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Cortical and Subcortical Morphometric and Iron Changes in Relapsing-Remitting Multiple Sclerosis and Their Association with White Matter T2 Lesion Load

A 3-Tesla Magnetic Resonance Imaging Study

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Abstract

Introduction

This study was carried out to investigate the global and regional morphometric and iron changes in grey matter (GM) of multiple sclerosis (MS) patients and link them to the white matter (WM) lesions in a multimodal magnetic resonance imaging approach.

Material and Methods

The study involved 30 relapsing-remitting MS (RRMS) patients along with 30 age-matched healthy controls (HC) who were scanned on a 3T Siemens Trio system. The scanning protocol included a 3D, high resolution T1, T2, and T2*-weighted sequences. The T1-w images were used in FreeSurfer for cortical reconstruction and volumetric segmentation, while T2-w images were used to extract the WM T2 lesions; however, iron and magnetic susceptibility were calculated from the phase data of the T2*-w sequence. Surface-based analyses were performed in FreeSurfer to investigate the regional cortical morphometric changes and their correlations with the expanded disability status scale (EDSS), WM T2 lesions load, cortical iron deposition and magnetic susceptibility.

Results

Significant differences were detected between the RRMS patients and HC for all cortical and subcortical morphometric changes. The EDSS and T2 lesion load showed weak to moderate correlation with the reduced cortical morphometric measurements, increased cortical magnetic susceptibility and iron concentration. All deep grey matter (dGM) volumes showed a significant strong positive correlation with the cortical surface area and volume in RRMS patients and HC.

Conclusions

Grey matter is very much involved in the RRMS and cortical morphometric changes occur in a non-uniform pattern and are very likely to be associated with cortical iron deposition and magnetic susceptibility, dGM atrophy, WM T2 lesion load, and disability.

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Acknowledgements

We would like to thank the Royal Medical Services for their great help and support and for allowing us to use their 3T MRI to scan our patients and healthy controls.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Medical Imaging, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan

    Ali Al-Radaideh

  2. Department of Radiology, King Hussien Medical Center, Jordanian Royal Medical Services, Amman, Jordan

    Imad Athamneh & Hadeel Alabadi

  3. Department of Internal Medicine, Neurology, King Hussein Medical Centre, Jordanian Royal Medical Services, Amman, Jordan

    Majed Hbahbih

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  1. Ali Al-Radaideh
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  2. Imad Athamneh
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  3. Hadeel Alabadi
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Correspondence to Ali Al-Radaideh.

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Conflict of interest

A. Al-Radaideh, I. Athamneh, H. Alabadi and M. Hbahbih declare that they have no competing interests.

Ethical standards

The present study was approved by the Royal Medical Service ethics committee and carried out in accordance with the code of ethics of the World Medical Association (Declaration of Helsinki). All participants were asked to sign a consent form and fill out the MRI safety questionnaire before participating in the study.

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Fig _S1

 Regions of statistically significant correlations of magnetic susceptibility; Fig _S2 Regions of statistically significant correlations of iron

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Al-Radaideh, A., Athamneh, I., Alabadi, H. et al. Cortical and Subcortical Morphometric and Iron Changes in Relapsing-Remitting Multiple Sclerosis and Their Association with White Matter T2 Lesion Load. Clin Neuroradiol 29, 51–64 (2019). https://doi.org/10.1007/s00062-017-0654-0

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  • DOI: https://doi.org/10.1007/s00062-017-0654-0

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