Abstract
Extensive gray matter (GM) involvement has been demonstrated in multiple sclerosis (MS) patients. This study was aimed to identify GM alterations in relapsing-remitting MS (RRMS) patients using synthetic quantitative MRI (qMRI). We assessed myelin volume fraction (MVF) in each voxel on the basis of R1 and R2 relaxation rates and proton density in 14 early and 28 late (disease duration ≤5 and >5 years, respectively) RRMS patients, and 15 healthy controls (HCs). The MVF and myelin volumes of GM (GM-MyVol) were compared between groups using GM-based spatial statistics (GBSS) and the Kruskal-Wallis test, respectively. Correlations between MVF or GM-MyVol and disease duration or expanded disability status scale were also evaluated. RRMS patients showed a lower MVF than HCs, predominantly in the limbic and para-limbic areas, with more extensive areas noted in late RRMS patients. Late-RRMS patients had the smallest GM-MyVol (20.44 mL; early RRMS, 22.77 mL; HCs, 23.36 mL). Furthermore, the GM-MyVol in the RRMS group was inversely correlated with disease duration (r = −0.43, p = 0.005). In conclusion, the MVF and MyVol obtained by synthetic qMRI can be used to evaluate GM differences in RRMS patients.
Highlights
Www.nature.com/scientificreports of the development and progression of gray matter (GM) pathology by, for example, indirect mapping of myelin density[6]
A lower myelin volume fraction (MVF), which reflects demyelination, was found in relapsing-remitting MS (RRMS) patients when compared with healthy controls (HCs) and in late RRMS patients when compared with those exhibiting early RRMS
These findings are in agreement with previous histopathological and radiological studies showing that demyelination is a major pathology finding in the GM of multiple sclerosis (MS) patients, and GM changes can be seen from an early stage of the disease[4,30]
Summary
Www.nature.com/scientificreports of the development and progression of GM pathology by, for example, indirect mapping of myelin density[6]. Various qMRI techniques have been widely used to assess the development and progression of GM pathology in MS, such as magnetization transfer (MT) imaging and myelin imaging based on proton density (PD) and transverse relaxation times of myelin water[6,9]. Fast macromolecular proton fraction (MPF) mapping[16] and combined T2* and T1 cortical mapping (combined myelin estimation map)[17] have been used to evaluate the GM in MS These methods show more specificity for myelin, their clinical use is hindered by their long acquisition times. The model has shown good repeatability[24] and correlation with myelin-sensitive Luxol fast-blue stained post-mortem brain assessments[25] and other myelin imaging techniques[26] It can quantify demyelination of WM in MS27,28. We investigated the correlation between MRI measurements and clinical scores, such as disease duration and Expanded Disability Severity Scale (EDSS) scores
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