Journal of Neurology
Abstract Volume 249 Issue 2 (2002) pp 193-199
Colette M. Griffin, Declan T. Chard, Geoff J. M. Parker, Gareth J. Barker, Alan J. Thompson, David H. Miller
NMR Research Unit, 6th floor, Institute of Neurology, Queen Square, London WC1N 3BG, UK, Tel.: +44-20/78 29-87 71, Fax: +44-20/72 78-56 16
In multiple sclerosis (MS), pathological changes have been found both in macroscopic lesions and normal appearing tissue. Magnetisation transfer ratio (MTR) and T1 relaxation time are abnormal in normal appearing tissues in established MS. This study used these MR techniques in early MS to study normal appearing tissues and lesions. The purpose was to determine whether abnormalities are already detectable in normal appearing tissues in early MS, and if so how they correlate with lesion characteristics.
Twenty two patients with early relapsing remitting (RR) MS (median disease duration 2 years, range 7 months-3 years) and 11 age-matched controls were studied. MTR and T1 relaxation times were measured in 9 regions of normal appearing white matter (NAWM) and 7 of normal appearing grey matter (NAGM). Gadolinium enhancing, T1-hypointense and T2 lesion loads were measured in all patients. #
When all regions were combined, there was a significant difference between patient and control NAWM for both T1 and MTR; T1 was abnormal in 6/9 and MTR in 3/9 NAWM regions. Global assessment of NAGM revealed a significant difference between patients and controls for T1 but not for MTR; T1 was significantly abnormal only in frontal NAGM. There was no significant correlation between NAWM T1 or MTR and any of the lesion load measurements.
This study reveals quantitative MR
abnormalities in both NAWM and NAGM in early RR MS, with more extensive
changes in the former. The lack of correlation between NAWM and lesion
abnormalities suggests that they have developed by at least partly independent
mechanisms. T1 may be more sensitive than MTR in detecting subtle pathological
changes in NAWM and NAGM.
© Steinkopff Verlag 2002