Magnetization transfer ratio in gray matter: a potential surrogate marker for progression in early primary progressive multiple sclerosis.
BACKGROUND
Magnetization transfer imaging has the potential to provide a surrogate marker for progression in primary progressive multiple sclerosis (PPMS).


OBJECTIVE
To investigate whether brain magnetization transfer imaging, T2 lesion load, and atrophy changes over 3 years reflect concurrent clinical changes, and which baseline imaging measure best predicts progression over 3 years in early PPMS.


METHODS
Prospective study.


METHODS
National Hospital for Neurology and Neurosurgery and the Institute of Neurology, London, England.


METHODS
Forty-seven patients with PPMS (of whom 43 completed the study) and 18 control subjects.


METHODS
Brain magnetization transfer imaging (including T2-weighted images) and volume sequences every 6 months for 3 years.


METHODS
Changes in Expanded Disability Status Scale (EDSS) score and associations with rate of change in imaging variables.


RESULTS
More rapid decline in gray matter mean and peak location magnetization transfer ratio and T2 lesion load increase were associated with greater rates of progression on the EDSS. Baseline gray matter peak height magnetization transfer ratio best predicted progression over 3 years.


CONCLUSIONS
Gray matter magnetization transfer ratio meets many of the criteria for a surrogate marker of progression in early PPMS.
Khaleeli
Zhaleh
Z
Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, England.
Altmann
Daniel R
DR
Cercignani
Mara
M
Ciccarelli
Olga
O
Miller
David H
DH
Thompson
Alan J
AJ
D000328:Adult; D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis* / Q000503:physiopathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000503:physiopathology; D010487:Periaqueductal Gray / Q000473:pathology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult