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Research ArticleBrain

Assessing Abnormal Iron Content in the Deep Gray Matter of Patients with Multiple Sclerosis versus Healthy Controls

C.A. Habib, M. Liu, N. Bawany, J. Garbern, I. Krumbein, H.-J. Mentzel, J. Reichenbach, C. Magnano, R. Zivadinov and E.M. Haacke
American Journal of Neuroradiology February 2012, 33 (2) 252-258; DOI: https://doi.org/10.3174/ajnr.A2773
C.A. Habib
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M. Liu
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N. Bawany
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J. Garbern
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I. Krumbein
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H.-J. Mentzel
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J. Reichenbach
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C. Magnano
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R. Zivadinov
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E.M. Haacke
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    Fig 1.

    SWI filtered-phase images displaying the basal ganglia and the midbrain of an age-matched healthy control (A−C) and patient with MS (D−F), showing abnormal iron deposition in the GP, PUT, and the CN (D); the SN and the RN of the midbrain (E); and the PT (F).

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    Fig 2.

    Average phase, normalized area, and total phase of RII in the CN and PT. Small dots represent healthy subjects. The solid line is the regression line, and the outer dashed lines represent the 95% prediction interval of the regression. Hollow squares and triangles represent patients with RRMS, and the solid squares and triangles represent patients with SPMS. The squares and triangles represent the left and right hemispheres respectively. Many of the patients with MS have brain iron content beyond the 95% prediction intervals.

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    Fig 3.

    Plots showing individual weighting of different parameters (average phase: upper row; normalized area: middle row; and the total phase: lower row) of the PT (A−C) and the RN (D−F). The asterisks represent the patients with RRMS, the triangles represent those with SPMS, and the diamonds represent the healthy subjects. Patients with MS and healthy subjects with weighting higher than 1 are shown in the plots (these results correspond to m = 3; for quantitative evaluation, please refer to Tables 1 and 2).

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    Fig 4.

    Four plots showing the subtotal (A−C) weighting factors and the total weighting factor (D) of the 4 structures with the weighting factor >1 (these results correspond to m = 3): CN, PT, RN, and SN. The asterisks represent the patients with RRMS, the triangles represent the patients with SPMS, and the diamonds represent healthy subjects. For quantitative results of these graphs, please refer to Table 3.

Tables

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    Table 1:

    Percentage of healthy and patient subjects with iron deposition higher than 2 SDs (P < .05) from the mean based on individual structures

    WeightsaRII-Average PhaseRII-Normalized AreaRII-Total Phase
    NPNPNP
    Subtotal12.362.516.463.516.451.9
    Individual
        CN3.718.34.520.25.312.5
        PT2.024.04.527.94.123.1
        RN4.533.76.634.66.130.8
        SN3.716.34.131.72.522.1
        GP4.57.73.36.74.55.8
        THA2.916.33.33.82.03.8
        PUT5.33.84.12.95.31.0
    • Note:—N indicates healthy subjects; P, patients.

    • ↵a Total weight for healthy subjects was 27.01, and for patients, 75.81.

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    Table 2:

    Percentage of healthy and patient subjects with iron deposition higher than 3 SDs (P < .05) from the mean based on individual structures

    WeightsaRII-Average PhaseRII-Normalized AreaRII-Total Phase
    NPNPNP
    Subtotal5.743.36.152.95.741.3
    Individual
        CN1.214.42.012.50.48.7
        PT1.213.51.218.30.815.4
        RN0.821.20.830.82.927.9
        SN2.010.62.021.22.510.6
        GP2.04.80.81.02.01.0
        THA0.86.70.01.00.80.0
        PUT2.00.03.31.02.51.0
    • Note:—N indicates healthy subjects; P, patients.

    • ↵a Total weight for healthy subjects was 12.7, and for patients, 65.4.

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    Table 3:

    Percentage of healthy and patient subjects with iron deposition higher than 2 and 3 SDs from the mean based on subtotal and total weightsa,b

    Weights2 SDs3 SDs
    RRSPHealthyRRSPHealthy
    MS/TMSMS/TMSHigh/TotalMS/TMSMS/TMSHigh/Total
    Total
        20–4028/36 (78%)6/8 (75%)15/112 (13%)24/36 (67%)4/8 (50%)1/112 (1%)
        41–7018/26 (69%)27/34 (79%)51/132 (38%)16/26 (62%)24/34 (71%)30/132 (23%)
        20–7046/62 (74%)33/42 (79%)66/244b (27%)40/62 (65%)28/42 (67%)31/244b (13%)
    Subtotal-normalized area
        20–4023/36 (64%)4/8 (50%)6/112 (5.4%)19/36 (53%)4/8 (50%)0/112 (0%)
        41–7016/26 (62%)23/34 (68%)34/132 (26%)12/26 (46%)20/34 (59%)15/132 (11%)
        20–7039/62 (63%)27/42 (64%)40/244 (16%)31/62 (50%)24/42 (57%)15/244 (6%)
    Subtotal-average phase
        20–4021/36 (58%)6/8 (75%)6/112 (5.4%)16/36 (44%)6/8 (75%)1/112 (1%)
        41–7013/26 (50%)25/34 (74%)24/132 (18%)9/36 (35%)14/34 (41%)13/132 (10%)
        20–7034/62 (55%)31/42 (74%)30/244 (12%)25/62 (40%)20/42 (50%)14/244 (6%)
    Subtotal-total phase
        20–4021/36 (58%)4/8 (50%)5/112 (4.5%)17/36 (47%)1/8 (13%)0/112 (0%)
        41–7010/26 (38%)19/34 (56%)35/132 (34%)8/26 (31%)17/34 (50%)14/132 (11%)
        20–7031/62 (50%)23/42 (55%)40/244 (16%)25/62 (40%)18/42 (43%)14/244 (6%)
    • Note:—TMS indicates total number of patients with MS.

    • ↵a Total weights summed over the 4 structures (CN, PT, RN, and SN) and all parameters (average phase, normalized area, and total phase). Subtotal weights summed over the 4 structures (CN, PT, RN, and SN) for individual parameters.

    • ↵b Both the left and right hemisphere measurements were included in this calculation. Since the total number of normal controls is 122, including the left and right measurements together will lead to 244 as the total count. This doubling also applies to the MS population studied. There are 62 values quoted for RR and 42 values for SP, yielding a total of 104.

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American Journal of Neuroradiology: 33 (2)
American Journal of Neuroradiology
Vol. 33, Issue 2
1 Feb 2012
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C.A. Habib, M. Liu, N. Bawany, J. Garbern, I. Krumbein, H.-J. Mentzel, J. Reichenbach, C. Magnano, R. Zivadinov, E.M. Haacke
Assessing Abnormal Iron Content in the Deep Gray Matter of Patients with Multiple Sclerosis versus Healthy Controls
American Journal of Neuroradiology Feb 2012, 33 (2) 252-258; DOI: 10.3174/ajnr.A2773

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Assessing Abnormal Iron Content in the Deep Gray Matter of Patients with Multiple Sclerosis versus Healthy Controls
C.A. Habib, M. Liu, N. Bawany, J. Garbern, I. Krumbein, H.-J. Mentzel, J. Reichenbach, C. Magnano, R. Zivadinov, E.M. Haacke
American Journal of Neuroradiology Feb 2012, 33 (2) 252-258; DOI: 10.3174/ajnr.A2773
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