title: Sulcal and gyral crown cortical grey matter involvement in multiple sclerosis: A magnetisation transfer ratio study.
abstract: BACKGROUND
  Histopathology has demonstrated extensive cortical grey matter (GM) demyelination in multiple sclerosis (MS), and suggests that sulcal folds may be preferentially affected, particularly in progressive MS. This has not been confirmed in vivo, and it is not known if it is relevant to clinical status.
  
  
  OBJECTIVE
  To determine sulcal and gyral crown magnetisation transfer ratio (MTR) in MS cortical GM, and the MTR associations with clinical status.
  
  
  METHODS
  We measured sulcal and gyral crown cortical GM MTR values in 61 MS patients and 32 healthy controls. Disability was measured using Expanded Disability Status Scale and Multiple Sclerosis Functional Composite scores.
  
  
  RESULTS
  MTR values were reduced in sulcal and gyral crown regions in all MS subtypes, more so in secondary progressive (SP) MS than relapsing remitting (RR) MS, and similarly in primary progressive (PP) MS and RRMS. Sulcal MTR was lower than gyral crown MTR in controls, PPMS and RRMS patients, but not in SPMS. MTR correlated with clinical status in RRMS and SPMS, but not PPMS.
  
  
  CONCLUSIONS
  Cortical pathology, as reflected by MTR, is present in all MS subtypes and most pronounced in SPMS. A preferential disease effect on sulcal cortical regions was not observed. Cortical MTR abnormalities appear to be more clinically relevant in relapse-onset rather than progressive-onset MS.
authors: NMR Research Unit, Department of Neuroinflammation, Queen Square house, Queen Square MS Centre, UCL Institute of Neurology, London WC1N 3BG, UK. Electronic address: r.samson@ucl.ac.uk.
authors: R S
authors: RS
authors: Samson
authors: NMR Research Unit, Department of Neuroinflammation, Queen Square house, Queen Square MS Centre, UCL Institute of Neurology, London WC1N 3BG, UK.
authors: N
authors: N
authors: Muhlert
authors: NMR Research Unit, Department of Neuroinflammation, Queen Square house, Queen Square MS Centre, UCL Institute of Neurology, London WC1N 3BG, UK.
authors: V
authors: V
authors: Sethi
authors: NMR Research Unit, Department of Neuroinflammation, Queen Square house, Queen Square MS Centre, UCL Institute of Neurology, London WC1N 3BG, UK.
authors: C A M
authors: CA
authors: Wheeler-Kingshott
authors: NMR Research Unit, Department of Neuroinflammation, Queen Square house, Queen Square MS Centre, UCL Institute of Neurology, London WC1N 3BG, UK.
authors: M A
authors: MA
authors: Ron
authors: NMR Research Unit, Department of Neuroinflammation, Queen Square house, Queen Square MS Centre, UCL Institute of Neurology, London WC1N 3BG, UK.
authors: D H
authors: DH
authors: Miller
authors: NMR Research Unit, Department of Neuroinflammation, Queen Square house, Queen Square MS Centre, UCL Institute of Neurology, London WC1N 3BG, UK.
authors: D T
authors: DT
authors: Chard
keywords: Cortical grey matter; Gyral crown; MRI; Magnetisation transfer ratio; Multiple sclerosis; Sulcal