Iron stores and cerebral veins in MS studied by susceptibility weighted imaging.
OBJECTIVE
In this paper, we seek to determine whether the iron deposition as seen by susceptibility weighted imaging (SWI) in the basal ganglia and thalamus of patients with multiple sclerosis is greater than the iron content measured in normal subjects (individuals unaffected by multiple sclerosis). As increased iron content may result from increased venous pressure, such information would add credence to the concept of Zamboni et al (1) that MS is caused by chronic cerebrospinal venous insufficiency.


METHODS
Fourteen MS patients were recruited for this study with a mean age of 38 years ranging from 19 to 66 year-old. A velocity compensated 3D gradient echo sequence was used to generate SW images with a high sensitivity to iron content. We evaluated iron in the following structures: substantia nigra, red nucleus, globus pallidus, putamen, caudate nucleus, thalamus and pulvinar thalamus. Each structure was broken into two parts, a high iron content region and a low iron content region. The measured values were compared to previously established baseline iron content in these structures as a function of age.


RESULTS
Twelve of fourteen patients had an increase in iron above normal levels and with a particular pattern of iron deposition in the medial venous drainage system that was associated with the confluence of the veins draining that structure.


CONCLUSIONS
Iron may serve as a biomarker of venous vascular damage in multiple sclerosis. The backward iron accumulation pattern seen in the basal ganglia and thalamus of most MS patients is consistent with the hypothesis of venous hypertension.
Haacke
E M
EM
Department of Radiology, Wayne State University, Detroit, MI, USA2 Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, China. nmrimaging@aol.com
Garbern
J
J
Miao
Y
Y
Habib
C
C
Liu
M
M
D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000098:blood supply* / Q000737:chemistry*; D015415:Biomarkers / Q000032:analysis; D002550:Cerebral Veins / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007501:Iron / Q000032:analysis*; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D013788:Thalamus / Q000098:blood supply* / Q000737:chemistry*; D015854:Up-Regulation; D014689:Venous Insufficiency / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D014690:Venous Pressure; D055815:Young Adult
D015415:Biomarkers; D007501:Iron