ArticleAnnals of neurology2017
Cortical pathology in multiple sclerosis detected by the T1/T2-weighted ratio from routine magnetic resonance imaging.
Article in Annals of neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 2 of them syntheses that pooled it.
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Who cites it
67 citing papers in PubMed, 2 syntheses or guidelines pooled it, 126 citations in OpenAlex.
- Intensity scaling of conventional brain magnetic resonance images avoiding cerebral reference regions: A systematic review.PloS one · 2024Pooled it
- Can MRI measure myelin? Systematic review, qualitative assessment, and meta-analysis of studies validating microstructural imaging with myelin histology.NeuroImage · 2021Pooled it
- Magnetic resonance T1w/T2w ratio: A parsimonious marker for Parkinson disease.Annals of neurology · 2019Trial
- Altered T1w/T2w-FLAIR Ratio in White Matter Hyperintensities as an Indicator of Structural Integrity Loss: Association with Alzheimer's Disease and Vascular Dementia.medRxiv : the preprint server for health sciences · 2026Article
- Altered frontal and occipital cortical microstructure in obsessive-compulsive disorder - a multisite mega-analysis.Molecular psychiatry · 2026Article
- Assessment of Optimal T1/T2-Weighted Combinations for Myelin Sensitivity: Effects of Echo Time and Exponents.Magnetic resonance in medicine · 2026Article
- Aging effects on nigrostriatal structure, hemodynamics, and connectivity: implications for Parkinson's disease.GeroScience · 2026Article
- T1-weighted/T2-weighted ratio reflects microstructural changes in Alzheimer's disease.Alzheimer's research & therapy · 2026Article
- Whole-brain in situ postmortem MR imaging using a combination of sequences for cortical lesion detection in multiple sclerosis.La Radiologia medica · 2026Article
- Evaluating the T1w/FLAIR ratio as a proxy for myelin: Associations with myelin water Imaging, diffusion metrics, and cognition.Neuroradiology · 2026Article
- Differentiating tremor-dominant parkinson's disease from essential tremor using neuromelanin- sensitive imaging and T1w/T2w ratio.NPJ Parkinson's disease · 2026Article
- The role of modifiable risk factors on the cerebral myelin content and cognition: findings from The Maastricht Study.GeroScience · 2026Article
- Relationship between N100 amplitude and T1w/T2w-ratio in the auditory cortex in schizophrenia spectrum disorders.Schizophrenia (Heidelberg, Germany) · 2026Article
- Longitudinal changes of choroid plexus volumes and MRI ratios in multiple sclerosis.Brain communications · 2026Article
- Enhancing the Visibility of Multiple Sclerosis Lesions using Fused Images of Fluid Attenuated Inversion Recovery (FLAIR) and white matter Attenuated Inversion Recovery (WAIR) MRI Sequences.Current medical imaging · 2026Article
- Thalamic Microstructural Alterations as Revealed by the T1/T2 Ratio in Chronic Pain Patients.Journal of clinical medicine · 2025Article
- Patient-centered brain transcriptomic and multimodal imaging determinants of clinical progression, physical activity, and treatment needs in Parkinson's disease.NPJ Parkinson's disease · 2025Article
- Large Numbers for Small Children-Up to What Age Do Infants Benefit from a Longer Echo Time in Cerebral T2 MRI Sequences?Children (Basel, Switzerland) · 2024Article
- Cortical myelin and thickness mapping provide insights into whole-brain tumor burden in diffuse midline glioma.Cerebral cortex (New York, N.Y. : 1991) · 2024Article
- Understanding the Pathophysiology and Magnetic Resonance Imaging of Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders.Korean journal of radiology · 2023Review
7 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn multiple sclerosis, neuropathological studies have shown widespread changes in the cerebral cortex. In vivo imaging is critical, because the histopathological substrate of most measurements is unknown.
methodsUsing a novel magnetic resonance imaging analysis technique, based on the ratio of T1- and T2-weighted signal intensities, we studied the cerebral cortex of a large cohort of patients in early stages of multiple sclerosis. A total of 168 patients with clinically isolated syndrome or relapsing-remitting multiple sclerosis (Expanded Disability Status Scale: median = 1, range = 0-3.5) and 80 age- and sex-matched healthy controls were investigated. We also searched for the histopathological substrate of the T1/T2-weighted ratio by combining postmortem imaging and histopathology in 9 multiple sclerosis brain donors.
resultsPatients showed lower T1/T2-weighted ratio values in parietal and occipital areas. The 4 most significant clusters appeared in the medial occipital and posterior cingulate cortex (each left and right). The decrease of the T1/T2-weighted ratio in the posterior cingulate was related to performance in attention. Analysis of the T1/T2-weighted ratio values of postmortem imaging yielded a strong correlation with dendrite density but none of the other parameters including myelin.
interpretationThe T1/T2-weighted ratio decreases in early stages of multiple sclerosis in a widespread manner, with a preponderance of posterior areas and with a contribution to attentional performance; it seems to reflect dendrite pathology. As the method is broadly available and applicable to available clinical scans, we believe that it is a promising candidate for studying and monitoring cortical pathology or therapeutic effects in multiple sclerosis. Ann Neurol 2017;82:519-529.
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