Periventricular magnetisation transfer abnormalities in early multiple sclerosis

Lukas Pirpamer, Bálint Kincses, Zsigmond Tamás Kincses, Christian Kiss, Anna Damulina, Michael Khalil, Rudolf Stollberger, Reinhold Schmidt, Christian Enzinger, Stefan Ropele*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: Recent studies suggested that CSF-mediated factors contribute to periventricular (PV) T2-hyperintense lesion formation in multiple sclerosis (MS) and this in turn correlates with cortical damage. We thus investigated if such PV-changes are observable microstructurally in early-MS and if they correlate with cortical damage.

METHODS: We assessed the magnetisation transfer ratio (MTR) in PV normal-appearing white matter (NAWM) and in MS lesions in 44 patients with a clinically isolated syndrome (CIS) suggestive of MS and 73 relapsing-remitting MS (RRMS) patients. Band-wise MTR values were related to cortical mean thickness (CMT) and compared with 49 healthy controls (HCs). For each band, MTR changes were assessed relative to the average MTR values of all HCs.

RESULTS: Relative to HCs, PV-MTR was significantly reduced up to 2.63% in CIS and 5.37% in RRMS (p < 0.0001). The MTR decreased towards the lateral ventricles with 0.18%/mm in CIS and 0.31%/mm in RRMS patients, relative to HCs. In RRMS, MTR-values adjacent to the ventricle and in PV-lesions correlated positively with CMT and negatively with EDSS.

CONCLUSION: PV-MTR gradients are present from the earliest stage of MS, consistent with more pronounced microstructural WM-damage closer to the ventricles. The positive association between reduced CMT and lower MTR in PV-NAWM suggests a common pathophysiologic mechanism. Together, these findings indicate the potential use of multimodal MRI as refined marker for MS-related tissue changes.

Original languageEnglish
Article number103012
JournalNeuroImage: Clinical
Publication statusPublished - 2022


  • Brain
  • Cerebral Ventricles/pathology
  • Demyelinating Diseases/pathology
  • Humans
  • Magnetic Resonance Imaging
  • Multiple Sclerosis/diagnostic imaging
  • Multiple Sclerosis, Relapsing-Remitting/pathology
  • White Matter/pathology


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