Deep grey matter T2 hypo-intensity in patients with paediatric multiple sclerosis

Antonia Ceccarelli, Maria A. Rocca, Elisabetta Perego, Lucia Moiola, Angelo Ghezzi, Vittorio Martinelli, Giancarlo Comi, Massimo Filippi

Research output: Contribution to journalArticle

Abstract

Objective: T2 hypo-intensity on magnetic resonance imaging scans is thought to reflect pathological iron deposition in the presence of disease. In this pilot study, we evaluated the utility of the quantification of T2 hypo-intensities in paediatric patients by estimating deep grey matter (DGM) T2 hypo-intensities in paediatric patients with multiple sclerosis (MS) or clinically isolated syndromes (CIS), and their changes over 1 year.Methods: A dual-echo sequence was obtained from 45 paediatric patients (10 with CIS, 35 with relapsing-remitting MS, 8 with an onset of the disease before the age of 10 and 37 during adolescence) and 14 age-matched healthy controls (HC). Eleven patients were reassessed both clinically and with MRI after 1 year. Normalized T2 intensity in the basal ganglia and thalamus was quantified.Results: At baseline, DGM T2 intensity was similar between paediatric patients and HC in all the structures analysed, except for the head of the left caudate nucleus (p = 0.001). DGM T2 intensity of the head of the left caudate nucleus was similar between paediatric CIS and RRMS patients, but it was reduced in adolescent-onset paediatric patients versus HC (p = 0.002). In all patients, DGM T2 intensity of the head of the left caudate nucleus was correlated with T2 lesion volume (r = -0.39, p = 0.007). DGM T2 intensity in all the structures analysed with longitudinal assessment remained stable over the follow-up in the cohort of patients.Conclusions: The quantification of DGM T2 intensity in paediatric patients may provide surrogate markers of neurodegeneration. In paediatric MS, DGM is likely to be affected by iron-related changes, which are likely to be, at least partially, secondary to WM damage.

Original languageEnglish
Pages (from-to)702-707
Number of pages6
JournalMultiple Sclerosis Journal
Volume17
Issue number6
DOIs
Publication statusPublished - 2011

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Multiple Sclerosis
Pediatrics
Caudate Nucleus
Iron
Gray Matter
Relapsing-Remitting Multiple Sclerosis
Basal Ganglia
Thalamus
Biomarkers
Magnetic Resonance Imaging

Keywords

  • deep grey matter
  • magnetic resonance imaging
  • paediatric multiple sclerosis
  • T2 hypo-intensity

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Deep grey matter T2 hypo-intensity in patients with paediatric multiple sclerosis. / Ceccarelli, Antonia; Rocca, Maria A.; Perego, Elisabetta; Moiola, Lucia; Ghezzi, Angelo; Martinelli, Vittorio; Comi, Giancarlo; Filippi, Massimo.

In: Multiple Sclerosis Journal, Vol. 17, No. 6, 2011, p. 702-707.

Research output: Contribution to journalArticle

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AU - Ceccarelli, Antonia

AU - Rocca, Maria A.

AU - Perego, Elisabetta

AU - Moiola, Lucia

AU - Ghezzi, Angelo

AU - Martinelli, Vittorio

AU - Comi, Giancarlo

AU - Filippi, Massimo

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N2 - Objective: T2 hypo-intensity on magnetic resonance imaging scans is thought to reflect pathological iron deposition in the presence of disease. In this pilot study, we evaluated the utility of the quantification of T2 hypo-intensities in paediatric patients by estimating deep grey matter (DGM) T2 hypo-intensities in paediatric patients with multiple sclerosis (MS) or clinically isolated syndromes (CIS), and their changes over 1 year.Methods: A dual-echo sequence was obtained from 45 paediatric patients (10 with CIS, 35 with relapsing-remitting MS, 8 with an onset of the disease before the age of 10 and 37 during adolescence) and 14 age-matched healthy controls (HC). Eleven patients were reassessed both clinically and with MRI after 1 year. Normalized T2 intensity in the basal ganglia and thalamus was quantified.Results: At baseline, DGM T2 intensity was similar between paediatric patients and HC in all the structures analysed, except for the head of the left caudate nucleus (p = 0.001). DGM T2 intensity of the head of the left caudate nucleus was similar between paediatric CIS and RRMS patients, but it was reduced in adolescent-onset paediatric patients versus HC (p = 0.002). In all patients, DGM T2 intensity of the head of the left caudate nucleus was correlated with T2 lesion volume (r = -0.39, p = 0.007). DGM T2 intensity in all the structures analysed with longitudinal assessment remained stable over the follow-up in the cohort of patients.Conclusions: The quantification of DGM T2 intensity in paediatric patients may provide surrogate markers of neurodegeneration. In paediatric MS, DGM is likely to be affected by iron-related changes, which are likely to be, at least partially, secondary to WM damage.

AB - Objective: T2 hypo-intensity on magnetic resonance imaging scans is thought to reflect pathological iron deposition in the presence of disease. In this pilot study, we evaluated the utility of the quantification of T2 hypo-intensities in paediatric patients by estimating deep grey matter (DGM) T2 hypo-intensities in paediatric patients with multiple sclerosis (MS) or clinically isolated syndromes (CIS), and their changes over 1 year.Methods: A dual-echo sequence was obtained from 45 paediatric patients (10 with CIS, 35 with relapsing-remitting MS, 8 with an onset of the disease before the age of 10 and 37 during adolescence) and 14 age-matched healthy controls (HC). Eleven patients were reassessed both clinically and with MRI after 1 year. Normalized T2 intensity in the basal ganglia and thalamus was quantified.Results: At baseline, DGM T2 intensity was similar between paediatric patients and HC in all the structures analysed, except for the head of the left caudate nucleus (p = 0.001). DGM T2 intensity of the head of the left caudate nucleus was similar between paediatric CIS and RRMS patients, but it was reduced in adolescent-onset paediatric patients versus HC (p = 0.002). In all patients, DGM T2 intensity of the head of the left caudate nucleus was correlated with T2 lesion volume (r = -0.39, p = 0.007). DGM T2 intensity in all the structures analysed with longitudinal assessment remained stable over the follow-up in the cohort of patients.Conclusions: The quantification of DGM T2 intensity in paediatric patients may provide surrogate markers of neurodegeneration. In paediatric MS, DGM is likely to be affected by iron-related changes, which are likely to be, at least partially, secondary to WM damage.

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