Magnetization transfer magnetic resonance imaging and clinical changes in patients with relapsing-remitting multiple sclerosis

Celia Oreja-Guevara, Arnaud Charil, Domenico Caputo, Rosella Cavarretta, Maria Pia Sormani, Massimo Filippi

Research output: Contribution to journalArticle

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Abstract

Background: Magnetization transfer (MT) magnetic resonance imaging (MRI) can provide in vivo quantitative estimates of microscopic tissue damage in normal-appearing white matter (NAWM) and gray matter (GM) from patients with multiple sclerosis (MS). Objective: To determine whether a onetime MT MRI can provide markers of short-term disease evolution in patients with relapsing-remitting MS. Design: Eighteen-month observational study. Setting: Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele. Patients: Twenty-two patients with untreated relapsing-remitting MS. Main Outcome Measures: Relapse rate; disability according to the Expanded Disability Status Scale (EDSS); dual-echo, 2-dimensional gradient echo with and without a saturationMTpulse and T1-weighted MRIs of the brain; and MT ratio (MTR) histograms for NAWM and GM. Results: During the study period, 13 patients (59%) experienced 25 relapses. The median EDSS score was 1.25 (range, 0-3.5) at study entry and 1.75 (range, 0-3) at study exit. Significant, although moderate, correlations were found between average GM MTR values at baseline and EDSS changes during the study period (r=-0.44; P=.04). A trend was observed for the correlation between NAWM MTR values at baseline and the EDSS changes throughout 18 months (r=-0.42; P=.05). For the relation between EDSS changes and baseline GM MTR, the slope of the regression line was -0.5 (95% confidence interval, -1.0 to 0.0), indicating that a decrease in the baseline GM MTR of 1% predicted an increase in the EDSS score of 0.5 point throughout the 18 months. Conclusion: This study indicates that a "snapshot" MT MRI assessment detects subtle brain tissue changes that are associated with short-term disability accumulation in patients with relapsing-remitting MS.

Original languageEnglish
Pages (from-to)736-740
Number of pages5
JournalArchives of Neurology
Volume63
Issue number5
Publication statusPublished - May 2006

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Relapsing-Remitting Multiple Sclerosis
Magnetic Resonance Imaging
Recurrence
Brain
Neuroimaging
Multiple Sclerosis
Observational Studies
Outcome Assessment (Health Care)
Gray Matter
Confidence Intervals
Grey Matter
Research
White Matter

ASJC Scopus subject areas

  • Neuroscience(all)

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Magnetization transfer magnetic resonance imaging and clinical changes in patients with relapsing-remitting multiple sclerosis. / Oreja-Guevara, Celia; Charil, Arnaud; Caputo, Domenico; Cavarretta, Rosella; Sormani, Maria Pia; Filippi, Massimo.

In: Archives of Neurology, Vol. 63, No. 5, 05.2006, p. 736-740.

Research output: Contribution to journalArticle

Oreja-Guevara, C, Charil, A, Caputo, D, Cavarretta, R, Sormani, MP & Filippi, M 2006, 'Magnetization transfer magnetic resonance imaging and clinical changes in patients with relapsing-remitting multiple sclerosis', Archives of Neurology, vol. 63, no. 5, pp. 736-740.
Oreja-Guevara, Celia ; Charil, Arnaud ; Caputo, Domenico ; Cavarretta, Rosella ; Sormani, Maria Pia ; Filippi, Massimo. / Magnetization transfer magnetic resonance imaging and clinical changes in patients with relapsing-remitting multiple sclerosis. In: Archives of Neurology. 2006 ; Vol. 63, No. 5. pp. 736-740.
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AU - Sormani, Maria Pia

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AB - Background: Magnetization transfer (MT) magnetic resonance imaging (MRI) can provide in vivo quantitative estimates of microscopic tissue damage in normal-appearing white matter (NAWM) and gray matter (GM) from patients with multiple sclerosis (MS). Objective: To determine whether a onetime MT MRI can provide markers of short-term disease evolution in patients with relapsing-remitting MS. Design: Eighteen-month observational study. Setting: Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele. Patients: Twenty-two patients with untreated relapsing-remitting MS. Main Outcome Measures: Relapse rate; disability according to the Expanded Disability Status Scale (EDSS); dual-echo, 2-dimensional gradient echo with and without a saturationMTpulse and T1-weighted MRIs of the brain; and MT ratio (MTR) histograms for NAWM and GM. Results: During the study period, 13 patients (59%) experienced 25 relapses. The median EDSS score was 1.25 (range, 0-3.5) at study entry and 1.75 (range, 0-3) at study exit. Significant, although moderate, correlations were found between average GM MTR values at baseline and EDSS changes during the study period (r=-0.44; P=.04). A trend was observed for the correlation between NAWM MTR values at baseline and the EDSS changes throughout 18 months (r=-0.42; P=.05). For the relation between EDSS changes and baseline GM MTR, the slope of the regression line was -0.5 (95% confidence interval, -1.0 to 0.0), indicating that a decrease in the baseline GM MTR of 1% predicted an increase in the EDSS score of 0.5 point throughout the 18 months. Conclusion: This study indicates that a "snapshot" MT MRI assessment detects subtle brain tissue changes that are associated with short-term disability accumulation in patients with relapsing-remitting MS.

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