Detecting macromolecular differences of the CSF in low disability multiple sclerosis using quantitative MT MRI at 3T

Richard D Lawless; Colin D McKnight; Kristin P O'Grady; Anna Je Combes; Baxter P Rogers; Atlee A Witt; Mereze Visagie; Delaney C Houston; Logan E Prock; Francesca R Bagnato; Seth A Smith

doi:10.1177/20552173231211396

Detecting macromolecular differences of the CSF in low disability multiple sclerosis using quantitative MT MRI at 3T

Mult Scler J Exp Transl Clin. 2023 Nov 13;9(4):20552173231211396. doi: 10.1177/20552173231211396. eCollection 2023 Oct-Dec.

Authors

Richard D Lawless^{1

2}, Colin D McKnight³, Kristin P O'Grady⁴, Anna Je Combes¹, Baxter P Rogers^{1

3}, Atlee A Witt¹, Mereze Visagie¹, Delaney C Houston¹, Logan E Prock¹, Francesca R Bagnato^{5

6}, Seth A Smith^{1

3

2}

Affiliations

¹ Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA.
² Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
³ Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
⁴ Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
⁵ Division of Neuroimmunology, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
⁶ Department of Neurology, VA Hospital, TN Valley Healthcare System, Nashville, TN, USA.

Abstract

Background: Imaging investigation of cerebrospinal fluid (CSF) in multiple sclerosis (MS) is understudied. Development of noninvasive methods to detect pathological CSF changes would have a profound effect on MS diagnosis and would offer insight into MS pathophysiology and mechanisms of neurological impairment.

Objective: We propose magnetization transfer (MT) MRI as a tool to detect macromolecular changes in spinal CSF.

Methods: MT and quantitative MT (qMT) data were acquired in the cervical region in 27 people with relapsing-remitting multiple sclerosis (pwRRMS) and 38 age and sex-matched healthy controls (HCs). MT ratio (MTR), the B₁, B₀, and R₁ corrected qMT-derived pool size ratio (PSR) were quantified in the spinal cord and CSF of each group.

Results: Both CSF MTR and CSF qMT-derived PSR were significantly increased in pwRRMS compared to HC (p = 0.027 and p = 0.020, respectively). CSF PSR of pwRRMS was correlated to Expanded Disability Status Scale Scores (p = 0.045, R = 0.352).

Conclusion: Our findings demonstrate increased CSF macromolecular content in pwRRMS and link CSF macromolecular content with clinical impairment. This highlights the potential role of CSF in processing products of demyelination.

Keywords: Multiple sclerosis; cerebrospinal fluid; magnetic resonance imaging; magnetization transfer ratio; spinal cord.

Abstract

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