Abstract

In multiple sclerosis (MS), the correlation between lesion load on conventional magnetic resonance imaging (MRI) and clinical disability is weak. This clinico-radiological paradox might partly be due to the low sensitivity of conventional MRI to detect gray matter demyelination. Magnetization transfer ratio (MTR) has previously been shown to detect white matter demyelination in mice. In this study, we investigated whether MTR can detect gray matter demyelination in cuprizone exposed mice. A total of 54 female C57BL/6 mice were split into one control group () and eight cuprizone exposed groups (). The mice were exposed to (w/w) cuprizone for up to six weeks. MTR images were obtained at a 7 Tesla Bruker MR-scanner before cuprizone exposure, weekly for six weeks during cuprizone exposure, and once two weeks after termination of cuprizone exposure. Immunohistochemistry staining for myelin (anti-Proteolopid Protein) and oligodendrocytes (anti-Neurite Outgrowth Inhibitor Protein A) was obtained after each weekly scanning. Rates of MTR change and correlations between MTR values and histological findings were calculated in five brain regions. In the corpus callosum and the deep gray matter a significant rate of MTR value decrease was found, per week () and per week () respectively. The MTR values correlated to myelin loss as evaluated by immunohistochemistry (Corpus callosum: . Deep gray matter: ), but did not correlate to oligodendrocyte density. Significant results were not found in the cerebellum, the olfactory bulb or the cerebral cortex. This study shows that MTR can be used to detect demyelination in the deep gray matter, which is of particular interest for imaging of patients with MS, as deep gray matter demyelination is common in MS, and is not easily detected on conventional clinical MRI.

Highlights

  • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS), characterized by demyelinated lesions, with a varying extent of remyelination

  • In the deep gray matter, Magnetization transfer ratio (MTR) in the cuprizone exposed group decreased significantly by 0:39% each week of cuprizone exposure compared to the MTR values in controls (b3~{0:39+SE 0:06%, t~{6:7, pv:0001): In the cerebellum (b3~{0:34+SE 0:10%, t~{3:4, p~:0059) and in the olfactory bulb (b3~{0:34+SE 0:09%, t~{4:1, p~:0019), the Linear Mixed Effects Regression (LMER) analyses showed a significant decrease in the MTR during cuprizone exposure

  • When excluding the baseline MTR values from the LMER analysis, there were no significant differences in the MTR change between cuprizone exposed mice and controls in the cerebellum

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Summary

Introduction

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS), characterized by demyelinated lesions, with a varying extent of remyelination. The extent of MS-gray matter demyelination has been determined in immunohistochemical studies, which found a similar proportion of demyelinated area in gray matter as in white matter. The true extent of gray matter demyelination has not been detected by MRI, as conventional MRI techniques have a very low sensitivity to gray matter demyelination, in particular to purely cortical lesions. This may be one of the contributors to the so-called clinico-radiological paradox, the weak correlation between total lesion load found in conventional MRI and clinical disability [2]

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