title: Dynamics of brain iron levels in multiple sclerosis: A longitudinal 3T MRI study.
abstract: OBJECTIVE
  We investigated longitudinal changes in iron concentration in the subcortical gray matter (caudate nucleus, globus pallidus, putamen, thalamus) of patients with clinically isolated syndrome (CIS) and definite multiple sclerosis (MS) and their relation to clinical and other morphologic variables.
  
  
  METHODS
  We followed 144 patients (76 CIS; median Expanded Disability Status Scale [EDSS] 1.0 [interquartile range (IQR) 0.0-2.0]; 68 MS; median EDSS 2.0 [IQR 1.0-3.3]) clinically and with 3T MRI over a median period of 2.9 (IQR 1.3-4.0) years. Iron concentration was determined by R2* relaxometry at baseline and last follow-up.
  
  
  RESULTS
  At baseline, subcortical gray matter iron deposition was higher in MS compared to CIS. In CIS, R2* rates increased in the globus pallidus (p < 0.001), putamen (p < 0.001), and caudate nucleus (p < 0.001), whereas R2* rates in the thalamus decreased (p < 0.05). In MS, R2* rates increased in the putamen (p < 0.05), remained stable in the globus pallidus and caudate nucleus, and decreased in the thalamus (p < 0.01). Changes in R2* relaxation rates were unrelated to changes in the volume of respective structures, of T2 lesion load, and of disability.
  
  
  CONCLUSIONS
  Iron accumulation in the basal ganglia is more pronounced in the early than later phases of the disease and occurs independent from other morphologic brain changes. Short-term changes in iron concentration are not associated with disease activity or changes in disability.
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria. michael.khalil@medunigraz.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Khalil
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Langkammer
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Pichler
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pinter
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gattringer
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Bachmaier
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Ropele
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Siegrid
authors.initials: S
authors.lastname: Fuchs
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Enzinger
authors.affiliation: From the Department of Neurology (M.K., C.L., A.P., D.P., T.G., S.R., S.F., C.E., F.F.), Department of Radiology (Division of Neuroradiology) (C.E.), and Institute for Medical Informatics, Statistics and Documentation (G.B.), Medical University of Graz, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: Fazekas
mesh_terms: D000328:Adult; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D003711:Demyelinating Diseases / Q000378:metabolism* / Q000473:pathology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D066128:Gray Matter / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000378:metabolism* / Q000473:pathology; D009929:Organ Size
chemical_list: D007501:Iron