title: Magnetization transfer ratio in lesions rather than normal-appearing brain relates to disability in patients with multiple sclerosis.
abstract: Magnetization transfer ratio (MTR) is a semi-quantitative measure that seems to correlate with the degree of myelin loss and generally tissue destruction in multiple sclerosis (MS). Our objective was to comprehensively assess the MTR of lesions and normal appearing (NA) tissue separately in the white matter (WM), the cortex, the thalamus and the basal ganglia (BG) and determine their relative contribution to disability. In this cross-sectional study 71 patients were included (59 with relapsing-remitting MS, 12 with secondary progressive MS). We used a three-dimensional MTR sequence with high spatial resolution, based on balanced steady-state free precession. Mean MTR was calculated for lesions and NA tissue separately for each tissue type. Lesional MTR was lower than normal-appearing MTR in WM, cortex and thalamus. In the regression analysis, MTR of cortical lesions (β = -0.23, p = 0.05) and MTR of WML (β = -0.21, p = 0.08) were related by trend to the expanded disability status scale. MTR of WML significantly predicted the paced auditory serial-addition test (β = 0.35, p = 0.004). MTR of normal-appearing tissue did not relate to any outcome. Our results suggest that MTR of lesions in the white matter and cortex rather than of normal-appearing tissue relates to disability in patients with MS.
authors.affiliation: Department of Neurology, University Hospital Basel, Basel, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Amann
authors.forename: Athina
authors.initials: A
authors.lastname: Papadopoulou
authors.forename: Michaela
authors.initials: M
authors.lastname: Andelova
authors.forename: Stefano
authors.initials: S
authors.lastname: Magon
authors.forename: Nicole
authors.initials: N
authors.lastname: Mueller-Lenke
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Naegelin
authors.forename: Christoph
authors.initials: C
authors.lastname: Stippich
authors.forename: Ernst Wilhelm
authors.initials: EW
authors.lastname: Radue
authors.forename: Oliver
authors.initials: O
authors.lastname: Bieri
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kappos
authors.forename: Till
authors.initials: T
authors.lastname: Sprenger
mesh_terms: D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology* / Q000503:physiopathology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology* / Q000503:physiopathology; D012720:Severity of Illness Index; D013788:Thalamus / Q000473:pathology; D066127:White Matter / Q000473:pathology*; D055815:Young Adult