Magnetisation transfer ratio abnormalities in primary and secondary progressive multiple sclerosis

James William L Brown; Azmain Chowdhury; Baris Kanber; Ferran Prados Carrasco; Arman Eshaghi; Carole H Sudre; Matteo Pardini; Rebecca S Samson; Steven Hp van de Pavert; Claudia Gandini Wheeler-Kingshott; Declan T Chard

doi:10.1177/1352458519841810

Magnetisation transfer ratio abnormalities in primary and secondary progressive multiple sclerosis

Mult Scler. 2020 May;26(6):679-687. doi: 10.1177/1352458519841810. Epub 2019 Apr 8.

Affiliations

¹ NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
² NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK.
³ NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, UK/National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals (UCLH), London, UK/Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
⁴ NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, UK/eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain.
⁵ Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, UK/Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK/School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
⁶ NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, and IRCCS AOU San Martino-IST, Genoa, Italy.
⁷ NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/Brain MRI 3T Mondino Research Center, IRCCS Mondino Foundation, Pavia, Italy/Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
⁸ NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, UK/National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals (UCLH), London, UK.

PMID: 30957691
DOI: 10.1177/1352458519841810

Abstract

Background: In relapse-onset multiple sclerosis (MS), tissue abnormality - as assessed with magnetisation transfer ratio (MTR) imaging - is greater in the outer cortical and inner periventricular layers. The cause of this remains unknown but meningeal inflammation has been implicated, particularly lymphoid follicles, which are seen in secondary progressive (SP) but not primary progressive (PP) MS. Cortical and periventricular MTR gradients might, therefore, differ in PPMS and SPMS if these follicles are responsible.

Objective: We assessed cortical and periventricular MTR gradients in PPMS, and compared gradients between people with PPMS and SPMS.

Methods: Using an optimised processing pipeline, periventricular normal-appearing white matter and cortical grey-matter MTR gradients were compared between 51 healthy controls and 63 people with progressive MS (28 PPMS, 35 SPMS).

Results: The periventricular gradient was significantly shallower in healthy controls (0.122 percentage units (pu)/band) compared to PPMS (0.952 pu/band, p < 0.0001) and SPMS (1.360 pu/band, p < 0.0001). The cortical gradient was also significantly shallower in healthy controls (-2.860 pu/band) compared to PPMS (-3.214 pu/band, p = 0.038) and SPMS (-3.328 pu/band, p = 0.016).

Conclusion: Abnormal periventricular and cortical MTR gradients occur in both PPMS and SPMS, suggesting comparable underlying pathological processes.

Keywords: Primary progressive multiple sclerosis; magnetisation transfer ratio; normal-appearing white matter; secondary progressive multiple sclerosis.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cerebral Cortex / diagnostic imaging
Cerebral Cortex / pathology*
Cohort Studies
Female
Humans
Magnetic Resonance Imaging* / methods
Male
Middle Aged
Multiple Sclerosis, Chronic Progressive / diagnostic imaging
Multiple Sclerosis, Chronic Progressive / pathology*
Multiple Sclerosis, Relapsing-Remitting / diagnostic imaging
Multiple Sclerosis, Relapsing-Remitting / pathology
White Matter / diagnostic imaging
White Matter / pathology*

Grants and funding

DH_/Department of Health/United Kingdom