Skip to main content

T1 Black Holes and Gray Matter Damage

  • Chapter
Neurodegeneration in Multiple Sclerosis

Part of the book series: Topics in Neuroscience ((TOPNEURO))

Abstract

Magnetic resonance imaging (MRI) has become important in the early diagnosis and monitoring of various neurologic disorders including multiple sclerosis (MS). MRI has emerged as a key supportive therapeutic outcome measure in MS-related clinical trials. The limitations of conventional MRI surrogates have driven researchers to develop better biomarkers, including those capturing destructive aspects of the disease. In this chapter, we discuss the most recent data highlighting the role of hypointense lesions on T1-weighted images (black holes; BH) and gray matter (GM) damage in the MRI assessment of MS. We focus on the most relevant pathologic, MRI, and clinical correlation studies addressing BH and GM injury.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bagnato F, Jeffries N, Richert ND et al (2003) Evolution of T1 black holes in patients with multiple sclerosis imaged monthly for 4 years. Brain 126:1782–1789

    Article  PubMed  Google Scholar 

  2. Bakshi R, Minagar A, Jaisani Z, Wolinsky JS (2005) Imaging of multiple sclerosis: role in neurotherapeutics. NeuroRx 2:277–303

    Article  PubMed  Google Scholar 

  3. van Walderveen MA, Kamphorst W, Scheltens P et al (1998) Histopathologic correlate of hypointense lesions on T1-weighted spin-echo MRI in multiple sclerosis. Neurology 50:1282–1288

    PubMed  Google Scholar 

  4. Bitsch A, Kuhlmann T, Stadelmann C et al (2001) A longitudinal MRI study of histopathologically defined hypointense multiple sclerosis lesions. Ann Neurol 49:793–796

    Article  PubMed  CAS  Google Scholar 

  5. Enzinger C, Ropele S, Smith S et al (2004) Accelerated evolution of brain atrophy and “black holes” in MS patients with APOE-epsilon 4. Ann Neurol 55:563–569

    Article  PubMed  CAS  Google Scholar 

  6. van Waesberghe JH, van Walderveen MA, Castelijns JA et al (1998) Patterns of lesion development in multiple sclerosis: longitudinal observations with T1-weighted spinecho and magnetization transfer MR. Am J Neuroradiol 19:675–683

    PubMed  Google Scholar 

  7. Truyen L, van Waesberghe JH, vanWalderveen MA et al (1996) Accumulation of hypointense lesions (“black holes”) on T1 spin-echo MRI correlates with disease progression in multiple sclerosis. Neurology 47:1469–1476

    PubMed  CAS  Google Scholar 

  8. Sanfilipo MP, Benedict RH, Sharma J et al (2005) The relationship between whole brain volume and disability in multiple sclerosis: a comparison of normalized gray vs. white matter with misclassification correction. Neuroimage 26:1068–1077

    Article  PubMed  Google Scholar 

  9. Zivadinov R, Leist TP (2005) Clinical-magnetic resonance imaging correlations in multiple sclerosis. J Neuroimaging 15:10S–21S

    Article  PubMed  Google Scholar 

  10. Filippi M, Rovaris M, Rocca MA et al (2001) Glatiramer acetate reduces the proportion of new MS lesions evolving into “black holes”. Neurology 57:731–733

    PubMed  CAS  Google Scholar 

  11. Dalton CM, Miszkiel KA, Barker GJ et al (2004) Effect of natalizumab on conversion of gadolinium enhancing lesions to T1 hypointense lesions in relapsing multiple sclerosis. J Neurol 251:407–413

    Article  PubMed  CAS  Google Scholar 

  12. Simon JH, Lull J, Jacobs LD et al (2000) A longitudinal study of T1 hypointense lesions in relapsing MS: MSCRG trial of interferon beta-1a. Multiple Sclerosis Collaborative Research Group. Neurology 55:185–192

    PubMed  CAS  Google Scholar 

  13. Barkhof F, van Waesberghe JH, Filippi M et al (2001) T(1) hypointense lesions in secondary progressive multiple sclerosis: effect of interferon beta-1b treatment. Brain 124:1396–1402

    Article  PubMed  CAS  Google Scholar 

  14. Comi G, Filippi M, Wolinsky JS (2001) European/Canadian multicenter, doubleblind, randomized, placebo-controlled study of the effects of glatiramer acetate on magnetic resonance imaging-measured disease activity and burden in patients with relapsing multiple sclerosis. European/Canadian Glatiramer Acetate Study Group. Ann Neurol 49:290–297

    Article  PubMed  CAS  Google Scholar 

  15. Kidd D, Barkhof F, McConnell R et al (1999) Cortical lesions in multiple sclerosis. Brain 122:17–26

    Article  PubMed  Google Scholar 

  16. Peterson JW, Bo L, Mork S et al (2001) Transected neurites, apoptotic neurons, and reduced inflammation in cortical multiple sclerosis lesions. Ann Neurol 50:389–400

    Article  PubMed  CAS  Google Scholar 

  17. Roemer S, Stadelmann C, Bruck W et al (2006) Cortical demyelination is present in early multiple sclerosis. Neurology 66(Suppl2):A93–A94

    Google Scholar 

  18. Bo L, Vedeler CA, Nyland HI et al (2003) Subpial demyelination in the cerebral cortex of multiple sclerosis patients. J Neuropathol Exp Neurol 62:723–732

    PubMed  Google Scholar 

  19. Kutzelnigg A, Lucchinetti CF, Stadelmann C et al (2005) Cortical demyelination and diffuse white matter injury in multiple sclerosis. Brain 128:2705–2712

    Article  PubMed  Google Scholar 

  20. Bakshi R, Ariyaratana S, Benedict RH, Jacobs L (2001) Fluid-attenuated inversion recovery magnetic resonance imaging detects cortical and juxtacortical multiple sclerosis lesions. Arch Neurol 58:742–748

    Article  PubMed  CAS  Google Scholar 

  21. Geurts JJ, Pouwels PJ, Uitdehaag BM et al (2005) Intracortical lesions in multiple sclerosis: improved detection with 3D double inversion-recovery MR imaging. Radiology 236:254–260

    Article  PubMed  Google Scholar 

  22. Bermel RA, Bakshi R (2006) The measurement and clinical relevance of brain atrophy in multiple sclerosis. Lancet Neurol 5:158–170

    Article  PubMed  Google Scholar 

  23. Dalton CM, Chard DT, Davies GR et al (2004) Early development of multiple sclerosis is associated with progressive grey matter atrophy in patients presenting with clinically isolated syndromes. Brain 127:1101–1107

    Article  PubMed  Google Scholar 

  24. Valsasina P, Benedetti B, Rovaris M et al (2005) Evidence for progressive gray matter loss in patients with relapsing-remitting MS. Neurology 65:1126–1128

    Article  PubMed  CAS  Google Scholar 

  25. Bermel RA, Innus MD, Tjoa CW, Bakshi R (2003) Selective caudate atrophy in multiple sclerosis: a 3D MRI parcellation study. Neuroreport 14:335–339

    Article  PubMed  Google Scholar 

  26. Wylezinska M, Cifelli A, Jezzard P et al (2003) Thalamic neurodegeneration in relapsing-remitting multiple sclerosis. Neurology 60:1949–1954

    PubMed  CAS  Google Scholar 

  27. Prinster A, Quarantelli M, Orefice G et al (2006) Grey matter loss in relapsing-remitting multiple sclerosis: a voxel-based morphometry study. Neuroimage 29:859–867

    Article  PubMed  CAS  Google Scholar 

  28. Inglese M, Liu S, Babb JS et al (2004) Three-dimensional proton spectroscopy of deep gray matter nuclei in relapsing-remitting MS. Neurology 63:170–172

    PubMed  CAS  Google Scholar 

  29. Audoin B, Ranjeva JP, Au Duong MV et al (2004) Voxel-based analysis of MTR images: a method to locate gray matter abnormalities in patients at the earliest stage of multiple sclerosis. J Magn Reson Imaging 20:765–771

    Article  PubMed  Google Scholar 

  30. Rovaris M, Gallo A, Valsasina P et al (2005) Short-term accrual of gray matter pathology in patients with progressive multiple sclerosis: an in vivo study using diffusion tensor MRI. Neuroimage 24:1139–1146

    Article  PubMed  Google Scholar 

  31. Bakshi R, Benedict RH, Bermel RA et al (2002) T2 hypointensity in the deep gray matter of patients with multiple sclerosis: a quantitative magnetic resonance imaging study. Arch Neurol 59:62–68

    Article  PubMed  Google Scholar 

  32. Brass SD, Chen N, Mulkern R, Bakshi R (2006) Magnetic resonance imaging of iron deposition in neurologic disorders. Top Magn Reson Imaging 17:31–40

    Article  PubMed  Google Scholar 

  33. Sanfilipo MP, Benedict RH, Weinstock-Guttman B, Bakshi R (2006) Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis. Neurology 66:685–692

    Article  PubMed  Google Scholar 

  34. Morgen K, Sammer G, Courtney SM et al (2006) Evidence for a direct association between cortical atrophy and cognitive impairment in relapsing-remitting MS. Neuroimage 30:891–898

    Article  PubMed  Google Scholar 

  35. Tjoa CW, Benedict RH, Weinstock-Guttman B et al (2005) MRI T2 hypointensity of the dentate nucleus is related to ambulatory impairment in multiple sclerosis. J Neurol Sci 234:17–24

    Article  PubMed  CAS  Google Scholar 

  36. Niepel G, Tench CR, Morgan PS et al (2006) Deep gray matter and fatigue in MS A T1 relaxation time study. J Neurol 253:896–902

    Article  PubMed  CAS  Google Scholar 

  37. Brass SD, Benedict R, Weinstock-Guttman B et al (2006) Cognitive impairment is associated with subcortical MRI gray matter T2 hypointensity in multiple sclerosis. Mult Scler 12:437–444

    Article  PubMed  CAS  Google Scholar 

  38. Houtchens MK, Benedict R, Killiany R et al (2005) Thalamic atrophy in multiple sclerosis: Clinical-MRI correlations. Neurology 64(Suppl1):A260

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag Italia

About this chapter

Cite this chapter

Neema, M., Dandamudi, V., Arora, A., Stankiewicz, J., Bakshi, R. (2007). T1 Black Holes and Gray Matter Damage. In: Filippi, M., Rovaris, M., Comi, G. (eds) Neurodegeneration in Multiple Sclerosis. Topics in Neuroscience. Springer, Milano. https://doi.org/10.1007/978-88-470-0391-0_4

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-0391-0_4

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0390-3

  • Online ISBN: 978-88-470-0391-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics