T2 Hypointensity in the Deep Gray Matter of Patients With Multiple Sclerosis: A Quantitative Magnetic Resonance Imaging Study

2002 
in patients with MS in all structures (P.005) except for the substantia nigra. T2 hypointensity was associated with third ventricle enlargement and higher T2 but not T1 plaque load. The regression model predicting third ventricle width included caudate T2 hypointensity (P=.006). The model predicting T2 lesion load included globus pallidus T2 hypointensity (P=.001). Caudate T2 hypointensity was the only variable associated with disability score in regression modeling (P=.03). All T2 hypointensities differentiated the secondary progressive from the relapsing-remitting clinical courses. The final model (P.001) predicting clinical course retained T2 hypointensity of the thalamus, caudate, and putamen but not MRI plaques or atrophy. Conclusions: Gray matter T2 hypointensity in MS is associated with brain atrophy and is a stronger predictor of disability and clinical course than are conventional MRI findings. While longitudinal studies are warranted, these results suggest that pathologic iron deposition is a surrogate marker of the destructive disease process.
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