Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up

Abstract

Background/Aim.Since 2014 and the publication of the results of the first study on the accumulation of gadolinium contrast, we have witnessed a growing body of evidence on the deposition and retention of gadolinium in the brain after the use of gadolinium-based contrast agents (GBCAs). However, there is still no strong clinical evidence of the adverse effects of GBCAs on the brain. The aim of the study was to determine the existence of gadolinium deposits in the brain of patients with realpsing-remiting (RR) multiple sclerosis (MS), after a 10-year follow-up period. During this period the patients have regularly,each year, undergone magnetic resonance imaging (MRI) with the administration of gadolinium contrast (gadopentetate dimeglumine - Magnevist?) in order to follow the course of the disease. Methods. A cohort of 20 patients was formed for the aim of this study. The ratio of the values of the signal intensity (SI) of different regions of the brain-to- cerebrospinal fluid (CSF) was compared , for each patient, on the initial MRI examination, and on MRI examination 10 years later . Results. Frontal cortex -to-CSF (p<0.01), occipital cortex-to-CSF (p <0.01), the white matter of the radial corona-to-CSF (p <0.01), parietal cortex-to-CSF (p <0.05), thalamus-to-CSF (p = 0.051), putamen-to-CSF (p =0.06), and anterior and posterior limb of the capsula interna -to-CSF (p=0.062) SI ratios increased after multiple gadopentetate administrations. Conclusion. In the cohort of 20 patients there was a statistically significant increase in SI in the pre-contrast T1W sequence in the following structures: frontal, parietal, and occipital cortex, as well as supratentorial white matter. An increase in the absolute values of the T1W signal in ? patients was registered in the frontal and occipital cortex and cerebellar hemispheres. Slightly less, but more than 55-65% of increase in SI was registered in structures of the parietal cortex, putamen, cornu anterior and posterior of the capsule interna, corpus callosum (CC) splenium, pons, thalamus, nucleus caudatus (NC), substantia nigra (SN), CC genu and temporal cortex.This result speaks in favor of the existence of chronic accumulation of gadolinium contrast agent gadopentetate dimeglumine, in brain structures.