T1/T2 Ratio Mapping Identifies Compartment-Specific Brain Changes in MS

T1-weighted/T2-weighted ratio mapping in 918 multiple sclerosis patients revealed lower ratios in lesions, normal-appearing white matter, cortical grey matter (p<.001) but higher in thalamus and deep grey matter (p≤.01), linked to disability and cognition.

• Cross-sectional multicenter study of 918 MS patients and 272 healthy controls.
• Poorer cognition associated with lower cortical ratios and higher thalamic/deep grey matter ratios (all p≤.004).
• T1W/T2W ratio specificity for myelin remains debated; cross-sectional design cannot establish causality.

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