A magnetization transfer MRI study of deep gray matter involvement in multiple sclerosis.
OBJECTIVE
Gray matter involvement in multiple sclerosis (MS) is of growing interest with respect to disease pathogenesis. Magnetization transfer imaging (MTI), an advanced MRI technique, is sensitive to disease in normal appearing white matter (NAWM) in patients with MS.


METHODS
We tested if MTI detected subcortical (deep) gray matter abnormalities in patients with MS (n= 60) vs. age-matched normal controls (NL, n= 20). Magnetization transfer ratio (MTR) maps were produced from axial proton density, conventional spin-echo, 5 mm gapless slices covering the whole brain. Region-of-interest-derived MTR histograms for the caudate, putamen, globus pallidus, thalamus, and NAWM were obtained. Whole brain MTR was also measured.


RESULTS
Mean whole brain MTR and the peak position of the NAWM MTR histogram were lower in patients with MS than NL (P < .001) and mean whole brain MTR was lower in secondary progressive (SP, n= 10) than relapsing-remitting (RR, n= 50, P < .001) patients. However, none of the subcortical gray matter nuclei showed MTR differences in MS vs. NL, RR vs. SP, or SP vs. NL.


CONCLUSIONS
The MTI technique used in this cohort was relatively insensitive to disease in the deep gray matter nuclei despite showing sensitivity for whole brain disease in MS. It remains to be determined if other MRI techniques are more sensitive than MTI for detecting pathology in these areas.
Sharma
Jitendra
J
Center for Neurological Imaging, Partners MS Center, Department of Neurology, Brigham/Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Zivadinov
Robert
R
Jaisani
Zeenat
Z
Fabiano
Andrew J
AJ
Singh
Baljinder
B
Horsfield
Mark A
MA
Bakshi
Rohit
R
D000328:Adult; D001921:Brain / Q000473:pathology*; D002421:Caudate Nucleus / Q000473:pathology; D005260:Female; D005917:Globus Pallidus / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D011699:Putamen / Q000473:pathology; D013788:Thalamus / Q000473:pathology