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Magnetic Resonance Imaging and Biochemical markers to assess disability in female subjects with Multiple Sclerosis.
Author(s)
Herbert, Estelle Penelope
Date Issued
2016
Type
Thesis
Publisher
Cape Peninsula University of Technology
Abstract
Multiple sclerosis (MS) affects the central nervous system (CNS) and is
characterized by multiple demyelinating lesions. It is in this context that a need arises for
reliable biomarkers such as Magnetic Resonance Imaging (MRI), which could lead to the
early diagnosis and therapeutic intervention when maximum potential impact is possible.
This study examines the impact of MRI as a marker and the sequences that give the best
images to aid in evaluation of disease progression (which can indirectly be seen as disability)
and the early diagnosis of MS which will, in turn, lead to more effective management of the
disease.
METHOD: Sixteen subjects underwent a neurological examination, the Expanded Disability
Status Scale (EDSS), blood tests for iron parameters and a 3Tesla Magnetic Resonance
Imaging (MRI) scan. In a study of MS, 11 had MRI data that could be analysed by using
tract-based spatial statistics (TBSS). Subjects were divided according to the EDSS score (8
of the subjects had an EDSS score of ≤ 3 while 3 subjects had scores of ≥ 6). Diffusion
tensor imaging (DTI), the fused Proton Density and Fluid Attenuation Recovery (FLAIR) was
utilised to compute the lesion numbers and standard laboratory procedures were used to
measure other biochemical markers (serum iron, % transferrin saturation, ferritin,
haemoglobin) in subjects with disability and simultaneously assess the disease process.
RESULTS: The FA of white matter tracts (WMTs) as a parameter of myelin integrity was
lower in subjects with MS only in those who had high EDSS scores. An association between
FA and iron parameters, especially percentage transferrin saturation (% Tf) sat were
observed, which suggests that iron availability to the WM may be a requirement for optimal
myelin functionality.
CONCLUSION: The FA of WMTs as a parameter of myelin integrity was lower only in those
MS subjects who had high EDSS scores. Subjects who had EDSS scores < 3 (i.e. who had a
“benign” disease outcome) had FA values similar to control values and this finding was not
related to their age or disease duration. The association found between FA and iron
parameters, especially % Tf sat, suggests that iron availability to the WM may be a
requirement for optimal myelin functionality. Results also suggest that serum iron
concentration, ferritin and % Tf sat had an effect on myelination. The lack of association
between FA and Hb suggests that the iron in this protein is not available for WM function.
characterized by multiple demyelinating lesions. It is in this context that a need arises for
reliable biomarkers such as Magnetic Resonance Imaging (MRI), which could lead to the
early diagnosis and therapeutic intervention when maximum potential impact is possible.
This study examines the impact of MRI as a marker and the sequences that give the best
images to aid in evaluation of disease progression (which can indirectly be seen as disability)
and the early diagnosis of MS which will, in turn, lead to more effective management of the
disease.
METHOD: Sixteen subjects underwent a neurological examination, the Expanded Disability
Status Scale (EDSS), blood tests for iron parameters and a 3Tesla Magnetic Resonance
Imaging (MRI) scan. In a study of MS, 11 had MRI data that could be analysed by using
tract-based spatial statistics (TBSS). Subjects were divided according to the EDSS score (8
of the subjects had an EDSS score of ≤ 3 while 3 subjects had scores of ≥ 6). Diffusion
tensor imaging (DTI), the fused Proton Density and Fluid Attenuation Recovery (FLAIR) was
utilised to compute the lesion numbers and standard laboratory procedures were used to
measure other biochemical markers (serum iron, % transferrin saturation, ferritin,
haemoglobin) in subjects with disability and simultaneously assess the disease process.
RESULTS: The FA of white matter tracts (WMTs) as a parameter of myelin integrity was
lower in subjects with MS only in those who had high EDSS scores. An association between
FA and iron parameters, especially percentage transferrin saturation (% Tf) sat were
observed, which suggests that iron availability to the WM may be a requirement for optimal
myelin functionality.
CONCLUSION: The FA of WMTs as a parameter of myelin integrity was lower only in those
MS subjects who had high EDSS scores. Subjects who had EDSS scores < 3 (i.e. who had a
“benign” disease outcome) had FA values similar to control values and this finding was not
related to their age or disease duration. The association found between FA and iron
parameters, especially % Tf sat, suggests that iron availability to the WM may be a
requirement for optimal myelin functionality. Results also suggest that serum iron
concentration, ferritin and % Tf sat had an effect on myelination. The lack of association
between FA and Hb suggests that the iron in this protein is not available for WM function.
Additional information
Thesis (M.Sc (Radiography))--Cape Peninsula University of Technology, 2016.
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