Large-scale, multicentre, quantitative MRI study of brain and cord damage in primary progressive multiple sclerosis

Marco Rovaris, Elda Judica, Jaume Sastre-Garriga, Alex Rovira, Maria Pia Sormani, Beatrice Benedetti, Tijmen Korteweg, Nicola De Stefano, Zhaleh Khaleeli, Xavier Montalban, Frederik Barkhof, David H. Miller, Chris Polman, Alan J. Thompson, Massimo Filippi

Research output: Contribution to journalArticlepeer-review


Although the mechanisms underlying the accumulation of disability in primary progressive (PP) multiple sclerosis (MS) are still unclear, a major role seems to be played by 'occult' tissue damage. We investigated whether conventional and magnetization transfer (MT) MRI may provide complementary information for the assessment of PPMS severity. Conventional and MT MRI scans from 226 PPMS patients and 84 healthy controls were collected for centralized analysis. The expanded disability status scale (EDSS) score was rated at the time of MRI acquisition. T2 lesion volume, normalized brain volume (NBV) and cervical cord cross-sectional area (CSA) were measured. Magnetization transfer ratio (MTR) histograms from whole brain tissue, normal-appearing white matter and grey matter (NAGM) were also obtained. Mean NBV, CSA and MTR histogram-derived metrics showed significant inter-centre heterogeneity. After correcting for the acquisition centre, pooled average MTR and histogram peak height values were different between PPMS patients and controls for all tissue classes (P-values between 0.03 and 0.0001). More severe brain and cord atrophy and MT MRI-detectable NAGM damage were found in patients who required walking aids than in those who did not (P-values: 0.03,

Original languageEnglish
Pages (from-to)455-464
Number of pages10
JournalMultiple Sclerosis Journal
Issue number4
Publication statusPublished - May 2008


  • Atrophy
  • Grey matter
  • MRI
  • Primary progressive multiple sclerosis

ASJC Scopus subject areas

  • Clinical Neurology

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