• René-Maxime Gracien, Alina Jurcoane, Marlies Wagner, Sarah C Reitz, Christoph Mayer, Steffen Volz, Stephanie-Michelle Hof, Vinzenz Fleischer, Amgad Droby, Helmuth Steinmetz, Sergiu Groppa, Elke Hattingen, Ralf Deichmann, and Johannes C Klein.
• Department of Neurology, Goethe University, Frankfurt/Main, Germany.
• J Magn Reson Imaging. 2016 Dec 1; 44 (6): 1600-1607.

PurposeTo investigate magnetization transfer ratio (MTR), T1 relaxation time, and proton density (PD) as indicators of gray matter damage in relapsing-remitting multiple sclerosis (RRMS), reflecting different aspects of microstructural damage and as imaging correlates of clinical disability. We aimed to determine which of these parameters may optimally quantify cortical damage, and serve as an imaging surrogate of clinical disability. In this study, cortical values of MTR, a surrogate for demyelination in MS, of PD, reflecting replacement of neural tissue by water, and of T1 , indicating a complex array of microstructural changes, were assessed in a group of RRMS patients in comparison to healthy controls (HC).Materials And Methods22 RRMS patients with varying disease duration (4.0 ± 6.54 years) and 10 HC received quantitative 3T magnetic resonance imaging (MRI) with MTR, T1 , and PD mapping. We tested for differences in cortical measurements between patients and HC. Additionally, correlation with disability as quantified by the Expanded Disability Status Scale was investigated.ResultsCortical parameter values were significantly altered in the RRMS group, with increased values of T1 (P = 0.008) and PD (P = 0.028) and reduced values of MTR (P = 0.043). Only cortical T1 was correlated with clinical disability measurements (P = 0.001, r = 0.65). Receiver operating characteristic analysis demonstrated the best discriminatory power for T1 (area under the curve 0.79, PD: 0.75, MTR 0.73).ConclusionOut of the parameters studied, cortical T1 is best suited to detect cortical damage as an imaging surrogate of clinical disability in RRMS. J. Magn. Reson. Imaging 2016;44:1600-1607.© 2016 International Society for Magnetic Resonance in Medicine.

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