Abstract
Increasing evidence suggests that iron deposition is present in the later stages of MS. In this study we examined abnormal phase values, indicative of increased iron content on SWI-filtered phase images of the SDGM in CIS patients and HC. We also examined the association of abnormal phase with conventional MR imaging outcomes at first clinical onset. Forty-two patients with CIS (31 female, 11 male) and 65 age and sex-matched HC (41 female, 24 male) were scanned on a 3T scanner. Mean age was 40.1 (SD = 10.4) years in patients with CIS, and 42.8 (SD = 14) years in HC, while mean disease duration was 1.2 years (SD = 1.3) in patients with CIS. MP-APT, NPTV, and normalized volume measurements were derived for all SDGM structures. Parametric and nonparametric group-wise comparisons were performed, and associations were determined with other MR imaging metrics. Patients with CIS had significantly increased MP-APT (P = .029) and MP-APT volume (P = .045) in the pulvinar nucleus of the thalamus compared with HC. Furthermore, the putamen (P = .004), caudate (P = .035), and total SDGM (P = .048) displayed significant increases in MP-APT volume, while MP-APT was also significantly increased in the putamen (P = .029). No global or regional volumetric MR imaging differences were found between the study groups. Significant correlations were observed between increased MP-APT volumes of total SDGM, caudate, thalamus, hippocampus, and substantia nigra with white matter atrophy and increased T2 lesion volume (P < .05). Patients with CIS showed significantly increased content and volume of iron, as determined by abnormal SWI-phase measurement, in the various SDGM structures, suggesting that iron deposition may precede structure-specific atrophy.
Highlights
AND PURPOSE: Increasing evidence suggests that iron deposition is present in the later stages of MS
Patients with CIS had significantly increased MP-APT (P ϭ .029) and MP-APT volume (P ϭ .045) in the pulvinar nucleus of the thalamus compared with HC
The putamen (P ϭ .004), caudate (P ϭ .035), and total SDGM (P ϭ .048) displayed significant increases in MP-APT volume, while MP-APT was significantly increased in the putamen (P ϭ .029)
Summary
Forty-two patients with CIS (31 female, 11 male) and 65 age and sexmatched HC (41 female, 24 male) were scanned on a 3T scanner. Parametric and nonparametric group-wise comparisons were performed, and associations were determined with other MR imaging metrics. Subjects We prospectively enrolled 42 consecutive patients with CIS (31 women, 11 men). Inclusion criteria were a diagnosis of CIS,[32] age 18 – 65 years, and disease duration between 0 and 5 years. Sixty-five age- and sex-matched HC were prospectively enrolled, all of whom had normal MR imaging and physical examinations. Patients with CIS underwent full neurologic assessment, including determination of EDSS.[33] Participants were excluded if they had a relapse or were treated with steroids within the month preceding study entry, were pregnant, or had any pre-existing medical conditions known to be associated with brain pathology. The internal institutional review board approved the study protocol and written informed consent was obtained from all participants
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