Complementary roles of grey matter MTR and T2 lesions in predicting progression in early PPMS

Carmen Tur (1) , Zhaleh Khaleeli (1) , Olga Ciccarelli (1) , Daniel R Altmann (2) , Mara Cercignani (3) , D H Miller (1) , a J Thompson (1)

1 Institute of Neurology
2 LSHTM
3 St Lucia Hospital

Objective: To investigate whether T2 lesion load and Magnetization Transfer Ratio (MTR) in the normal-appearing white matter (NAWM) and grey matter (GM) at study entry are independent predictors of progression and whether their changes correlate with the accrual of disability, over five years in early primary progressive multiple sclerosis (PPMS). Methods: Forty-seven patients with early PPMS and 18 healthy controls were recruited at baseline and then invited to attend clinical assessments six monthly for three years, and after five years. At each time point, all subjects underwent brain MRI including T2-weighted, magnetization transfer, and volumetric sequences. T2 lesion load, MTR histogram parameters and volumes for NAWM and GM, were calculated. Statistical analyses were used in patients to identify predictors of progression and correlations between MRI changes and clinical changes over time. Results: Baseline T2 lesion load and GM peak location and peak height MTR were independent predictors of progression. A model including these three predictors explained 91% of the variance of the progression measured by the timed 25-foot walk test, a significantly higher percentage than that obtained when the predictors were modelled individually (80%, 74% and 68%, respectively). Greater progression rate correlated with a steeper increase in T2 lesion load and a faster rate of decline in GM mean and peak location MTR. Conclusions: The combined assessment of both visible white matter damage and GM involvement is useful in predicting progression in PPMS.

Mots clés: MRI; MULTIPLE SCLEROSIS

Carmen Tur, Zhaleh Khaleeli, Olga Ciccarelli, Daniel R Altmann, Mara Cercignani, et al.. Complementary roles of grey matter MTR and T2 lesions in predicting progression in early PPMS. Journal of Neurology, Neurosurgery and Psychiatry, 2010, 82 (4), pp.423. ⟨10.1136/jnnp.2010.209890⟩. ⟨hal-00588620⟩