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Neuroimage Clin. 2014 Mar 31;4:641-8. doi: 10.1016/j.nicl.2014.02.004. eCollection 2014.

Age independently affects myelin integrity as detected by magnetization transfer magnetic resonance imaging in multiple sclerosis.

Author information

1
Imanova Centre for Imaging Sciences, London, UK ; Division of Experimental Medicine, Imperial College London, UK.
2
Division of Brain Sciences, Imperial College London, UK.
3
Department of Imaging, Imperial College Healthcare NHS Trust, UK.
4
Imanova Centre for Imaging Sciences, London, UK ; Division of Brain Sciences, Imperial College London, UK.
5
Division of Brain Sciences, Imperial College London, UK ; Neurosciences, GlaxoSmithKline Research and Development, UK.
6
Department of Health Sciences (DISSAL), University of Genoa, Italy.
7
Division of Brain Sciences, Imperial College London, UK ; Department of Imaging, Imperial College Healthcare NHS Trust, UK.
8
Division of Brain Sciences, Imperial College London, UK ; Department of Clinical Neurosciences, Imperial College Healthcare NHS Trust, UK.

Abstract

BACKGROUND:

Multiple sclerosis (MS) is a heterogeneous disorder with a progressive course that is difficult to predict on a case-by-case basis. Natural history studies of MS have demonstrated that age influences clinical progression independent of disease duration.

OBJECTIVE:

To determine whether age would be associated with greater CNS injury as detected by magnetization transfer MRI.

MATERIALS AND METHODS:

Forty MS patients were recruited from out-patient clinics into two groups stratified by age but with similar clinical disease duration as well as thirteen controls age-matched to the older MS group. Images were segmented by automated programs and blinded readers into normal appearing white matter (NAWM), normal appearing gray matter (NAGM), and white matter lesions (WMLs) and gray matter lesions (GMLs) in the MS groups. WML and GML were delineated on T2-weighted 3D fluid-attenuated inversion recovery (FLAIR) and T1 weighted MRI volumes. Mean magnetization transfer ratio (MTR), region volume, as well as MTR histogram skew and kurtosis were calculated for each region.

RESULTS:

All MTR measures in NAGM and MTR histogram metrics in NAWM differed between MS subjects and controls, as expected and previously reported by several studies, but not between MS groups. However, MTR measures in the WML did significantly differ between the MS groups, in spite of no significant differences in lesion counts and volumes.

CONCLUSIONS:

Despite matching for clinical disease duration and recording no significant WML volume difference, we demonstrated strong MTR differences in WMLs between younger and older MS patients. These data suggest that aging-related processes modify the tissue response to inflammatory injury and its clinical outcome correlates in MS.

KEYWORDS:

Aging; GM, gray matter; GML, gray matter lesion; MRI; MTR, magnetization transfer ratio; Magnetization transfer; Multiple sclerosis; NAGM, normal appearing gray matter; NAWM, normal appearing white matter; WM, white matter; WML, white matter lesion

PMID:
24936415
PMCID:
PMC4053639
DOI:
10.1016/j.nicl.2014.02.004
[Indexed for MEDLINE]
Free PMC Article

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