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Research paper
Relationship of grey and white matter abnormalities with distance from the surface of the brain in multiple sclerosis
  1. Matteo Pardini1,2,
  2. Carole H Sudre3,4,
  3. Ferran Prados1,3,
  4. Özgür Yaldizli1,5,
  5. Varun Sethi1,
  6. Nils Muhlert1,6,7,
  7. Rebecca S Samson1,
  8. Steven H van de Pavert1,
  9. M Jorge Cardoso3,4,
  10. Sebastien Ourselin3,4,
  11. Claudia A M Gandini Wheeler-Kingshott1,8,9,
  12. David H Miller1,10,
  13. Declan T Chard1,10
  1. 1Department of Neuroinflammation, NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, London, UK
  2. 2Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
  3. 3Department of Medical Physics and Bioengineering, Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
  4. 4Dementia Research Centre, UCL Institute of Neurology, London, UK
  5. 5Department of Neurology, University Hospital Basel, Basel, Switzerland
  6. 6School of Psychology and Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK
  7. 7School of Psychological Sciences, University of Manchester, Manchester UK
  8. 8Brain MRI 3T Center, C. Mondino National Neurological Institute, Pavia, Italy
  9. 9Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
  10. 10National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, London, UK
  1. Correspondence to Dr Declan Chard, Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; d.chard{at}


Objective To assess the association between proximity to the inner (ventricular and aqueductal) and outer (pial) surfaces of the brain and the distribution of normal appearing white matter (NAWM) and grey matter (GM) abnormalities, and white matter (WM) lesions, in multiple sclerosis (MS).

Methods 67 people with relapse-onset MS and 30 healthy controls were included in the study. Volumetric T1 images and high-resolution (1 mm3) magnetisation transfer ratio (MTR) images were acquired and segmented into 12 bands between the inner and outer surfaces of the brain. The first and last bands were discarded to limit partial volume effects with cerebrospinal fluid. MTR values were computed for all bands in supratentorial NAWM, cerebellar NAWM and brainstem NA tissue, and deep and cortical GM. Band WM lesion volumes were also measured.

Results Proximity to the ventricular surfaces was associated with progressively lower MTR values in the MS group but not in controls in supratentorial and cerebellar NAWM, brainstem NA and in deep and cortical GM. The density of WM lesions was associated with proximity to the ventricles only in the supratentorial compartment, and no link was found with distance from the pial surfaces.

Conclusions In MS, MTR abnormalities in NAWM and GM are related to distance from the inner and outer surfaces of the brain, and this suggests that there is a common factor underlying their spatial distribution. A similar pattern was not found for WM lesions, raising the possibility that different factors promote their formation.

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