title: Magnetization transfer imaging in premanifest and manifest Huntington disease.
abstract: OBJECTIVE
  MTI has the potential to detect abnormalities in normal-appearing white and gray matter on conventional MR imaging. Early detection methods and disease progression markers are needed in HD research. Therefore, we investigated MTI parameters and their clinical correlates in premanifest and manifest HD.
  
  
  METHODS
  From the Leiden TRACK-HD study, 78 participants (28 controls, 25 PMGC, 25 MHD) were included. Brain segmentation of cortical gray matter, white matter, caudate nucleus, putamen, pallidum, thalamus, amygdala, and hippocampus was performed using FSL's automated tools FAST and FIRST. Individual MTR values were calculated from these regions and MTR histograms constructed. Regression analysis of MTR measures from all gene carriers with clinical measures was performed.
  
  
  RESULTS
  MTR peak height was reduced in both cortical gray (P = .01) and white matter (P = .006) in manifest HD compared with controls. Mean MTR was also reduced in cortical gray matter (P = .01) and showed a trend in white matter (P = .052). Deep gray matter structures showed a uniform pattern of reduced MTR values (P < .05). No differences between premanifest gene carriers and controls were found. MTR values correlated with disease burden and motor and cognitive impairment.
  
  
  CONCLUSIONS
  Throughout the brain, disturbances in MTI parameters are apparent in early HD and are homogeneous across white and gray matter. The correlation of MTI with clinical measures indicates the potential to act as a disease monitor in clinical trials. However, our study does not provide evidence for MTI as a marker in premanifest HD.
authors.affiliation: Department of Neurology, Leiden University Medical Centre, Albinusdreef 22300 RC Leiden, The Netherlands. s.j.a.van_den_bogaard@lumc.nl
authors.forename: S J A
authors.initials: SJ
authors.lastname: van den Bogaard
authors.forename: E M
authors.initials: EM
authors.lastname: Dumas
authors.forename: J
authors.initials: J
authors.lastname: Milles
authors.forename: R
authors.initials: R
authors.lastname: Reilmann
authors.forename: J C
authors.initials: JC
authors.lastname: Stout
authors.forename: D
authors.initials: D
authors.lastname: Craufurd
authors.forename: M A
authors.initials: MA
authors.lastname: van Buchem
authors.forename: J
authors.initials: J
authors.lastname: van der Grond
authors.forename: R A C
authors.initials: RA
authors.lastname: Roos
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D042241:Early Diagnosis; D006801:Humans; D006816:Huntington Disease / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity