• Niels Bergsland, Eleonora Tavazzi, Maria Marcella Laganà, Francesca Baglio, Pietro Cecconi, Stefano Viotti, Robert Zivadinov, Giuseppe Baselli, and Marco Rovaris.
• MR Research Laboratory, IRCCS, Don Gnocchi Foundation ONLUS, Milan, Italy.
• J Neuroimaging. 2017 Jan 1; 27 (1): 107-113.

Background And PurposeWith respect to healthy controls (HCs), increased iron concentrations in the deep gray matter (GM) and decreased white matter (WM) integrity are common findings in multiple sclerosis (MS) patients. The association between these features of the disease remains poorly understood. We investigated the relationship between deep iron deposition in the deep GM and WM injury in associated fiber tracts in MS patients.MethodsSixty-six MS patients (mean age 50.0 years, median Expanded Disability Status Scale 5.25, mean disease duration 19.1 years) and 29 HCs, group matched for age and sex were imaged on a 1.5T scanner. Susceptibility-weighted imaging and diffusion tensor imaging (DTI) were used for assessing high-pass filtered phase values in the deep GM and normal appearing WM (NAWM) integrity in associated fiber tracts, respectively. Correlation analyses investigated the associations between filtered phase values (suggestive of iron content) and WM damage.ResultsAreas indicative of increased iron levels were found in the left and right caudates as well as in the left thalamus. MS patients presented with decreased DTI-derived measures of tissue integrity in the associated WM tracts. Greater mean, axial and radial diffusivities were associated with increased iron levels in all three GM areas (r values .393 to .514 with corresponding P values .003 to <.0001). Global NAWM diffusivity measures were not related to mean filtered phase values within the deep GM.ConclusionsIncreased iron concentration in the deep GM is associated with decreased tissue integrity of the connected WM in MS patients.Copyright © 2016 by the American Society of Neuroimaging.

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