and effects are worse for SP MS than for RR MS.
authors.affiliation: Departments of Radiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Hugo
authors.initials: H
authors.lastname: Vrenken
authors.forename: Jeroen J G
authors.initials: JJ
authors.lastname: Geurts
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: L Noor
authors.initials: LN
authors.lastname: van Dijk
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Dattola
authors.forename: Bas
authors.initials: B
authors.lastname: Jasperse
authors.forename: Ronald A
authors.initials: RA
authors.lastname: van Schijndel
authors.forename: Chris H
authors.initials: CH
authors.lastname: Polman
authors.forename: Jonas A
authors.initials: JA
authors.lastname: Castelijns
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.forename: Petra J W
authors.initials: PJ
authors.lastname: Pouwels
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D011446:Prospective Studies