MRI Technique Maps Susceptibility of MS Progression Through Brain Iron Levels

Iron is a crucial component of several cellular functions in the brain, including myelination of neurons, and can be harmful when levels are too high or low. Monitoring iron concentration in the brains of patients with multiple sclerosis (MS) may help identify the risk of disease progression and disability, according to a recently-published study.

Typically, brain atrophy is used as a marker to predict cognitive and physical decline in patients with MS. However, because brain atrophy takes time to identify, an earlier measure of MS-related disability risk is needed.

The study, published in Radiology, investigated the use of a new, advanced MRI technique designed to determine susceptibility of disease progression by measuring brain iron levels. The researchers compared brain iron levels in patients with MS with those of a healthy control group using the technique, called quantitative susceptibility mapping.

The study included 600 patients with MS, including 452 with early-stage disease and 148 whose disease had progressed.

According to the researchers, a brain region with more iron would indicate higher magnetic susceptibility, whereas a region with less iron would suggest lower susceptibility.

“It is known that there is more iron in the deep gray matter structures in MS patients, but also we’ve seen in recent literature that there are regions where we find less iron in the brains of these patients,” lead study author Robert Zivadinov, MD, PhD, professor of neurology at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, said in a press release.

In the study, patients with MS had higher levels of iron in the basal ganglia compared with 250 healthy control participants. However, the researchers noted that those with MS had lower levels of iron in their thalamus, a brain region that helps process sensory input by acting as a relay between certain brain structures and the spinal cord. For the first time, the researchers reported increasing iron levels in the basal ganglia and lower iron levels in the thalamic structures, which were associated with longer disease duration, higher disability degree, and disease progression.

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The findings suggest a potential role for quantitative susceptibility mapping in clinical trials for a promising new trial, the researchers noted.

“Susceptibility is an interesting imaging marker of disease severity that can predict which patients are at severe risk of progressing,” Dr Zivadinov concluded in the press release. “To be able to act against changes in susceptibility would be extremely beneficial.”

Reference

Brain Iron Levels May Predict Multiple Sclerosis Disabilities [news release]. RSNA’s website. https://press.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?ID=2021. Accessed July 17, 2018.