Magnetization Transfer Of Normal-Appearing White Matter In Primary/Progressive Multiple Sclerosis

Leary SM, Silver NC, Stevenson VL, Barker GJ, Miller DH, Thompson AJ
Mult Scler 1999 Oct;5(5):313-6
Institute of Neurology, NMR Research Unit, Queen Square, London WC1N 3BG, UK
PMID# 10516773; UI# 99448050

Patients with Primary/Progressive Multiple Sclerosis may develop severe disability despite a paucity of Lesions on conventional Magnetic Resonance Imaging, raising the possibility that intrinsic changes in Normal-Appearing White Matter (NAWM) contribute to disability.

This study has measured Magnetization Transfer Ratio (MTR), an index of tissue damage, of NAWM in 52 patients with Primary/Progressive Multiple Sclerosis and 26 healthy controls.

Absolute values of MTR were obtained from the Genu of the Corpus Callosum and Pons, and mean values were calculated from bilateral regions in the Centrum Semiovale, Frontal White Matter, Parieto-Occipital White Matter and posterior limb of the Internal Capsule.

The median MTR was lower in all regions in patients compared to controls. Median values (per cent units) were significantly lower in:

  1. Corpus Callosum (39.73 vs 40.63; P=0.01)
  2. Frontal White Matter (39.11 vs 39.59; P=0.01)
  3. Centrum Semiovale (37.21 vs 37.82; P<0.05)

This study has demonstrated small but widespread decreases in MTR in NAWM in Primary/Progressive Multiple Sclerosis supporting the hypothesis that there are intrinsic changes in NAWM which may contribute to Disability in this patient group.

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