Iron Levels in Brain May Predict MS Disabilities

A new study describes a highly accurate magnetic resonance imaging (MRI) technique that suggests altered deep gray matter iron is associated with the evolution of multiple sclerosis (MS).

Researchers at the University at Buffalo (UB; NY, USA) and the Buffalo Neuroimaging Analysis Center (BNAC; NY, USA) conducted a prospective study in 600 participants with MS to examine deep gray matter using quantitative susceptibility mapping (QSM), and to assess the relationship between susceptibility and clinical disability. All MS patients, and 250 age- and sex-matched healthy control participants were imaged with a 3T MRI scanner to measure deep gray matter magnetic susceptibility, using region of interest and voxelwise methods.

The results revealed that the MS patients had higher levels of iron in the basal ganglia than the control patients. On the other hand, MS patients had lower levels of iron in the thalamus, an important brain region that helps process sensory input by acting as a relay between certain brain structures and the spinal cord. Lower iron content in the thalamus and higher iron content in other deep gray matter structures in MS patients were associated with longer disease duration, higher disability degree, and faster disease progression. The study was published on July 17, 2018, in Radiology.

“Brain atrophy is the current gold standard for predicting cognitive and physical decline in MS, but it has limitations; it takes a long time to see. We need an earlier measure of who will develop MS-related disability,” said lead author Professor Robert Zivadinov, MD, PhD, of UB and BNAC. “The results point to a potential role for quantitative susceptibility mapping in clinical trials of promising new drugs. To be able to act against changes in susceptibility would be extremely beneficial.”

The role of iron accumulation in white and gray matter damage in MS is well known, but it is not yet clear if local changes in brain tissue iron concentrations are a causal factor in neurodegeneration, or a by-product of cell death. Histopathologic and MRI data have consistently shown profound changes in iron concentration in all the central nervous system compartments, with reduced iron content in newly forming white matter lesions, cortical lesions, thalamus and normal-appearing white matter, and higher iron content in the rim of chronic active lesions and structures of the basal ganglia.

Related Links:
University at Buffalo
Buffalo Neuroimaging Analysis Center