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Mult Scler. 2017 Oct 1:1352458517736148. doi: 10.1177/1352458517736148. [Epub ahead of print]

USPIO-positive MS lesions are associated with greater tissue damage than gadolinium-positive-only lesions during 3-year follow-up.

Author information

1
Department of Neurology, Rennes University Hospital, Rennes, France/VisAGeS team, INRIA (INSERM, CNRS, Rennes 1 University), Rennes, France/CHU Hôpital Pontchaillou, Rennes, France.
2
VisAGeS team, INRIA (INSERM, CNRS, Rennes 1 University), Rennes, France.
3
CEMEREM, Timone University Hospital, Marseille, France/CNRS and Center for Magnetic Resonance in Biology and Medicine (CRMBM-UMR 7339), Aix-Marseille University and CNRS, Marseille, France.
4
VisAGeS team, INRIA (INSERM, CNRS, Rennes 1 University), Rennes, France/Department of Radiology, Rennes University Hospital, Rennes, France.
5
Department of Neurology, Reims University Hospital, Reims, France.
6
CNRS and Center for Magnetic Resonance in Biology and Medicine (CRMBM-UMR 7339), Aix-Marseille University, Marseille, France.
7
Department of Neurology, Rennes University Hospital, Rennes, France/VisAGeS team, INRIA (INSERM, CNRS, Rennes 1 University), Rennes, France/Plurithematic Clinical Investigation Center (CIC-P 1414), INSERM, Rennes, France.

Abstract

BACKGROUND:

Identifying in vivo the processes that determine lesion severity in multiple sclerosis (MS) remains a challenge.

OBJECTIVES:

To describe the dynamics of ultrasmall superparamagnetic iron oxide (USPIO) enhancement in MS lesions and the relationship between USPIO enhancement and microstructural changes over 3 years.

METHODS:

Lesion development was assessed at baseline, Months 3, 6, and 9, using magnetic resonance imaging (MRI) with gadolinium and USPIO. Microstructural changes were assessed at baseline, Months 3, 6, 9, 12, 18, 24, and 36, using relaxometry, magnetization transfer, and diffusion-weighted imaging.

RESULTS:

We included 15 patients with clinically isolated syndrome. In the 52 MRI scans acquired with USPIO, 22 lesions were USPIO and gadolinium positive, and 44 were USPIO negative but gadolinium positive. Lesions no longer exhibited sustained USPIO enhancement 3 months later. At baseline, lesions that were both USPIO and gadolinium positive had lower magnetization transfer ratio values (common language effect size = 0.84, p = 0.0005) and lower fractional anisotropy values (0.83, p = 0.001) than gadolinium-positive-only lesions. USPIO-positive lesions remained associated with greater damage than gadolinium-positive-only lesions throughout the 3-year follow-up.

CONCLUSION:

USPIO enhancement, mainly reflecting monocyte infiltration, is transient and is associated with persistent tissue damage after 3 years.

KEYWORDS:

Multiple sclerosis; USPIO; clinically isolated syndrome; diffusion tensor imaging; gadolinium; magnetic resonance imaging; magnetization transfer imaging

PMID:
29064775
DOI:
10.1177/1352458517736148

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