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Tomura N, Saginoya T, Sanpei T, Konno T, Fujihara K. Contrast-enhanced double inversion recovery sequence for patients with multiple sclerosis: feasibility of subtraction images between pre- and post-contrast images. Acta Radiol 2023; 64:719-724. [PMID: 35306900 DOI: 10.1177/02841851221080831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few reports have examined the feasibility of a post-contrast double inversion recovery (DIR) magnetic resonance (MR) sequence in patients with multiple sclerosis (MS) because of partial or complete signal loss of enhancing MS lesions. PURPOSE To compare subtracted images of DIR (pre-contrast - post-contrast DIR images) with contrast enhanced T1-weighted (CE-T1W) images in the depiction of contrast enhancement of MS lesions. MATERIAL AND METHODS In total, 27 patients were included. Two neuroradiologists interpreted both images of CE-T1W imaging and subtracted DIR, and interpretation of the images was classified into a score of 1-5 (from 5, definitely superior contrast of lesions on DIR subtraction compared to conventional CE-T1W imaging, to 1, definitely superior contrast of lesions on CE-T1W imaging. The interrater agreement (κ coefficient) was measured. The signal-to-noise ratio (SNR) and contrast-noise-ratio (CNR) of the lesion were compared. RESULTS A significant difference (P < 0.001) in scoring was seen between conventional CE-T1W imaging (2.1 ± 1.5 with one reviewer and 2.4 ± 1.5 with the other) and DIR subtraction (4.4 ± 1.0 with one reviewer and 4.7 ± 0.8 with the other). SNR from conventional CE-T1W imaging (24.8 ± 14.7) was significantly superior to that from DIR subtraction (4.0 ± 1.0; P < 0.001). CNR in DIR subtraction (326.4 ± 250.0) was significantly superior to that in conventional CE-T1W imaging (0.8 ± 5.5; P < 0.001). For interrater agreement in the evaluation of contrast enhancement of the lesions, κ coefficients were 0.84 for conventional CE-T1W imaging and 0.72 for DIR subtraction. CONCLUSION Subtracted DIR image enables more obvious contrast enhancement of the MS lesions compared with conventional CE-T1W imaging.
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Affiliation(s)
- Noriaki Tomura
- Department of Neuroradiology, Radiology and Neurology, 13704Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Fukushima, Japan
| | - Toshiyuki Saginoya
- Department of Neuroradiology, Radiology and Neurology, 13704Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Fukushima, Japan
| | - Takashi Sanpei
- Department of Neuroradiology, Radiology and Neurology, 13704Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Fukushima, Japan
| | - Takashi Konno
- Department of Neuroradiology, Radiology and Neurology, 13704Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Fukushima, Japan
| | - Kazuo Fujihara
- Department of Neuroradiology, Radiology and Neurology, 13704Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Fukushima, Japan
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2
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Davion JB, Lopes R, Jougleux C, Viard R, Dumont J, Leclerc X, Outteryck O. Brief International Cognitive Assessment for Multiple Sclerosis scores are associated with the cortical thickness of specific cortical areas in relapsing-remitting patients. Rev Neurol (Paris) 2021; 178:326-336. [PMID: 34657733 DOI: 10.1016/j.neurol.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 06/02/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive impairment is frequent and disabling in multiple sclerosis (MS). The Brief International Cognitive Assessment in MS (BICAMS) is a recent short battery usable in clinical practice for cognitive evaluation of MS patients. OBJECTIVE To find cortical areas or brain volumes on magnetic resonance imaging (MRI) structural sequences associated with BICAMS scores in MS. METHODS In this cross-sectional single-center study (NCT03656055, September 4, 2018), 96 relapsing remitting-MS patients under natalizumab and without recent clinical or radiological inflammation were included. Patients underwent brain MRI and the three BICAMS tests, evaluating information processing speed (SDMT), visuo-spatial memory (BVMT-R), and verbal memory (FVLT). RESULTS Cortical thickness in the left frontal superior and the right precentral gyri was associated with BVMT-R scores whereas cortical thickness in the left Broca's area and the right superior temporal gyrus was associated with FVLT scores. We observed associations between white matter inflammatory lesions connected to these cortical regions and BICAMS subscores. CONCLUSIONS BICAMS scores are associated with specific cortical areas, the cognitive domain matching the known functions of the cortical area. Specific cognitive impairments in MS may be associated with specific cortical regions, themselves influenced by white matter inflammatory lesions and demographical parameters (age, sex, education level).
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Affiliation(s)
- J-B Davion
- U1172 - LilNCog - Lille Neuroscience & Cognition, university Lille, 59000 Lille, France; Department of neurology, CHU Lille, 59000 Lille, France
| | - R Lopes
- U1172 - LilNCog - Lille Neuroscience & Cognition, university Lille, 59000 Lille, France; Department of neuroradiology, CHU Lille, 59000 Lille, France; CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UMS 2014 - PLBS, university Lille, 59000 Lille, France
| | - C Jougleux
- U1172 - LilNCog - Lille Neuroscience & Cognition, university Lille, 59000 Lille, France; Department of neurology, CHU Lille, 59000 Lille, France
| | - R Viard
- Department of neuroradiology, CHU Lille, 59000 Lille, France; CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UMS 2014 - PLBS, university Lille, 59000 Lille, France
| | - J Dumont
- Department of neuroradiology, CHU Lille, 59000 Lille, France; CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UMS 2014 - PLBS, university Lille, 59000 Lille, France
| | - X Leclerc
- U1172 - LilNCog - Lille Neuroscience & Cognition, university Lille, 59000 Lille, France; Department of neuroradiology, CHU Lille, 59000 Lille, France
| | - O Outteryck
- U1172 - LilNCog - Lille Neuroscience & Cognition, university Lille, 59000 Lille, France; Department of neuroradiology, CHU Lille, 59000 Lille, France.
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Ontaneda D, Raza PC, Mahajan KR, Arnold DL, Dwyer MG, Gauthier SA, Greve DN, Harrison DM, Henry RG, Li DKB, Mainero C, Moore W, Narayanan S, Oh J, Patel R, Pelletier D, Rauscher A, Rooney WD, Sicotte NL, Tam R, Reich DS, Azevedo CJ. Deep grey matter injury in multiple sclerosis: a NAIMS consensus statement. Brain 2021; 144:1974-1984. [PMID: 33757115 PMCID: PMC8370433 DOI: 10.1093/brain/awab132] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/13/2022] Open
Abstract
Although multiple sclerosis has traditionally been considered a white matter disease, extensive research documents the presence and importance of grey matter injury including cortical and deep regions. The deep grey matter exhibits a broad range of pathology and is uniquely suited to study the mechanisms and clinical relevance of tissue injury in multiple sclerosis using magnetic resonance techniques. Deep grey matter injury has been associated with clinical and cognitive disability. Recently, MRI characterization of deep grey matter properties, such as thalamic volume, have been tested as potential clinical trial end points associated with neurodegenerative aspects of multiple sclerosis. Given this emerging area of interest and its potential clinical trial relevance, the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative held a workshop and reached consensus on imaging topics related to deep grey matter. Herein, we review current knowledge regarding deep grey matter injury in multiple sclerosis from an imaging perspective, including insights from histopathology, image acquisition and post-processing for deep grey matter. We discuss the clinical relevance of deep grey matter injury and specific regions of interest within the deep grey matter. We highlight unanswered questions and propose future directions, with the aim of focusing research priorities towards better methods, analysis, and interpretation of results.
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Affiliation(s)
- Daniel Ontaneda
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Praneeta C Raza
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Kedar R Mahajan
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Douglas L Arnold
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, The State University of New York, Buffalo, NY 14214, USA
| | - Susan A Gauthier
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA
| | - Douglas N Greve
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02129, USA
| | - Daniel M Harrison
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Roland G Henry
- Department of Neurology, Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
- The UC San Francisco and Berkeley Bioengineering Graduate Group, University of California San Francisco, San Francisco, CA 94143, USA
| | - David K B Li
- Department of Radiology and Medicine (Neurology), University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
| | - Caterina Mainero
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02129, USA
| | - Wayne Moore
- Department of Pathology and Laboratory Medicine, and International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Sridar Narayanan
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Jiwon Oh
- Division of Neurology, St. Michael’s Hospital, University of Toronto, Toronto, Ontario M5B 1W8, Canada
| | - Raihaan Patel
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec H4H 1R3, Canada
- Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Daniel Pelletier
- Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
| | - Alexander Rauscher
- Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health and Science University, Portland, OR 97239, USA
| | - Nancy L Sicotte
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Roger Tam
- Department of Radiology and Medicine (Neurology), University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
- Biomedical Engineering, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Daniel S Reich
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20824, USA
| | - Christina J Azevedo
- Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
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Penner IK, Gass A, Schreiber H, Wattjes MP. [Neuropsychological and MRI diagnostics in secondary progressive multiple sclerosis]. DER NERVENARZT 2021; 92:1293-1301. [PMID: 33891150 PMCID: PMC8648628 DOI: 10.1007/s00115-021-01118-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 11/24/2022]
Abstract
Hintergrund Die Multiple Sklerose ist im longitudinalen Verlauf oft ein Krankheitskontinuum mit initial schubförmig-remittierender Phase (RRMS) und späterer sekundärer Progredienz (SPMS). Die meisten bisher zugelassenen Therapien sind bei SPMS nicht ausreichend wirksam. Die frühe Erkennung der SPMS-Konversion ist daher entscheidend für die Therapiewahl. Wichtige Entscheidungshilfen können dabei die Testung kognitiver Teilleistungen und die Magnetresonanztomographie (MRT) sein. Ziel der Arbeit Darstellung der Bedeutung kognitiver Testungen und von MRT-Untersuchungen für Prädiktion und Erfassung der SPMS-Konversion. Ausarbeitung von Strategien der Verlaufsbeobachtung und Therapiesteuerung in der Praxis, insbesondere in der ambulanten Versorgung. Material und Methoden Übersichtsarbeit auf Basis einer unsystematischen Literaturrecherche. Ergebnisse Standardisierte kognitive Testung kann für die frühe SPMS-Diagnose hilfreich sein und die Verlaufsbewertung erleichtern. Eine jährliche Anwendung sensitiver Screeningtests wie Symbol Digit Modalities Test (SDMT) und Brief Visual Memory Test-Revised (BVMT‑R) oder der Brief International Cognitive Assessment for MS (BICAMS)-Testbatterie ist empfehlenswert. Persistierende inflammatorische Aktivität im MRT in den ersten drei Jahren der Erkrankung sowie das Vorhandensein kortikaler Läsionen sind prädiktiv für eine SPMS-Konversion. Ein standardisiertes MRT-Monitoring auf Merkmale einer progressiven MS kann den klinisch und neurokognitiv begründeten SPMS-Verdacht stützen. Diskussion Die interdisziplinäre Versorgung von MS-Patienten durch klinisch versierte Neurologen, unterstützt durch neuropsychologische Testung und MRT, hat einen hohen Stellenwert für die SPMS-Prädiktion und Diagnose. Letztere erlaubt eine frühe Umstellung auf geeignete Therapien, da bei SPMS andere Interventionen als für die RRMS notwendig sind. Nach erfolgter medikamentöser Umstellung erlaubt die klinische, neuropsychologische und bildgebende Vigilanz ein stringentes Monitoring auf neuroinflammatorische und -degenerative Aktivität sowie Therapiekomplikationen.
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Affiliation(s)
- I-K Penner
- Klinik für Neurologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland. .,COGITO Zentrum für angewandte Neurokognition und neuropsychologische Forschung, Merowingerplatz 1, 40225, Düsseldorf, Deutschland.
| | - A Gass
- Neurologische Klinik, Universitätsmedizin Mannheim, Mannheim, Deutschland
| | - H Schreiber
- Nervenärztliche Gemeinschaftspraxis, Neuropoint Akademie und NTD, Ulm, Deutschland
| | - M P Wattjes
- Institut für diagnostische und interventionelle Neuroradiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
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5
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Schoonheim MM, Pinter D, Prouskas SE, Broeders TA, Pirpamer L, Khalil M, Ropele S, Uitdehaag BM, Barkhof F, Enzinger C, Geurts JJ. Disability in multiple sclerosis is related to thalamic connectivity and cortical network atrophy. Mult Scler 2021; 28:61-70. [PMID: 33870779 DOI: 10.1177/13524585211008743] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Thalamic atrophy is proposed to be a major predictor of disability progression in multiple sclerosis (MS), while thalamic function remains understudied. OBJECTIVES To study how thalamic functional connectivity (FC) is related to disability and thalamic or cortical network atrophy in two large MS cohorts. METHODS Structural and resting-state functional magnetic resonance imaging (fMRI) was obtained in 673 subjects from Amsterdam (MS: N = 332, healthy controls (HC): N = 96) and Graz (MS: N = 180, HC: N = 65) with comparable protocols, including disability measurements in MS (Expanded Disability Status Scale, EDSS). Atrophy was measured for the thalamus and seven well-recognized resting-state networks. Static and dynamic thalamic FC with these networks was correlated with disability. Significant correlates were included in a backward multivariate regression model. RESULTS Disability was most strongly related (adjusted R2 = 0.57, p < 0.001) to higher age, a progressive phenotype, thalamic atrophy and increased static thalamic FC with the sensorimotor network (SMN). Static thalamus-SMN FC was significantly higher in patients with high disability (EDSS ⩾ 4) and related to network atrophy but not thalamic atrophy or lesion volumes. CONCLUSION The severity of disability in MS was related to increased static thalamic FC with the SMN. Thalamic FC changes were only related to cortical network atrophy, but not to thalamic atrophy.
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Affiliation(s)
- Menno M Schoonheim
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Daniela Pinter
- Department of Neurology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Austria
| | - Stefanos E Prouskas
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Tommy Aa Broeders
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Lukas Pirpamer
- Department of Neurology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Austria
| | - Michael Khalil
- Department of Neurology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Austria
| | - Stefan Ropele
- Department of Neurology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Austria
| | - Bernard Mj Uitdehaag
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands/Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Christian Enzinger
- Department of Neurology and Department of Radiology, Division of Neuroradiology, Vascular and Inverventional Radiology, Medical University of Graz, Graz, Austria
| | - Jeroen Jg Geurts
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
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Petracca M, Pontillo G, Moccia M, Carotenuto A, Cocozza S, Lanzillo R, Brunetti A, Brescia Morra V. Neuroimaging Correlates of Cognitive Dysfunction in Adults with Multiple Sclerosis. Brain Sci 2021; 11:346. [PMID: 33803287 PMCID: PMC8000635 DOI: 10.3390/brainsci11030346] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023] Open
Abstract
Cognitive impairment is a frequent and meaningful symptom in multiple sclerosis (MS), caused by the accrual of brain structural damage only partially counteracted by effective functional reorganization. As both these aspects can be successfully investigated through the application of advanced neuroimaging, here, we offer an up-to-date overview of the latest findings on structural, functional and metabolic correlates of cognitive impairment in adults with MS, focusing on the mechanisms sustaining damage accrual and on the identification of useful imaging markers of cognitive decline.
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Affiliation(s)
- Maria Petracca
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (M.M.); (A.C.); (V.B.M.)
| | - Giuseppe Pontillo
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (G.P.); (S.C.); (A.B.)
- Department of Electrical Engineering and Information Technology, University of Naples “Federico II”, 80125 Naples, Italy
| | - Marcello Moccia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (M.M.); (A.C.); (V.B.M.)
| | - Antonio Carotenuto
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (M.M.); (A.C.); (V.B.M.)
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (G.P.); (S.C.); (A.B.)
| | - Roberta Lanzillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (M.M.); (A.C.); (V.B.M.)
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (G.P.); (S.C.); (A.B.)
| | - Vincenzo Brescia Morra
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (M.M.); (A.C.); (V.B.M.)
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Treaba CA, Herranz E, Barletta VT, Mehndiratta A, Ouellette R, Sloane JA, Klawiter EC, Kinkel RP, Mainero C. The relevance of multiple sclerosis cortical lesions on cortical thinning and their clinical impact as assessed by 7.0-T MRI. J Neurol 2021; 268:2473-2481. [PMID: 33523256 DOI: 10.1007/s00415-021-10400-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to investigate at 7.0-T MRI a) the role of multiple sclerosis (MS) cortical lesions in cortical tissue loss b) their relation to neurological disability. METHODS In 76 relapsing remitting and 26 secondary progressive MS patients (N = 102) and 56 healthy subjects 7.0-T T2*-weighted images were acquired for lesion segmentation; 3.0-T T1-weighted structural scans for cortical surface reconstruction/cortical thickness estimation. Patients were dichotomized based on the median cortical lesion volume in low and high cortical lesion load groups that differed by age, MS phenotype and degree of neurological disability. Group differences in cortical thickness were tested on reconstructed cortical surface. Patients were evaluated clinically by means of the Expanded Disability Status Scale (EDSS). RESULTS Cortical lesions were detected in 96% of patients. White matter lesion load was greater in the high than in the low cortical lesion load MS group (p = 0.01). Both MS groups disclosed clusters (prevalently parietal) of cortical thinning relative to healthy subjects, though these regions did not show the highest cortical lesion density, which predominantly involved frontal regions. Cortical thickness decreased on average by 0.37 mm, (p = 0.002) in MS patients for each unit standard deviation change in white matter lesion volume. The odds of having a higher EDSS were associated with cortical lesion volume (1.78, p = 0.01) and disease duration (1.15, p < 0.001). CONCLUSION Cortical thinning in MS is not directly related to cortical lesion load but rather with white matter lesion volume. Neurological disability in MS is better explained by cortical lesion volume assessment.
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Affiliation(s)
- Constantina A Treaba
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Elena Herranz
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Valeria T Barletta
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Ambica Mehndiratta
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Russell Ouellette
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Jacob A Sloane
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Eric C Klawiter
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Caterina Mainero
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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8
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Park CC, Thongkham DW, Sadigh G, Saindane AM, Chu R, Bakshi R, Allen JW, Hu R. Detection of Cortical and Deep Gray Matter Lesions in Multiple Sclerosis Using DIR and FLAIR at 3T. J Neuroimaging 2020; 31:408-414. [PMID: 33351983 DOI: 10.1111/jon.12822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/27/2020] [Accepted: 11/27/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND PURPOSE The comparative detection rates of deep gray matter (GM) multiple sclerosis (MS) lesions using double inversion recovery (DIR) and fluid-attenuated inversion-recovery (FLAIR) on 3T MR imaging remain unknown. We aimed to assess the detectability of cortical and deep GM MS lesions using DIR and FLAIR on 3T clinical exams and evaluate the relationship between deep GM lesions and brain atrophy. METHODS One hundred fifty consecutive MS patients underwent routine brain MRI that included 3D DIR and 2D T2 FLAIR on the same 3T scanner. Three neuroradiologists independently reviewed all exams for cortical and deep GM lesions. Statistical parametric mapping (SPM) and FMRIB software library (FSL)-FIRST pipelines were used to determine normalized whole brain and deep GM volumes. RESULTS A total of 65 cortical and 98 deep lesions were detected on DIR versus 24 and 20, respectively, on FLAIR. Among all 150 patients, the number and percentage of patients with GM lesions on DIR and FLAIR were as follows: cortical 43 (28.7%) versus 24 (16.0%) (P < .001), thalamus 47 (31.3%) versus 20 (13.3%) (P < .001), putamen 10 (6.7%) versus 3 (2.0%) (P = .02), globus pallidus 9 (6.0%) versus 3 (1.3%) (P = .02), and caudate 5 (3.3%) versus 1 (0.7%) (P = .125). Presence of deep GM lesions weakly correlated with deep GM volume fractions. CONCLUSION Deep GM MS lesions can be detected using routine clinical brain MRI including DIR and FLAIR at 3T. Future studies to optimize these sequences may improve the detection rates of cortical and deep GM lesions. The presence of GM lesions showed weak correlation with GM atrophy.
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Affiliation(s)
- Charlie C Park
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Dean W Thongkham
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Gelareh Sadigh
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Amit M Saindane
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia.,Department of Neurosurgery, Emory University, Atlanta, Georgia
| | - Renxin Chu
- Department of Neurology and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rohit Bakshi
- Department of Neurology and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Ranliang Hu
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
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9
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Petracca M, El Mendili MM, Moro M, Cocozza S, Podranski K, Fleysher L, Inglese M. Laminar analysis of the cortical T1/T2-weighted ratio at 7T. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:7/6/e900. [PMID: 33087580 PMCID: PMC7641144 DOI: 10.1212/nxi.0000000000000900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/04/2020] [Indexed: 11/16/2022]
Abstract
Objective In this observational study, we explored cortical structure as function of cortical depth through a laminar analysis of the T1/T2-weighted (T1w/T2w) ratio, which has been related to dendrite density in ex vivo brain tissue specimens of patients with MS. Methods In 39 patients (22 relapsing-remitting, 13 female, age 41.1 ± 10.6 years; 17 progressive, 11 female, age 54.1 ± 9.9 years) and 21 healthy controls (8 female, , age 41.6 ± 10.6 years), we performed a voxel-wise analysis of T1w/T2w ratio maps from high-resolution 7T images from the subpial surface to the gray matter/white matter boundary. Six layers were sampled to ensure accuracy based on mean cortical thickness and image resolution. Results At the voxel-wise comparison (p < 0.05, family wise error rate corrected), the whole MS group showed lower T1w/T2w ratio values than controls, both when considering the entire cortex and each individual layer, with peaks occurring in the fusiform, temporo-occipital, and superior and middle frontal cortex. In relapsing-remitting patients, differences in the T1w/T2w ratio were only identified in the subpial layer, with the peak occurring in the fusiform cortex, whereas results obtained in progressive patients mirrored the widespread damage found in the whole group. Conclusions Laminar analysis of T1w/T2w ratio mapping confirms the presence of cortical damage in MS and shows a variable expression of intracortical damage according to the disease phenotype. Although in the relapsing-remitting stage, only the subpial layer appears susceptible to damage, in progressive patients, widespread cortical abnormalities can be observed, not only, as described before, with regard to myelin/iron concentration but, possibly, to other microstructural features.
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Affiliation(s)
- Maria Petracca
- From the Department of Neurology (M.P., M.M.E.M., M.M., S.C., K.P., M.I.), Icahn School of Medicine at Mount Sinai, NY; Aix-Marseille Univ (M.M.E.M.), CNRS, CRMBM; APHM (M.M.E.M.), Hôpital de la Timone, CEMEREM, Marseille, France; Department of Informatics (M.M.), Bioengineering, Robotics and Systems Engineering (DIBRIS) and Machine Learning Genoa Center (MaLGa), University of Genoa; Department of Advanced Biomedical Sciences (S.C.), University of Naples "Federico II", Italy; Department of Radiology (L.F.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics (M.I.), Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research, University of Genoa; and Ospedale Policlinico San Martino-IRCCS (M.I.), Genoa, Italy
| | - Mohamed M El Mendili
- From the Department of Neurology (M.P., M.M.E.M., M.M., S.C., K.P., M.I.), Icahn School of Medicine at Mount Sinai, NY; Aix-Marseille Univ (M.M.E.M.), CNRS, CRMBM; APHM (M.M.E.M.), Hôpital de la Timone, CEMEREM, Marseille, France; Department of Informatics (M.M.), Bioengineering, Robotics and Systems Engineering (DIBRIS) and Machine Learning Genoa Center (MaLGa), University of Genoa; Department of Advanced Biomedical Sciences (S.C.), University of Naples "Federico II", Italy; Department of Radiology (L.F.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics (M.I.), Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research, University of Genoa; and Ospedale Policlinico San Martino-IRCCS (M.I.), Genoa, Italy
| | - Matteo Moro
- From the Department of Neurology (M.P., M.M.E.M., M.M., S.C., K.P., M.I.), Icahn School of Medicine at Mount Sinai, NY; Aix-Marseille Univ (M.M.E.M.), CNRS, CRMBM; APHM (M.M.E.M.), Hôpital de la Timone, CEMEREM, Marseille, France; Department of Informatics (M.M.), Bioengineering, Robotics and Systems Engineering (DIBRIS) and Machine Learning Genoa Center (MaLGa), University of Genoa; Department of Advanced Biomedical Sciences (S.C.), University of Naples "Federico II", Italy; Department of Radiology (L.F.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics (M.I.), Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research, University of Genoa; and Ospedale Policlinico San Martino-IRCCS (M.I.), Genoa, Italy
| | - Sirio Cocozza
- From the Department of Neurology (M.P., M.M.E.M., M.M., S.C., K.P., M.I.), Icahn School of Medicine at Mount Sinai, NY; Aix-Marseille Univ (M.M.E.M.), CNRS, CRMBM; APHM (M.M.E.M.), Hôpital de la Timone, CEMEREM, Marseille, France; Department of Informatics (M.M.), Bioengineering, Robotics and Systems Engineering (DIBRIS) and Machine Learning Genoa Center (MaLGa), University of Genoa; Department of Advanced Biomedical Sciences (S.C.), University of Naples "Federico II", Italy; Department of Radiology (L.F.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics (M.I.), Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research, University of Genoa; and Ospedale Policlinico San Martino-IRCCS (M.I.), Genoa, Italy
| | - Kornelius Podranski
- From the Department of Neurology (M.P., M.M.E.M., M.M., S.C., K.P., M.I.), Icahn School of Medicine at Mount Sinai, NY; Aix-Marseille Univ (M.M.E.M.), CNRS, CRMBM; APHM (M.M.E.M.), Hôpital de la Timone, CEMEREM, Marseille, France; Department of Informatics (M.M.), Bioengineering, Robotics and Systems Engineering (DIBRIS) and Machine Learning Genoa Center (MaLGa), University of Genoa; Department of Advanced Biomedical Sciences (S.C.), University of Naples "Federico II", Italy; Department of Radiology (L.F.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics (M.I.), Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research, University of Genoa; and Ospedale Policlinico San Martino-IRCCS (M.I.), Genoa, Italy
| | - Lazar Fleysher
- From the Department of Neurology (M.P., M.M.E.M., M.M., S.C., K.P., M.I.), Icahn School of Medicine at Mount Sinai, NY; Aix-Marseille Univ (M.M.E.M.), CNRS, CRMBM; APHM (M.M.E.M.), Hôpital de la Timone, CEMEREM, Marseille, France; Department of Informatics (M.M.), Bioengineering, Robotics and Systems Engineering (DIBRIS) and Machine Learning Genoa Center (MaLGa), University of Genoa; Department of Advanced Biomedical Sciences (S.C.), University of Naples "Federico II", Italy; Department of Radiology (L.F.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics (M.I.), Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research, University of Genoa; and Ospedale Policlinico San Martino-IRCCS (M.I.), Genoa, Italy
| | - Matilde Inglese
- From the Department of Neurology (M.P., M.M.E.M., M.M., S.C., K.P., M.I.), Icahn School of Medicine at Mount Sinai, NY; Aix-Marseille Univ (M.M.E.M.), CNRS, CRMBM; APHM (M.M.E.M.), Hôpital de la Timone, CEMEREM, Marseille, France; Department of Informatics (M.M.), Bioengineering, Robotics and Systems Engineering (DIBRIS) and Machine Learning Genoa Center (MaLGa), University of Genoa; Department of Advanced Biomedical Sciences (S.C.), University of Naples "Federico II", Italy; Department of Radiology (L.F.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics (M.I.), Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research, University of Genoa; and Ospedale Policlinico San Martino-IRCCS (M.I.), Genoa, Italy.
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Kim M, Jewells V. Multimodal Image Analysis for Assessing Multiple Sclerosis and Future Prospects Powered by Artificial Intelligence. Semin Ultrasound CT MR 2020; 41:309-318. [DOI: 10.1053/j.sult.2020.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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11
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Mahajan KR, Nakamura K, Cohen JA, Trapp BD, Ontaneda D. Intrinsic and Extrinsic Mechanisms of Thalamic Pathology in Multiple Sclerosis. Ann Neurol 2020; 88:81-92. [PMID: 32286701 DOI: 10.1002/ana.25743] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Thalamic atrophy is among the earliest brain changes detected in patients with multiple sclerosis (MS) and the degree of thalamic atrophy is a strong predictor of disability progression. The causes of thalamic atrophy are not fully understood. Here, we investigate the contributions of thalamic demyelinated lesions, thalamic neuronal loss, and cerebral white matter (WM) lesions to thalamic volume. METHODS We used postmortem in situ magnetic resonance imaging (MRI) scans of 95 subjects with MS to correlate thalamic lesion volumes with global MRI metrics. We histologically characterized thalamic demyelination patterns and compared neuronal loss and neuritic pathology in the thalami with the extremes of volume. RESULTS Grossly apparent thalamic discolorations in cm-thick brain slices were T2/fluid-attenuated inversion recovery (FLAIR) hyperintense, T1-hypointense, and appeared as perivascular demyelinated lesions with dystrophic neurons/axons. Subependymal demyelinated lesions with axonal loss and microglial/macrophage activation were also observed. The 12 subjects with the least thalamic volume had a 17.6% reduction of median neuronal density in the dorsomedial/ventrolateral and pulvinar nuclei compared with the 14 subjects with the greatest thalamic volume (p = 0.03). After correcting for age, disease duration, sex, and T2 lesion volume, the total (p = 0.20), ovoid (p = 0.31), or subependymal (p = 0.44) MRI thalamic lesion volumes correlated with thalamic volume. Thalamic volume correlated with cerebral T2 lesion volume (Spearman's rho = -0.65, p < 0.001; p < 0.0001 after correcting for age, disease duration, and sex). INTERPRETATION Our findings suggest the degeneration of efferent/afferent thalamic projections and/or a neurodegenerative process as greater contributors to thalamic atrophy than thalamic demyelinating lesions. ANN NEUROL 2020 ANN NEUROL 2020;88:81-92.
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Affiliation(s)
- Kedar R Mahajan
- Mellen Center for MS Treatment and Research, Neurologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.,Department of Neuroscience, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Kunio Nakamura
- Department of Biomedical Engineering, Lerner Research Institute, Neurologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Jeffrey A Cohen
- Mellen Center for MS Treatment and Research, Neurologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Bruce D Trapp
- Department of Neuroscience, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Daniel Ontaneda
- Mellen Center for MS Treatment and Research, Neurologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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Cocozza S, Cosottini M, Signori A, Fleysher L, El Mendili MM, Lublin F, Inglese M, Roccatagliata L. A clinically feasible 7-Tesla protocol for the identification of cortical lesions in Multiple Sclerosis. Eur Radiol 2020; 30:4586-4594. [PMID: 32211962 DOI: 10.1007/s00330-020-06803-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/25/2020] [Accepted: 03/11/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the capability of sequences acquired on a 7-T MRI scanner, within times and anatomical coverage appropriate for clinical studies, to identify cortical lesions (CLs) in patients with Multiple Sclerosis (MS). Furthermore, we aimed to confirm the clinical significance of CL, testing the correlations between gray matter (GM) lesions and clinical scores. METHODS A 7-T MRI protocol included 3D-T1-weighted and T2*-weighted sequences. Images were evaluated independently by three readers of different experience, and the number of CLs was recorded. Between-rater concordance was assessed calculating the intraclass correlation coefficient (ICC). Lin's concordance correlation coefficient was used to compare CL detection between sequences, while partial correlations and multivariable regression models were used to study the relationship between CL and clinical data. RESULTS Forty MS patients (M/F, 17/23; 44.7 ± 12.6 years) were enrolled in this study, and CLs were identified in 35/40 subjects (87.5%). CL detection rate on 3D-T1-weighted images was significantly correlated with the detection rate on T2*-weighted images (r = 0.99; p < 0.001), with high concordance between readers (ICC ≥ 0.995). CLs were significantly correlated with both motor and cognitive scores (all with p ≤ 0.04). CONCLUSIONS CL can be identified over the whole brain at 7-T in MS using a 3D-T1-weighted volume, acquired in a clinically feasible time and with comparable performance to that achievable using the T2*-weighted sequence. Based on the central role of CL in the development of clinical disability, we suggest that 3D-T1-weighted volume may play a role in the evaluation of CL in MS undergoing MRI on ultra-high-field scanners. KEY POINTS • Cortical lesions can be identified in a clinically feasible time with a 7-T protocol, which includes a 3D-T1-weighted volume. • Cortical lesions correlated significantly with both motor and cognitive disability in MS patients. • Given their correlation with clinical disability, evaluation of a cortical lesion on a 7-T clinical protocol could help in the management of MS patients.
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Affiliation(s)
- Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Lazar Fleysher
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Fred Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Matilde Inglese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA. .,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Largo Paolo Daneo 3, Genoa, Italy. .,Ospedale Policlinico San Martino IRCCS, Genoa, Italy.
| | - Luca Roccatagliata
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Department of Neuroradiology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
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13
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Cassiano MT, Lanzillo R, Alfano B, Costabile T, Comerci M, Prinster A, Moccia M, Megna R, Morra VB, Quarantelli M, Brunetti A. Voxel-based analysis of gray matter relaxation rates shows different correlation patterns for cognitive impairment and physical disability in relapsing-remitting multiple sclerosis. NEUROIMAGE-CLINICAL 2020; 26:102201. [PMID: 32062567 PMCID: PMC7025083 DOI: 10.1016/j.nicl.2020.102201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/13/2020] [Accepted: 01/28/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Regional analyses of markers of microstructural gray matter (GM) changes, including relaxation rates, have shown inconsistent correlations with physical and cognitive impairment in MS. OBJECTIVE To assess voxelwise the correlation of the R1 and R2 relaxation rates with the physical and cognitive impairment in MS. METHODS GM R1 and R2 relaxation rate maps were obtained in 241 relapsing-remitting MS patients by relaxometric segmentation of MRI studies. Correlations with the Expanded Disability Status Scale (EDSS) and the percentage of impaired cognitive test (Brief Repeatable Battery and Stroop Test, available in 186 patients) were assessed voxelwise, including voxel GM content as nuisance covariate to remove the effect of atrophy on the correlations. RESULTS Extensive clusters of inverse correlation between EDSS and R2 were detected throughout the brain, while inverse correlations with R1 were mostly limited to perirolandic and supramarginal cortices. Cognitive impairment correlated negatively with R1, and to a lesser extent with R2, in the middle frontal, mesial temporal, midcingulate and medial parieto-occipital cortices. CONCLUSION In relapsing-remitting MS patients, GM microstructural changes correlate diffusely with physical disability, independent of atrophy, with a preferential role of the sensorimotor cortices. Neuronal damage in the limbic system and dorsolateral prefrontal cortices correlates with cognitive dysfunction.
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Affiliation(s)
- Maria Teresa Cassiano
- Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80131 Naples, Italy
| | - Roberta Lanzillo
- Department of Neurosciences, Reproductive Science and Odontostomatology, University "Federico II", Naples, Italy
| | - Bruno Alfano
- Biostructure and Bioimaging Institute, National Research Council, Via De Amicis, 95, 80145 Naples, Italy
| | - Teresa Costabile
- Department of Neurosciences, Reproductive Science and Odontostomatology, University "Federico II", Naples, Italy
| | - Marco Comerci
- Biostructure and Bioimaging Institute, National Research Council, Via De Amicis, 95, 80145 Naples, Italy
| | - Anna Prinster
- Biostructure and Bioimaging Institute, National Research Council, Via De Amicis, 95, 80145 Naples, Italy
| | - Marcello Moccia
- Department of Neurosciences, Reproductive Science and Odontostomatology, University "Federico II", Naples, Italy
| | - Rosario Megna
- Biostructure and Bioimaging Institute, National Research Council, Via De Amicis, 95, 80145 Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neurosciences, Reproductive Science and Odontostomatology, University "Federico II", Naples, Italy
| | - Mario Quarantelli
- Biostructure and Bioimaging Institute, National Research Council, Via De Amicis, 95, 80145 Naples, Italy.
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80131 Naples, Italy
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Mori M. Anatomical connectivity elucidated by analysing thalamic atrophy in neuromyelitis optica. J Neurol Neurosurg Psychiatry 2019; 90:1075. [PMID: 31227560 DOI: 10.1136/jnnp-2019-320694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/02/2019] [Accepted: 06/07/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Masahiro Mori
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
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Yamashiro A, Kobayashi M, Saito T. Cerebrospinal fluid T1 value phantom reproduction at scan room temperature. J Appl Clin Med Phys 2019; 20:166-175. [PMID: 31179645 PMCID: PMC6612700 DOI: 10.1002/acm2.12659] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 01/05/2023] Open
Abstract
The T1 value of pure water, which is often used as a phantom to simulate cerebrospinal fluid, is significantly different from that of in-vivo cerebrospinal fluid. The purpose of this study was to develop a phantom with a T1 value equivalent to that of in-vivo cerebrospinal fluid under examination room temperature (23°C-25°C). In this study, 1.5 and 3.0 T magnetic resonance imaging scanners were used. We examined the signal intensity change in relation to pure water temperature, the T1 values of acetone-diluted solutions (0-100 v/v%, in 10 steps), and the correlation coefficients obtained from volunteers and the prepared phantoms. The T1 value was close to the value reported in the literature for cerebrospinal fluid when the acetone-diluted solution was 70 v/v% or higher at scan room temperature. The value at that time was 3532.81-4704.57 ms at 1.5 T and it ranged from 4052.41 to 5701.61 ms at 3.0 T. The highest correlation with the values obtained from the volunteers was r = 0.993 with pure acetone at 1.5 T and r = 0.991 with acetone 90 v/v% at 3.0 T. The relative error of the best phantom-volunteer match was 32.61 (%) ± 6.71 at 1.5 T and 46.67 (%) ± 4.31 at 3.0 T. The T1 value measured by the null point method did not detect a significant difference between in vivo CSF and acetone 100 v/v% at 1.5 T and acetone 90 v/v% at 3.0 T. The T1 value of cerebrospinal fluid in the living body at scan room temperature was reproduced with acetone. The optimum concentration of acetone for cerebrospinal-fluid reproduction was pure acetone at 1.5 T and 90 v/v% at 3.0 T.
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Affiliation(s)
- Akihiro Yamashiro
- Department of Radiology, Nagano Red Cross Hospital, Nagano-City, Nagano-ken, Japan
| | - Masato Kobayashi
- Department of Radiology, Shinano Town Shin-Etsu Hospital, Kamiminochi-gun, Nagano-ken, Japan
| | - Takaaki Saito
- Department of Radiology, Iiyama Red Cross Hospital, Iiyama-City, Nagano-ken, Japan
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Charalambous T, Tur C, Prados F, Kanber B, Chard DT, Ourselin S, Clayden JD, A M Gandini Wheeler-Kingshott C, Thompson AJ, Toosy AT. Structural network disruption markers explain disability in multiple sclerosis. J Neurol Neurosurg Psychiatry 2019; 90:219-226. [PMID: 30467210 PMCID: PMC6518973 DOI: 10.1136/jnnp-2018-318440] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/26/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate whether structural brain network metrics correlate better with clinical impairment and information processing speed in multiple sclerosis (MS) beyond atrophy measures and white matter lesions. METHODS This cross-sectional study included 51 healthy controls and 122 patients comprising 58 relapsing-remitting, 28 primary progressive and 36 secondary progressive. Structural brain networks were reconstructed from diffusion-weighted MRIs and standard metrics reflecting network density, efficiency and clustering coefficient were derived and compared between subjects' groups. Stepwise linear regression analyses were used to investigate the contribution of network measures that explain clinical disability (Expanded Disability Status Scale (EDSS)) and information processing speed (Symbol Digit Modalities Test (SDMT)) compared with conventional MRI metrics alone and to determine the best statistical model that explains better EDSS and SDMT. RESULTS Compared with controls, network efficiency and clustering coefficient were reduced in MS while these measures were also reduced in secondary progressive relative to relapsing-remitting patients. Structural network metrics increase the variance explained by the statistical models for clinical and information processing dysfunction. The best model for EDSS showed that reduced network density and global efficiency and increased age were associated with increased clinical disability. The best model for SDMT showed that lower deep grey matter volume, reduced efficiency and male gender were associated with worse information processing speed. CONCLUSIONS Structural topological changes exist between subjects' groups. Network density and global efficiency explained disability above non-network measures, highlighting that network metrics can provide clinically relevant information about MS pathology.
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Affiliation(s)
- Thalis Charalambous
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK
| | - Carmen Tur
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK
| | - Ferran Prados
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK
| | - Baris Kanber
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK
| | - Declan T Chard
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK
| | - Sebastian Ourselin
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK
| | - Jonathan D Clayden
- UCL GOS Institute of Child Health, University College London, London, UK
| | - Claudia A M Gandini Wheeler-Kingshott
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK
- Brain MRI 3T Research Center, C. Mondino National Neurological Institute, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Alan J Thompson
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK
| | - Ahmed T Toosy
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK
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Schoonheim MM, Geurts JJG. What Causes Deep Gray Matter Atrophy in Multiple Sclerosis? AJNR Am J Neuroradiol 2018; 40:107-108. [PMID: 30591510 DOI: 10.3174/ajnr.a5942] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- M M Schoonheim
- Department of Anatomy and Neurosciences MS Center Amsterdam Amsterdam Neuroscience Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam, the Netherlands
| | - J J G Geurts
- Department of Anatomy and Neurosciences MS Center Amsterdam Amsterdam Neuroscience Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam, the Netherlands
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Rasche L, Scheel M, Otte K, Althoff P, van Vuuren AB, Gieß RM, Kuchling J, Bellmann-Strobl J, Ruprecht K, Paul F, Brandt AU, Schmitz-Hübsch T. MRI Markers and Functional Performance in Patients With CIS and MS: A Cross-Sectional Study. Front Neurol 2018; 9:718. [PMID: 30210439 PMCID: PMC6123531 DOI: 10.3389/fneur.2018.00718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/08/2018] [Indexed: 01/04/2023] Open
Abstract
Introduction: Brain atrophy is a widely accepted marker of disease severity with association to clinical disability in multiple sclerosis (MS). It is unclear to which extent this association reflects common age effects on both atrophy and function. Objective: To explore how functional performance in gait, upper extremities and cognition is associated with brain atrophy in patients with Clinically Isolated Syndrome (CIS) and relapsing-remitting MS (RRMS), controlling for effects of age and sex. Methods: In 27 patients with CIS, 59 with RRMS (EDSS ≤3) and 63 healthy controls (HC), 3T MRI were analyzed for T2 lesion count (T2C), volume (T2V) and brain volumes [normalized brain volume (NBV), gray matter volume (NGMV), white matter volume (NWMV), thalamic volume (NThalV)]. Functional performance was measured with short maximum walking speed (SMSW speed), 9-hole peg test (9HPT) and symbol digit modalities test (SDMT). Linear regression models were created for functional variables with stepwise inclusion of age, sex and MR imaging markers. Results: CIS differed from HC only in T2C and T2V. RRMS differed from HC in NBV, NGMV and NThalV, T2C and T2V, but not in NWMV. A strong association with age was seen in HC, CIS and RRMS groups for NBV (r = -0.5 to -0.6) and NGMV (r = -0.6 to -0.8). Associations with age were seen in HC and RRMS but not CIS for NThalV (r = -0.3; r = -0.5), T2C (rs = 0.3; rs = 0.2) and T2V (rs = 0.3; rs = 0.3). No effect of age was seen on NWMV. Correlations of functional performance with age in RRMS were seen for SMSW speed, 9HPTand SDMT (r = -0.27 to -0.46). Regression analyses yielded significant models only in the RRMS group for 9HPT, SMSW speed and EDSS. These included NBV, NGMV, NThalV, NWMV, logT2V, age and sex as predictors. NThalV was the only MRI variable predicting a functional measure (9HPTr) with a higher standardized beta than age and sex (R2 = 0.36, p < 1e-04). Conclusion: Thalamic atrophy was a stronger predictor of hand function (9HPT) in RRMS, than age and sex. This underlines the clinical relevance of thalamic atrophy and the relevance of hand function as a clinical marker even in mildly disabled patients.
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Affiliation(s)
- Ludwig Rasche
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
| | - Michael Scheel
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
- Department of Neuroradiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Karen Otte
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
- Motognosis GmbH, Berlin, Germany
| | - Patrik Althoff
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
| | - Annemieke B. van Vuuren
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
- VU University Medical Center, Amsterdam, Netherlands
| | - Rene M. Gieß
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
| | - Joseph Kuchling
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
- Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Judith Bellmann-Strobl
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Klemens Ruprecht
- Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
- Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Alexander U. Brandt
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
- Department of Neurology, University of California, Irvine, Irvine, CA, United States
| | - Tanja Schmitz-Hübsch
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Cluster of Excellence, Berlin, Germany
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Abstract
Since its technical development in the early 1980s, magnetic resonance imaging (MRI) has quickly been adopted as an essential tool in supporting the diagnosis, longitudinal monitoring, evaluation of therapeutic response, and scientific investigations in multiple sclerosis (MS). The clinical usage of MRI has increased in parallel with technical innovations in the technique itself; the widespread adoption of clinically routine MRI at 1.5T has allowed sensitive qualitative and quantitative assessments of macroscopic central nervous system (CNS) inflammatory demyelinating lesions and tissue atrophy. However, conventional MRI lesion measures lack specificity for the underlying MS pathology and only weakly correlate with clinical status. Higher field strength units and newer, advanced MRI techniques offer increased sensitivity and specificity in the detection of disease activity and disease severity. This review summarizes the current status and future prospects regarding the role of MRI in the characterization of MS-related brain and spinal cord involvement.
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Affiliation(s)
- Christopher C Hemond
- Laboratory for Neuroimaging Research, Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Departments of Neurology and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Rohit Bakshi
- Laboratory for Neuroimaging Research, Partners Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Departments of Neurology and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115
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Schoonheim MM, Ciccarelli O. The value of including thalamic atrophy as a clinical trial endpoint in multiple sclerosis. Neurology 2018. [PMID: 29540583 DOI: 10.1212/wnl.0000000000005279] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Menno M Schoonheim
- From the Department of Anatomy and Neurosciences (M.M.S.), Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neuroinflammation (O.C.), UCL Institute of Neurology, University College London; and National Institute for Health Research (O.C.), University College London Hospitals Biomedical Research Centre, UK.
| | - Olga Ciccarelli
- From the Department of Anatomy and Neurosciences (M.M.S.), Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neuroinflammation (O.C.), UCL Institute of Neurology, University College London; and National Institute for Health Research (O.C.), University College London Hospitals Biomedical Research Centre, UK
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21
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Moroso A, Ruet A, Lamargue-Hamel D, Munsch F, Deloire M, Ouallet JC, Cubizolle S, Charré-Morin J, Saubusse A, Tourdias T, Dousset V, Brochet B. Preliminary evidence of the cerebellar role on cognitive performances in clinically isolated syndrome. J Neurol Sci 2017; 385:1-6. [PMID: 29406885 DOI: 10.1016/j.jns.2017.11.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 11/02/2017] [Accepted: 11/29/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Cerebellar and cognitive dysfunction can occur early in clinically isolated syndrome (CIS). Eye tracking is a reliable tool for the evaluation of both subtle cerebellar symptoms and cognitive impairment. OBJECTIVES To investigate the early cognitive profile using neuropsychological and ocular motor (OM) testing in CIS with and without cerebellar dysfunction with OM testing compared to healthy subjects (HS). METHODS Twenty-eight patients and 12 HC underwent OM and neuropsychological testing. Cerebellar impairment was defined by the registration of saccadic intrusions and/or at least 10% of dysmetria during ocular motor recording. Visually guided saccade (VGS), memory-guided saccade (MGS) and antisaccade (AS) paradigms were compared to neuropsychological assessments. RESULTS The group of patients with cerebellar dysfunction (n=16) performed worse on MGS latencies and error rates, and had worse working memory, executive function and information processing speed (IPS) z scores than patients without cerebellar dysfunction. IPS was correlated with the AS error rate in all patients and with the VGS error rate and the MGS final eye position ratio in cerebellar patients. CONCLUSION Eye tracking is a sensitive tool to assess cognitive and cerebellar dysfunctions in CIS. In CIS patients, cerebellar impairment is associated with working memory, executive functions and IPS slowness.
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Affiliation(s)
- Amandine Moroso
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Aurélie Ruet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Delphine Lamargue-Hamel
- Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Fanny Munsch
- Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Mathilde Deloire
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | | | - Stéphanie Cubizolle
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Julie Charré-Morin
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Aurore Saubusse
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Thomas Tourdias
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Vincent Dousset
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Bruno Brochet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France.
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22
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Distinct cognitive impairments in different disease courses of multiple sclerosis—A systematic review and meta-analysis. Neurosci Biobehav Rev 2017; 83:568-578. [DOI: 10.1016/j.neubiorev.2017.09.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/02/2017] [Accepted: 09/04/2017] [Indexed: 12/13/2022]
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23
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Rocca MA, Comi G, Filippi M. The Role of T1-Weighted Derived Measures of Neurodegeneration for Assessing Disability Progression in Multiple Sclerosis. Front Neurol 2017; 8:433. [PMID: 28928705 PMCID: PMC5591328 DOI: 10.3389/fneur.2017.00433] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/08/2017] [Indexed: 12/26/2022] Open
Abstract
Introduction Multiple sclerosis (MS) is characterised by the accumulation of permanent neurological disability secondary to irreversible tissue loss (neurodegeneration) in the brain and spinal cord. MRI measures derived from T1-weighted image analysis (i.e., black holes and atrophy) are correlated with pathological measures of irreversible tissue loss. Quantifying the degree of neurodegeneration in vivo using MRI may offer a surrogate marker with which to predict disability progression and the effect of treatment. This review evaluates the literature examining the association between MRI measures of neurodegeneration derived from T1-weighted images and disability in MS patients. Methods A systematic PubMed search was conducted in January 2017 to identify MRI studies in MS patients investigating the relationship between “black holes” and/or atrophy in the brain and spinal cord, and disability. Results were limited to human studies published in English in the previous 10 years. Results A large number of studies have evaluated the association between the previous MRI measures and disability. These vary considerably in terms of study design, duration of follow-up, size, and phenotype of the patient population. Most, although not all, have shown that there is a significant correlation between disability and black holes in the brain, as well as atrophy of the whole brain and grey matter. The results for brain white matter atrophy are less consistently positive, whereas studies evaluating spinal cord atrophy consistently showed a significant correlation with disability. Newer ways of measuring atrophy, thanks to the development of segmentation and voxel-wise methods, have allowed us to assess the involvement of strategic regions of the CNS (e.g., thalamus) and to map the regional distribution of damage. This has resulted in better correlations between MRI measures and disability and in the identification of the critical role played by some CNS structures for MS clinical manifestations. Conclusion The evaluation of MRI measures of atrophy as predictive markers of disability in MS is a highly active area of research. At present, measurement of atrophy remains within the realm of clinical studies, but its utility in clinical practice has been recognized and barriers to its implementation are starting to be addressed.
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Affiliation(s)
- Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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24
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Moroso A, Ruet A, Lamargue-Hamel D, Munsch F, Deloire M, Coupé P, Charré-Morin J, Saubusse A, Ouallet JC, Planche V, Tourdias T, Dousset V, Brochet B. Microstructural analyses of the posterior cerebellar lobules in relapsing-onset multiple sclerosis and their implication in cognitive impairment. PLoS One 2017; 12:e0182479. [PMID: 28792528 PMCID: PMC5549727 DOI: 10.1371/journal.pone.0182479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 07/19/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The posterior cerebellar lobules seem to be the anatomical substrate of cognitive cerebellar processes, but their microstructural alterations in multiple sclerosis (MS) remain unclear. OBJECTIVES To correlate diffusion metrics in lobules VI to VIIIb in persons with clinically isolated syndrome (PwCIS) and in cognitively impaired persons with MS (CIPwMS) with their cognitive performances. METHODS Sixty-nine patients (37 PwCIS, 32 CIPwMS) and 36 matched healthy subjects (HS) underwent 3T magnetic resonance imaging, including 3D T1-weighted and diffusion tensor imaging (DTI). Fractional anisotropy (FA) and mean diffusivity (MD) were calculated within each lobule and in the cerebellar peduncles. We investigated the correlations between cognitive outcomes and the diffusion parameters of cerebellar sub-structures and performed multiple linear regression analysis to predict cognitive disability. RESULTS FA was generally lower and MD was higher in the cerebellum and specifically in the vermis Crus II, lobules VIIb and VIIIb in CIPwMS compared with PwCIS and HS. In hierarchical regression analyses, 31% of the working memory z score variance was explained by FA in the left lobule VI and in the left superior peduncle. Working memory was also associated with MD in the vermis Crus II. FA in the left lobule VI and right VIIIa predicted part of the information processing speed (IPS) z scores. CONCLUSION DTI indicators of cerebellar microstructural damage were associated with cognitive deficits in MS. Our results suggested that cerebellar lobular alterations have an impact on attention, working memory and IPS.
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Affiliation(s)
- Amandine Moroso
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Aurélie Ruet
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | | | - Fanny Munsch
- Univ. Bordeaux, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Mathilde Deloire
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Pierrick Coupé
- Univ. Bordeaux, Bordeaux, France
- LaBRI, UMR 5800, PICTURA, Talence, France
| | - Julie Charré-Morin
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Aurore Saubusse
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Jean-Christophe Ouallet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Vincent Planche
- Univ. Bordeaux, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Thomas Tourdias
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Vincent Dousset
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Bruno Brochet
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
- * E-mail:
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25
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Lee H, Nakamura K, Narayanan S, Brown R, Chen J, Atkins HL, Freedman MS, Arnold DL. Impact of immunoablation and autologous hematopoietic stem cell transplantation on gray and white matter atrophy in multiple sclerosis. Mult Scler 2017; 24:1055-1066. [DOI: 10.1177/1352458517715811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Immunoablation and autologous hematopoietic stem cell transplantation (IA/aHSCT) halts relapses, white matter (WM) lesion formation, and pathological whole-brain (WB) atrophy in multiple sclerosis (MS) patients. Whether the latter was due to effects on gray matter (GM) or WM warranted further exploration. Objective: To model GM and WM volume changes after IA/aHSCT to further understand the effects seen on WB atrophy. Methods: GM and WM volume changes were calculated from serial baseline and follow-up magnetic resonance imaging (MRI) ranging from 1.5 to 10.5 years in 19 MS patients treated with IA/aHSCT. A mixed-effects model with two predictors (total busulfan dose and baseline T1-weighted WM lesion volume “T1LV”) characterized the time-courses after IA/aHSCT. Results: Accelerated short-term atrophy of 2.1% and 3.2% occurred in GM and WM, respectively, on average. Both busulfan dose and T1LV were significant predictors of WM atrophy, whereas only busulfan was a significant predictor of GM atrophy. Compared to baseline, a significant reduction in GM atrophy, not WM atrophy, was found. The average rates of long-term GM and WM atrophy were −0.18%/year (standard error (SE): 0.083) and −0.07%/year (SE: 0.14), respectively. Conclusion: Chemotherapy-related toxicity affected both GM and WM. WM was further affected by focal T1-weighted lesion-related pathologies. Long-term rates of GM and WM atrophy were comparable to those of normal-aging.
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Affiliation(s)
- Hyunwoo Lee
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Kunio Nakamura
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada/Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sridar Narayanan
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Robert Brown
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Jacqueline Chen
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Harold L Atkins
- Ottawa Hospital Blood and Marrow Transplant Program, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Mark S Freedman
- Department of Medicine (Neurology), The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Douglas L Arnold
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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Hacohen Y, Patel CB, Hintzen R. A single demyelinating attack is enough to limit brain growth in children. Neurology 2017; 88:1691-1692. [DOI: 10.1212/wnl.0000000000003894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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27
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Moroso A, Ruet A, Lamargue-Hamel D, Munsch F, Deloire M, Coupé P, Ouallet JC, Planche V, Moscufo N, Meier DS, Tourdias T, Guttmann CRG, Dousset V, Brochet B. Posterior lobules of the cerebellum and information processing speed at various stages of multiple sclerosis. J Neurol Neurosurg Psychiatry 2017; 88:146-151. [PMID: 27789541 DOI: 10.1136/jnnp-2016-313867] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/20/2016] [Accepted: 10/08/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cerebellar damage has been implicated in information processing speed (IPS) impairment associated with multiple sclerosis (MS) that might result from functional disconnection in the frontocerebellar loop. Structural alterations in individual posterior lobules, in which cognitive functioning seems preponderant, are still unknown. Our aim was to investigate the impact of grey matter (GM) volume alterations in lobules VI to VIIIb on IPS in persons with clinically isolated syndrome (PwCIS), MS (PwMS) and healthy subjects (HS). METHODS 69 patients (37 PwCIS, 32 PwMS) and 36 HS underwent 3 T MRI including 3-dimensional T1-weighted MRIs. Cerebellum lobules were segmented using SUIT V.3.0 to estimate their normalised GM volume. Neuropsychological testing was performed to assess IPS and main cognitive functions. RESULTS Normalised GM volumes were significantly different between PwMS and HS for the right (p<0.001) and left lobule VI (p<0.01), left crus I, right VIIb and entire cerebellum (p<0.05 for each comparison) and between PwMS and PwCIS for all lobules in subregions VI and left crus I (p<0.05). IPS, attention and working memory were impaired in PwMS compared with PwCIS. In the whole population of patients (PwMS and PwCIS), GM loss in vermis VI (R2=0.36; p<0.05 when considering age and T2 lesion volume as covariates) were associated with IPS impairment. CONCLUSIONS GM volume decrease in posterior lobules (especially vermis VI) was associated with reduced IPS. Our results suggest a significant impact of posterior lobules pathology in corticocerebellar loop disruption resulting in automation and cognitive optimisation lack in MS. TRIAL REGISTRATION Clinicaltrail NCT01207856, NCT01865357; Pre-results.
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Affiliation(s)
- Amandine Moroso
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Aurélie Ruet
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | | | - Fanny Munsch
- University Bordeaux, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Mathilde Deloire
- Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France
| | - Pierrick Coupé
- University Bordeaux, Bordeaux, France.,LaBRI, UMR 5800, PICTURA, Talence, France
| | - Jean-Christophe Ouallet
- Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France
| | - Vincent Planche
- University Bordeaux, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Nicolas Moscufo
- Department of Radiology, Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Dominik S Meier
- Department of Radiology, Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas Tourdias
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Charles R G Guttmann
- Department of Radiology, Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vincent Dousset
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Bruno Brochet
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
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28
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Rocca MA, Battaglini M, Benedict RHB, De Stefano N, Geurts JJG, Henry RG, Horsfield MA, Jenkinson M, Pagani E, Filippi M. Brain MRI atrophy quantification in MS: From methods to clinical application. Neurology 2016; 88:403-413. [PMID: 27986875 DOI: 10.1212/wnl.0000000000003542] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/18/2016] [Indexed: 01/06/2023] Open
Abstract
Patients with the main clinical phenotypes of multiple sclerosis (MS) manifest varying degrees of brain atrophy beyond that of normal aging. Assessment of atrophy helps to distinguish clinically and cognitively deteriorating patients and predicts those who will have a less-favorable clinical outcome over the long term. Atrophy can be measured from brain MRI scans, and many technological improvements have been made over the last few years. Several software tools, with differing requirements on technical ability and levels of operator intervention, are currently available and have already been applied in research or clinical trial settings. Despite this, the measurement of atrophy in routine clinical practice remains an unmet need. After a short summary of the pathologic substrates of brain atrophy in MS, this review attempts to guide the clinician towards a better understanding of the methods currently used for quantifying brain atrophy in this condition. Important physiologic factors that affect brain volume measures are also considered. Finally, the most recent research on brain atrophy in MS is summarized, including whole brain and various compartments thereof (i.e., white matter, gray matter, selected CNS structures). Current methods provide sufficient precision for cohort studies, but are not adequate for confidently assessing changes in individual patients over the scale of months or a few years.
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Affiliation(s)
- Maria A Rocca
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Marco Battaglini
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Ralph H B Benedict
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Nicola De Stefano
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Jeroen J G Geurts
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Roland G Henry
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Mark A Horsfield
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Mark Jenkinson
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Elisabetta Pagani
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Massimo Filippi
- From the Neuroimaging Research Unit (M.A.R., E.P., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan; Department of Medicine, Surgery and Neuroscience (M.B., N.D.S.), University of Siena, Italy; Department of Neurology (R.H.B.B.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York; Department of Anatomy and Neuroscience (J.J.G.G.), Section of Clinical Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, the Netherlands; Department of Neurology (R.G.H.), University of California, San Francisco; Xinapse Systems Ltd. (M.A.H.), Colchester, Essex, UK; and FMRIB Centre (M.J.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK.
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29
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Affiliation(s)
- Nils Muhlert
- From the School of Psychological Science, University of Manchester, UK
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30
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Prosperini L, Castelli L, De Luca F, Fabiano F, Ferrante I, De Giglio L. Task-dependent deterioration of balance underpinning cognitive-postural interference in MS. Neurology 2016; 87:1085-92. [DOI: 10.1212/wnl.0000000000003090] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/06/2016] [Indexed: 11/15/2022] Open
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31
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Labiano-Fontcuberta A, Mato-Abad V, Álvarez-Linera J, Hernández-Tamames JA, Martínez-Ginés ML, Aladro Y, Ayuso L, Domingo-Santos Á, Benito-León J. Gray Matter Involvement in Radiologically Isolated Syndrome. Medicine (Baltimore) 2016; 95:e3208. [PMID: 27043685 PMCID: PMC4998546 DOI: 10.1097/md.0000000000003208] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The unanticipated magnetic resonance imaging (MRI) detection in the brain of asymptomatic subjects of white matter lesions suggestive of multiple sclerosis has recently been named as radiologically isolated syndrome (RIS). The pathophysiological processes of RIS remain largely unknown and questions as to whether gray matter alterations actually occur in this entity are yet to be investigated in more detail. By means of a 3 T multimodal MRI approach, we searched for cortical and deep gray matter changes in a cohort of RIS patients. Seventeen RIS patients, 17 clinically isolated syndrome (CIS) patients (median disease duration from symptom onset = 12 months), and 17 healthy controls underwent MRI and neuropsychological testing. Normalized deep gray matter volumes and regional cortical thickness were assessed using FreeSurfer. SIENAX was used to obtain normalized global and cortical brain volumes. Voxelwise morphometry analysis was performed by using SPM8 software to localize regions of brain tissue showing significant changes of fractional anisotropy or mean diffusivity. Although no differences were observed between CIS and healthy controls groups, RIS patients showed significantly lower normalized cortical volume (673 ± 27.07 vs 641 ± 35.88 [cm³ × 10³, Tukey P test = 0.009) and mean thalamic volume (0.0051 ± 0.4 vs 0.0046 ± 0.4 mm, P = 0.014) compared with healthy controls. RIS patients also showed significant thinning in a number of cortical areas, that were primarily distributed in frontal and temporal lobes (P < 0.05, uncorrected). Strong correlations were observed between T2-white matter lesion volume and regional cortical thickness (rho spearman ranging from 0.60 to 0.80). Our data suggest that white matter lesions on T2-weighted images are not the only hallmark of RIS. Future longitudinal studies with larger samples are warranted to better clarify the effect of RIS-related white matter lesions on gray matter tissue.
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Affiliation(s)
- Andrés Labiano-Fontcuberta
- From the Department of Neurology, University Hospital "12 de Octubre" (AL-F, AD-S, JB-L); Neuroimaging Laboratory, Center for Biomedical Technology, Rey Juan Carlos University, Móstoles (VM-A, JAH-T); Department of Radiology, Hospital Ruber International (JA-L); Department of Neurology, University Hospital "Gregorio Marañón," Madrid, Spain (MLM-G); Department of Neurology, University Hospital of Getafe, Getafe (YA); Department of Neurology, University Hospital "Principe de Asturias," Alcalá de Henares (LA); Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) (JB-L); and Department of Medicine, Complutense University (JB-L), Madrid, Spain
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32
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Steenwijk MD, Geurts JJG, Daams M, Tijms BM, Wink AM, Balk LJ, Tewarie PK, Uitdehaag BMJ, Barkhof F, Vrenken H, Pouwels PJW. Cortical atrophy patterns in multiple sclerosis are non-random and clinically relevant. Brain 2015; 139:115-26. [DOI: 10.1093/brain/awv337] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/29/2015] [Indexed: 01/07/2023] Open
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