Contributions
Abstract: P1051
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Multiple sclerosis (MS) can affect any part of the brain, but it does not do so uniformly. Histopathological and imaging studies have shown that demyelinating lesions in white matter (WM) and grey matter (GM) tend to occur close to the inner (periventricular) and outer (subpial) surfaces of the brain, and in GM neuronal loss is also greater towards the outside of the brain. Using high-resolution magnetisation transfer ratio (MTR) imaging, consistent with this we found a gradient in cortical GM abnormality, and more recently a similar gradient normal-appearing (NA) WM abnormality around the lateral ventricles.
Objective: To determine whether or not the association between proximity to the inner (ventricular and aqueductal) and outer (pial) surfaces of the brain and the distribution of WM and GM MTR abnormalities, and white matter (WM) lesions, is similar throughout the brain.
Methods: Sixty-seven people with relapse-onset MS and 30 healthy controls were included in the study. Volumetric T1-weighted images and high-resolution (1 mm3) MTR images were acquired. These images were co-registered, and the T1-weighted images segmented into 12 bands between the inner and outer surfaces of the brain. The first and last bands were discarded to limit partial volume effects with cerebrospinal fluid. Mean MTR values were computed for each bands in supra-tentorial and cerebellar NAWM, brainstem NA tissue, and cortical and deep GM. Proportion of each band occupied by WM lesions was also measured.
Results: In supra-tentorial and cerebellar NAWM, brainstem NA and in deep and cortical GM, proximity to the ventricular and pial surfaces was associated with progressively lower MTR values in the MS group compared with controls. The density of WM lesions was associated with proximity to the ventricles only in the supra-tentorial compartment, and no link was found with distance from the pial surfaces.
Conclusions: In MS, MTR abnormalities in WM and GM are consistently related to distance from the inner and outer surfaces of the brain, and this suggests that there is a common factor underlying their spatial distribution. A similar pattern was not found for WM lesions, raising the possibility that different factors promote their formation.
Disclosure: Dr. Pardini received research support from Novartis.
Ms. Sudre reports no disclosure.
Dr. Prados reports no disclosures.
Dr. Yaldizli has received lecture fees from Teva, Novartis and Bayer Schering which was exclusively used for funding of research and continuous medical education in the Department of Neurology at the University Hospital Basel.
Dr. Sethi receives research support from Biogen Idec and Novartis.
Dr. Muhlert reports no disclosures.
Dr. Samson reports no disclosures.
Mr. van de Pavert reports no disclosures.
Dr. Cardoso reports no disclosures
Prof. Ourselin reports no disclosures
Prof. Wheeler-Kingshott is on the advisory board for BG12 (Biogen).
Prof. Miller has received honoraria from Biogen Idec, Novartis, GlaxoSmithKline, and Bayer Schering, and research grant support for doing MRI analysis in multiple sclerosis trials sponsored by GlaxoSmithKline, Biogen Idec, and Novartis.
Dr. Chard has received honoraria (paid to his employer) from Ismar Healthcare NV, Swiss MS Society, Excemed (previously Serono Symposia International Foundation), Merck, Bayer and Teva for faculty-led education work; Teva for advisory board work; meeting expenses from Merck, Teva, Novartis, the MS Trust and National MS Society; and has previously held stock in GlaxoSmithKline.
Abstract: P1051
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Multiple sclerosis (MS) can affect any part of the brain, but it does not do so uniformly. Histopathological and imaging studies have shown that demyelinating lesions in white matter (WM) and grey matter (GM) tend to occur close to the inner (periventricular) and outer (subpial) surfaces of the brain, and in GM neuronal loss is also greater towards the outside of the brain. Using high-resolution magnetisation transfer ratio (MTR) imaging, consistent with this we found a gradient in cortical GM abnormality, and more recently a similar gradient normal-appearing (NA) WM abnormality around the lateral ventricles.
Objective: To determine whether or not the association between proximity to the inner (ventricular and aqueductal) and outer (pial) surfaces of the brain and the distribution of WM and GM MTR abnormalities, and white matter (WM) lesions, is similar throughout the brain.
Methods: Sixty-seven people with relapse-onset MS and 30 healthy controls were included in the study. Volumetric T1-weighted images and high-resolution (1 mm3) MTR images were acquired. These images were co-registered, and the T1-weighted images segmented into 12 bands between the inner and outer surfaces of the brain. The first and last bands were discarded to limit partial volume effects with cerebrospinal fluid. Mean MTR values were computed for each bands in supra-tentorial and cerebellar NAWM, brainstem NA tissue, and cortical and deep GM. Proportion of each band occupied by WM lesions was also measured.
Results: In supra-tentorial and cerebellar NAWM, brainstem NA and in deep and cortical GM, proximity to the ventricular and pial surfaces was associated with progressively lower MTR values in the MS group compared with controls. The density of WM lesions was associated with proximity to the ventricles only in the supra-tentorial compartment, and no link was found with distance from the pial surfaces.
Conclusions: In MS, MTR abnormalities in WM and GM are consistently related to distance from the inner and outer surfaces of the brain, and this suggests that there is a common factor underlying their spatial distribution. A similar pattern was not found for WM lesions, raising the possibility that different factors promote their formation.
Disclosure: Dr. Pardini received research support from Novartis.
Ms. Sudre reports no disclosure.
Dr. Prados reports no disclosures.
Dr. Yaldizli has received lecture fees from Teva, Novartis and Bayer Schering which was exclusively used for funding of research and continuous medical education in the Department of Neurology at the University Hospital Basel.
Dr. Sethi receives research support from Biogen Idec and Novartis.
Dr. Muhlert reports no disclosures.
Dr. Samson reports no disclosures.
Mr. van de Pavert reports no disclosures.
Dr. Cardoso reports no disclosures
Prof. Ourselin reports no disclosures
Prof. Wheeler-Kingshott is on the advisory board for BG12 (Biogen).
Prof. Miller has received honoraria from Biogen Idec, Novartis, GlaxoSmithKline, and Bayer Schering, and research grant support for doing MRI analysis in multiple sclerosis trials sponsored by GlaxoSmithKline, Biogen Idec, and Novartis.
Dr. Chard has received honoraria (paid to his employer) from Ismar Healthcare NV, Swiss MS Society, Excemed (previously Serono Symposia International Foundation), Merck, Bayer and Teva for faculty-led education work; Teva for advisory board work; meeting expenses from Merck, Teva, Novartis, the MS Trust and National MS Society; and has previously held stock in GlaxoSmithKline.