Multimodal quantitative MRI assessment of cortical damage in relapsing-remitting multiple sclerosis.

PURPOSE

To investigate magnetization transfer ratio (MTR), T relaxation time, and proton density (PD) as indicators of gray matter damage in relapsing-remitting multiple sclerosis (RRMS), reflecting different aspects of microstructural damage and as imaging correlates of clinical disability. We aimed to determine which of these parameters may optimally quantify cortical damage, and serve as an imaging surrogate of clinical disability. In this study, cortical values of MTR, a surrogate for demyelination in MS, of PD, reflecting replacement of neural tissue by water, and of T , indicating a complex array of microstructural changes, were assessed in a group of RRMS patients in comparison to healthy controls (HC).

MATERIALS AND METHODS

22 RRMS patients with varying disease duration (4.0 ± 6.54 years) and 10 HC received quantitative 3T magnetic resonance imaging (MRI) with MTR, T , and PD mapping. We tested for differences in cortical measurements between patients and HC. Additionally, correlation with disability as quantified by the Expanded Disability Status Scale was investigated.

RESULTS

Cortical parameter values were significantly altered in the RRMS group, with increased values of T (P = 0.008) and PD (P = 0.028) and reduced values of MTR (P = 0.043). Only cortical T was correlated with clinical disability measurements (P = 0.001, r = 0.65). Receiver operating characteristic analysis demonstrated the best discriminatory power for T (area under the curve 0.79, PD: 0.75, MTR 0.73).

CONCLUSION

Out of the parameters studied, cortical T is best suited to detect cortical damage as an imaging surrogate of clinical disability in RRMS. J. Magn. Reson. Imaging 2016;44:1600-1607.