Multi-parametric investigation of thalamic iron and neurotransmitter dyshomeostasis in multiple sclerosis patients with high disability

Motivation: Several studies found lower susceptibility in the thalamus of MS patients. Few of these studies have focused on an advanced MS disease stage. Goal(s): To determine if iron and metabolite levels reflect inflammation-induced iron loss in the deep gray matter of patients with advanced MS. Approach: 14 MS patients (EDSS scores >4.0, aged >40 years) and age- and sex-matched controls. We employed multi-echo GRE, Magnetization Transfer Ratio, and a HERMES sequence for edited GABA and glutathione (GSH) assessment in the thalamus. Results: Reduced iron metrics and NAA findings were in line with our hypothesis of iron loss in the thalamus concomitant to neurodegeneration. Impact: Using a combination of edited spectroscopy and MT, R2* and QSM, this study provides support for inflammation-related iron loss in the thalamus of patients with MS.