Changes and variability of proton density and T1 relaxation times in early multiple sclerosis: MRI markers of neuronal damage in the cerebral cortex.
OBJECTIVE
Proton density (PD) and T1 relaxation time are promising quantitative MRI (qMRI) markers of neuronal damage in multiple sclerosis (MS). However, it is unknown whether cortical differences of these parameters between patients and controls exist in the early stages of disease. This study investigates cortical T1 and PD in early MS stages, hypothesizing that these are altered and display a high spatial variability.


METHODS
Quantitative T1 and PD mapping was performed on 11 patients with clinically isolated syndrome (CIS)/early MS in remission and 11 healthy controls. The normal appearing cortical gray matter was extracted, lobar regions were identified, and mean values and standard deviations of both parameters were calculated within each region.


RESULTS
Increased PD was detected in MS/CIS patients in the cerebral cortex as a whole and all subregions, indicating an increase of water content. Increase of PD variability reached significance in the whole cortex and in the frontal and parietal regions. Longer T1 relaxation times and increased variability were found in the cerebral cortex in all regions studied, indicating a change of microstructural tissue composition that is spatially heterogeneous.


CONCLUSIONS
The data show spatially heterogeneous cortical involvement in early MS is reflected in T1 and PD qMRI.


CONCLUSIONS
• Cortical involvement in early MS is reflected in T1/PD quantitative MRI. • The changes are spatially heterogeneous. • Cortical damage goes beyond increased water content.
Department of Neurology, University Hospital, Goethe University, Frankfurt/Main, Germany. rene-maxime.gracien@kgu.de.|Brain Imaging Center, University Hospital, Goethe University, Frankfurt/Main, Germany. rene-maxime.gracien@kgu.de.
René-Maxime
RM
Gracien
Department of Neurology, University Hospital, Goethe University, Frankfurt/Main, Germany.|Brain Imaging Center, University Hospital, Goethe University, Frankfurt/Main, Germany.
Sarah C
SC
Reitz
Department of Neurology, University Hospital, Goethe University, Frankfurt/Main, Germany.|Brain Imaging Center, University Hospital, Goethe University, Frankfurt/Main, Germany.
Stephanie Michelle
SM
Hof
Department of Neurology, University Hospital, Gutenberg University, Mainz, Germany.|Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Hospital, Gutenberg University, Mainz, Germany.
Vinzenz
V
Fleischer
Department of Neurology, University Hospital, Gutenberg University, Mainz, Germany.|Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Hospital, Gutenberg University, Mainz, Germany.
Hilga
H
Zimmermann
Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Hospital, Gutenberg University, Mainz, Germany.
Amgad
A
Droby
Department of Neurology, University Hospital, Goethe University, Frankfurt/Main, Germany.
Helmuth
H
Steinmetz
Department of Neurology, University Hospital, Gutenberg University, Mainz, Germany.|Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Hospital, Gutenberg University, Mainz, Germany.
Frauke
F
Zipp
Brain Imaging Center, University Hospital, Goethe University, Frankfurt/Main, Germany.
Ralf
R
Deichmann
Department of Neurology, University Hospital, Goethe University, Frankfurt/Main, Germany.|Brain Imaging Center, University Hospital, Goethe University, Frankfurt/Main, Germany.
Johannes C
JC
Klein
D000328:Adult; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis*
Demyelinating diseases; Diagnostic imaging; Gray matter; Magnetic resonance imaging; Multiple sclerosis