Background Increased iron deposition has been implicated in the pathophysiology of multiple scle-rosis (MS), based on visual analysis of signal reduction on T 2 -weighted images. R 2 * relaxometry allows to assess brain iron accumulation quantitatively. Objective To investigate regional brain iron deposition in patients with a clinically isolated syn-drome (CIS) or relapsing–remitting MS (RRMS) and its associations with demographical, clinical, and conventional magnetic resonance imaging (MRI) parameters. Methods We studied 69 patients (CIS, n = 32; RRMS, n = 37) with 3T MRI and analyzed regional R 2 * relaxation rates and their correlations with age, disease duration, disability, T 2 lesion load, and normalized brain volumes. Results Basal ganglia R 2 * relaxation rates increased in parallel with age (r = 0.3–0.6; P < 0.01) and were significantly higher in RRMS than in CIS (P < 0.05). Using multivariate linear regression analysis, the rate of putaminal iron deposition was independently predicted by the patients' age, disease duration, and gray matter atrophy. Conclusions Quantitative assessment by R 2 * relaxometry suggests increased iron deposition in the basal ganglia of MS patients, which is associated with disease duration and brain atrophy. This tech-nique together with long-term follow-up thus appears suited to clarify whether regional iron accu-mulation contributes to MS morbidity or merely reflects an epiphenomenon. Multiple Sclerosis 2009; 15: 1048–1054.
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