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Jakimovski D, Gibney BL, Marr K, Ramasamy DP, Dwyer MG, Bergsland N, Weinstock-Guttman B, Ramanathan M, Zivadinov R. Lower cerebral arterial blood flow is associated with greater serum neurofilament light chain levels in multiple sclerosis patients. Veins and Lymphatics 2022. [DOI: 10.4081/vl.2022.10952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Hypoperfusion, vascular pathology, and cardiovascular risk factors are associated with disease severity in multiple sclerosis (MS).1,2 In particular, the total cerebral arterial blood flow (CABF), measured as a sum of all arterial flow in the neck, was associated with the cognitive performance of MS patients.3
Objective: To assess relationships between CABF and serum neurofilament light chain (sNfL), as neuronal damage biomarker with good prognostic value and treatment responsiveness.4 If the cerebrovascular changes are an independent pathophysiological factor in MS, a relationship should remain significant after controlling for common MS-based disease measures (i.e., T2 lesion volume and brain volume).
Materials and methods: Total CABF was measured in 137 patients (86 clinically isolated syndrome (CIS)/relapsing-remitting (RR) and 51 progressive MS (PMS)) and 48 healthy controls (HCs) using Doppler ultrasound. sNfL was quantitated using a single molecule assay (Simoa). Three point zero T magnetic resonance imaging (MRI) examination allowed quantification of T2 lesion and whole-brain volume (WBV). Multiple linear regression models determined the sNfL associated with CABF after correction for demographic and MRI-derived variables.
Results: After adjustment for age, sex and body mass index (BMI), total CABF remained statistically significant and model comparisons showed that CABF explained additional 2.6% of the sNfL variance (β=-0.167, p=0.044). (Table 1) CABF also remained significant in a step-wise regression model (β=0.18, p=0.034) upon the inclusion of T2 lesion burden and WBV effects. The explained sNfL variance improved from 17.4%, 22.7% with the presence of at least 2 CVD variable and 25.8% with both CVD and CABF predictors. Lastly, the disease-modifying therapy was not kept in the final model as an independent predictor of sNfL. Patients in the lowest CABF quartile (CABF≤761 mL/min) had significantly higher sNfL (34.6 pg/mL versus 23.9 pg/mL, adjusted-p=0.042) when compared to the highest quartile (CABF≥1130 mL/min).
Conclusions: Lower CABF is associated with increased sNfL in MS patients, highlighting direct and independent relationship between cerebral hypoperfusion and axonal pathology. This relationship remained significant in the CIS/RRMS after adjusting for age, sex, and BMI effects.
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Jakimovski D, Gibney BL, Marr K, Ramasamy DP, Dwyer MG, Bergsland N, Weinstock-Guttman B, Ramanathan M, Zivadinov R. Lower cerebral arterial blood flow is associated with greater serum neurofilament light chain levels in multiple sclerosis patients. Eur J Neurol 2022; 29:2299-2308. [PMID: 35474598 DOI: 10.1111/ene.15374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 03/14/2022] [Accepted: 04/21/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hypoperfusion, vascular pathology, and cardiovascular risk factors are associated with disease severity in multiple sclerosis (MS). We aimed to assess relationships between cerebral arterial blood flow (CABF) and serum neurofilament light chain (sNfL), as neuronal damage biomarker. METHODS AND MATERIALS Total CABF was measured in 137 patients (86 clinically isolated syndrome (CIS)/relapsing-remitting (RR) and 51 progressive MS (PMS)) and 48 healthy controls (HCs) using Doppler ultrasound. sNfL was quantitated using single molecule assay (Simoa). 3.0T MRI examination allowed quantification of T2 lesion and whole-brain volume (WBV). Multiple linear regression models determined the sNfL associated with CABF after correction for demographic and MRI-derived variables. RESULTS After adjustment for age, sex and BMI, total CABF remained statistically significant and model comparisons showed that CABF explained additional 2.6% of the sNfL variance (β=-0.167, p=0.044). CABF also remained significant in a step-wise regression model (β=0.18, p=0.034) upon the inclusion of T2 lesion burden and WBV effects. Patients in the lowest CABF quartile (CABF≤761mL/min) had significantly higher sNfL (34.6pg/mL versus 23.9pg/mL, adjusted-p=0.042) when compared to the highest quartile (CABF≥1130mL/min). CONCLUSION Lower CABF is associated with increased sNfL in MS patients, highlighting the relationship between cerebral hypoperfusion and axonal pathology.
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Affiliation(s)
- Dejan Jakimovski
- Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Brianna L Gibney
- Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Karen Marr
- Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael G Dwyer
- Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
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Barnett M, Bergsland N, Weinstock-Guttman B, Butzkueven H, Kalincik T, Desmond P, Gaillard F, van Pesch V, Ozakbas S, Rojas JI, Boz C, Altintas A, Wang C, Dwyer MG, Yang S, Jakimovski D, Kyle K, Ramasamy DP, Zivadinov R. Brain atrophy and lesion burden are associated with disability progression in a multiple sclerosis real-world dataset using only T2-FLAIR: The NeuroSTREAM MSBase study. Neuroimage Clin 2021; 32:102802. [PMID: 34469848 PMCID: PMC8408519 DOI: 10.1016/j.nicl.2021.102802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/28/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Methodological challenges limit the use of brain atrophy and lesion burden measures in the follow-up of multiple sclerosis (MS) patients on clinical routine datasets. OBJECTIVE To determine the feasibility of T2-FLAIR-only measures of lateral ventricular volume (LVV) and salient central lesion volume (SCLV), as markers of disability progression (DP) in MS. METHODS A total of 3,228 MS patients from 9 MSBase centers in 5 countries were enrolled. Of those, 2,875 (218 with clinically isolated syndrome, 2,231 with relapsing-remitting and 426 with progressive disease subtype) fulfilled inclusion and exclusion criteria. Patients were scanned on either 1.5 T or 3 T MRI scanners, and 5,750 brain scans were collected at index and on average after 42.3 months at post-index. Demographic and clinical data were collected from the MSBase registry. LVV and SCLV were measured on clinical routine T2-FLAIR images. RESULTS Longitudinal LVV and SCLV analyses were successful in 96% of the scans. 57% of patients had scanner-related changes over the follow-up. After correcting for age, sex, disease duration, disability, disease-modifying therapy and LVV at index, and follow-up time, MS patients with DP (n = 671) had significantly greater absolute LVV change compared to stable (n = 1,501) or disability improved (DI, n = 248) MS patients (2.0 mL vs. 1.4 mL vs. 1.1 mL, respectively, ANCOVA p < 0.001, post-hoc pair-wise DP vs. Stable p = 0.003; and DP vs. DI, p = 0.002). Similar ANCOVA model was also significant for SCLV (p = 0.03). CONCLUSIONS LVV-based atrophy and SCLV-based lesion outcomes are feasible on clinically acquired T2-FLAIR scans in a multicenter fashion and are associated with DP over mid-term.
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Affiliation(s)
- Michael Barnett
- Sydney Neuroimaging Analysis Centre, Camperdown, Sydney, Australia; Brain and Mind Centre, University of Sydney, Sydney, Australia.
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA; IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Italy
| | - Bianca Weinstock-Guttman
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA
| | | | - Tomas Kalincik
- CORe, Department of Medicine, The University of Melbourne, Melbourne, Australia; MS Centre, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Patricia Desmond
- Department of Radiology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Frank Gaillard
- Department of Radiology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | | | | | | | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - Ayse Altintas
- Koç University School of Medicine, Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey
| | - Chenyu Wang
- Sydney Neuroimaging Analysis Centre, Camperdown, Sydney, Australia; Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA; Center for Biomedical Imaging, Clinical Translational Science Institute, USA; University at Buffalo, NY, USA
| | - Suzie Yang
- Sydney Neuroimaging Analysis Centre, Camperdown, Sydney, Australia
| | - Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA
| | - Kain Kyle
- Sydney Neuroimaging Analysis Centre, Camperdown, Sydney, Australia; Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA; Center for Biomedical Imaging, Clinical Translational Science Institute, USA; University at Buffalo, NY, USA
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Fuchs TA, Dwyer MG, Jakimovski D, Bergsland N, Ramasamy DP, Weinstock-Guttman B, Hb Benedict R, Zivadinov R. Quantifying disease pathology and predicting disease progression in multiple sclerosis with only clinical routine T2-FLAIR MRI. Neuroimage Clin 2021; 31:102705. [PMID: 34091352 PMCID: PMC8182301 DOI: 10.1016/j.nicl.2021.102705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 12/17/2022]
Abstract
We explored five brain pathology measures from clinical-quality T2-FLAIR MRI in MS. These included LVV, thalamus volume, MOV, SCLV and network efficiency. T2-FLAIR measures predicted a majority of the variance in research-quality MRI. T2-FLAIR measures correlated with neurologic disability and cognitive function. T2-FLAIR measures predicted disability progression over five-years. T2-FLAIR measures can be used in legacy clinical datasets.
Background Although quantitative measures from research-quality MRI provide a means to study multiple sclerosis (MS) pathology in vivo, these metrics are often unavailable in legacy clinical datasets. Objective To determine how well an automatically-generated quantitative snapshot of brain pathology, measured only on clinical routine T2-FLAIR MRI, can substitute for more conventional measures on research MRI in terms of capturing multi-factorial disease pathology and providing similar clinical relevance. Methods MRI with both research-quality sequences and conventional clinical T2-FLAIR was acquired for 172 MS patients at baseline, and neurologic disability was assessed at baseline and five-years later. Five measures (thalamus volume, lateral ventricle volume, medulla oblongata volume, lesion volume, and network efficiency) for quantifying disparate aspects of neuropathology from low-resolution T2-FLAIR were applied to predict standard research-quality MRI measures. They were compared in regard to association with future neurologic disability and disease progression over five years. Results The combination of the five T2-FLAIR measures explained most of the variance in standard research-quality MRI. T2-FLAIR measures were associated with neurologic disability and cognitive function five-years later (R2 = 0.279, p < 0.001; R2 = 0.382, p < 0.001), similar to standard research-quality MRI (R2 = 0.279, p < 0.001; R2 = 0.366, p < 0.001). They also similarly predicted disability progression over five years (%-correctly-classified = 69.8, p = 0.034), compared to standard research-quality MRI (%-correctly-classified = 72.4%, p = 0.022) in relapsing-remitting MS. Conclusion A set of five T2-FLAIR-only measures can substitute for standard research-quality MRI, especially in relapsing-remitting MS. When only clinical T2-FLAIR is available, it can be used to obtain substantially more quantitative information about brain pathology and disability than is currently standard practice.
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Affiliation(s)
- Tom A Fuchs
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Jacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Ralph Hb Benedict
- Jacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
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Jakimovski D, Zivadinov R, Bergsland N, Ramasamy DP, Hagemeier J, Genovese AV, Hojnacki D, Weinstock-Guttman B, Dwyer MG. Clinical feasibility of longitudinal lateral ventricular volume measurements on T2-FLAIR across MRI scanner changes. Neuroimage Clin 2021; 29:102554. [PMID: 33472143 PMCID: PMC7816007 DOI: 10.1016/j.nicl.2020.102554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 11/18/2022]
Abstract
Central and whole brain atrophy are faster in MS patients with disability progression. These measures can be reliably assessed on clinically-available FLAIR images. They are meaningful even with longitudinal scanner and field strength changes.
Background Greater brain atrophy is associated with disability progression (DP) in patients with multiple sclerosis (PwMS). However, methodological challenges limit its routine clinical use. Objective To determine the feasibility of atrophy measures as markers of DP in PwMS scanned across different MRI field strengths. Methods A total of 980 PwMS were scanned on either 1.5 T or 3.0 T MRI scanners. Demographic and clinical data were retrospectively collected, and the presence of DP was determined according to standard clinical trial criteria. Lateral ventricular volume (LVV) change was measured with the NeuroSTREAM technique on clinical routine T2-FLAIR images. Percent brain volume change (PBVC) was measured using SIENA and ventricular cerebrospinal fluid (vCSF) % change was measured using VIENA and SIENAX algorithms on 3D T1-weighted images (WI). Stable vs. DP PwMS were compared using analysis of covariance (ANCOVA). Mixed modeling determined the effect of MRI scanner change on MRI-derived atrophy measures. Results Longitudinal LVV analysis was successful in all PwMS. SIENA-based PBVC and VIENA-based changes failed in 37.6% of cases, while SIENAX-based vCSF failed in 12.9% of cases. PwMS with DP (n = 241) had significantly greater absolute (20.9% vs. 8.7%, d = 0.66, p < 0.001) and annualized LVV % change (4.1% vs. 2.3%, d = 0.27, p < 0.001) when compared to stable PwMS (n = 739). In subjects with both analyses available, both 3D-T1 and T2-FLAIR-based analyses differentiated PwMS with DP (n = 149). However, only NeuroSTREAM and VIENA-based LVV/vCSF were able to show greater atrophy in PwMS that were scanned on different scanners. PBVC and SIENAX-based vCSF % changes were significantly affected by scanner change (Beta = −0.16, t-statistics = −2.133, p = 0.033 and Beta = −2.08, t-statistics = −4.084, p < 0.001), whereas no MRI scanner change effects on NeuroSTREAM-based PLVVC and VIENA-based vCSF % change were noted. Conclusions LVV-based atrophy on T2-FLAIR is a clinically relevant measure in spite of MRI scanner changes and mild disability levels.
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Affiliation(s)
- Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Antonia Valentina Genovese
- Institute of Radiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - David Hojnacki
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences University at Buffalo, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences University at Buffalo, Buffalo, NY, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.
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Jakimovski D, Zivadinov R, Dwyer MG, Bergsland N, Ramasamy DP, Browne RW, Weinstock-Guttman B, Ramanathan M. High density lipoprotein cholesterol and apolipoprotein A-I are associated with greater cerebral perfusion in multiple sclerosis. J Neurol Sci 2020; 418:117120. [PMID: 32947088 DOI: 10.1016/j.jns.2020.117120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The pathophysiological mechanisms underlying the associations of multiple sclerosis (MS) neurodegeneration serum cholesterol profiles is currently unknown. OBJECTIVE To determine associations between lipid profile measures and cerebral perfusion-based indices in MS patients. METHODS Seventy-seven MS patients underwent 3 T MRI. Cerebral blood volume (CBV), time-to-peak (TTP) and mean transit time (MTT) measures were computed from dynamic susceptibility contrast (DSC) perfusion-weighted imaging (PWI) for normal-appearing brain tissue (NABT), GM, cortex, deep gray matter (DGM) and thalamus. Total cholesterol, low and high-density lipoprotein cholesterol (LDL-C and HDL-C) and the apolipoproteins (Apo), ApoA-I, ApoA-II, ApoB, ApoC-II and ApoE levels were measured in plasma. Age and body mass index (BMI)-adjusted correlations were used to assess the associations between PWI and lipid profile measures. RESULTS Higher HDL-C levels were associated with shorter MTT, which are indicative of greater perfusion, in NABT (p = 0.012), NAWM (p = 0.021), GM (p = 0.009), cortex (p = 0.014), DGM p = 0.015; and thalamus p = 0.015). The HDL-C-associated apolipoproteins, ApoA-I and ApoA-II, were associated with shorter MTT of the same brain regions (all p < 0.028). HDL-C and ApoA-I levels were also associated with shorter TTP, indicative of faster cerebral blood delivery. ApoC-II was associated with lower nCBV of the GM and cortex (p = 0.035 and p = 0.014, respectively). CONCLUSION The HDL pathway is associated with better global brain perfusion and faster cerebral blood delivery as measured by shorter MTT and TTP, respectively. ApoC-II may be associated with lower cortical and DGM perfusion.
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Affiliation(s)
- Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Richard W Browne
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, NY, USA
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
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Ziliotto N, Zivadinov R, Jakimovski D, Baroni M, Bergsland N, Ramasamy DP, Weinstock-Guttman B, Ramanathan M, Marchetti G, Bernardi F. Relationships Among Circulating Levels of Hemostasis Inhibitors, Chemokines, Adhesion Molecules, and MRI Characteristics in Multiple Sclerosis. Front Neurol 2020; 11:553616. [PMID: 33178104 PMCID: PMC7593335 DOI: 10.3389/fneur.2020.553616] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Several studies suggested cross talk among components of hemostasis, inflammation, and immunity pathways in the pathogenesis, neurodegeneration, and occurrence of cerebral microbleeds (CMBs) in multiple sclerosis (MS). Objectives: This study aimed to evaluate the combined contribution of the hemostasis inhibitor protein C (PC) and chemokine C-C motif ligand 18 (CCL18) levels to brain atrophy in MS and to identify disease-relevant correlations among circulating levels of hemostasis inhibitors, chemokines, and adhesion molecules, particularly in CMB occurrence in MS. Methods: Plasma levels of hemostasis inhibitors (ADAMTS13, PC, and PAI1), CCL18, and soluble adhesion molecules (sNCAM, sICAM1, sVCAM1, and sVAP1) were evaluated by multiplex in 138 MS patients [85 relapsing-remitting (RR-MS) and 53 progressive (P-MS)] and 42 healthy individuals (HI) who underwent 3-T MRI exams. Association of protein levels with MRI outcomes was performed by regression analysis. Correlations among protein levels were assessed by partial correlation and Pearson's correlation. Results: In all patients, regression analysis showed that higher PC levels were associated with lower brain volumes, including the brain parenchyma (p = 0.002), gray matter (p < 0.001), cortex (p = 0.001), deep gray matter (p = 0.001), and thalamus (p = 0.001). These associations were detectable in RR-MS but not in P-MS patients. Higher CCL18 levels were associated with higher T2-lesion volumes in all MS patients (p = 0.03) and in the P-MS (p = 0.003). In the P-MS, higher CCL18 levels were also associated with lower volumes of the gray matter (p = 0.024), cortex (p = 0.043), deep gray matter (p = 0.029), and thalamus (p = 0.022). PC-CCL18 and CCL18-PAI1 levels were positively correlated in both MS and HI, PC–sVAP1 and PAI1–sVCAM1 only in MS, and PC–sICAM1 and PC–sNCAM only in HI. In MS patients with CMBs (n = 12), CCL18–PAI1 and PAI1–sVCAM1 levels were better correlated than those in MS patients without CMBs, and a novel ADAMTS13–sVAP1 level correlation (r = 0.78, p = 0.003) was observed. Conclusions: Differences between clinical phenotype groups in association of PC and CCL18 circulating levels with MRI outcomes might be related to different aspects of neurodegeneration. Disease-related pathway dysregulation is supported by several protein level correlation differences between MS patients and HI. The integrated analysis of plasma proteins and MRI measures provide evidence for new relationships among hemostasis, inflammation, and immunity pathways, relevant for MS and for the occurrence of CMBs.
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Affiliation(s)
- Nicole Ziliotto
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York, Buffalo, NY, United States.,Center for Biomedical Imaging at the Clinical Translational Science Institute, State University of New York, Buffalo, NY, United States
| | - Dejan Jakimovski
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York, Buffalo, NY, United States
| | - Marcello Baroni
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York, Buffalo, NY, United States.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York, Buffalo, NY, United States
| | - Bianca Weinstock-Guttman
- Center for Biomedical Imaging at the Clinical Translational Science Institute, State University of New York, Buffalo, NY, United States
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, United States
| | - Giovanna Marchetti
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Francesco Bernardi
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
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Pol S, Liang S, Schweser F, Dhanraj R, Schubart A, Preda M, Sveinsson M, Ramasamy DP, Dwyer MG, Weckbecker G, Zivadinov R. Subcutaneous anti-CD20 antibody treatment delays gray matter atrophy in human myelin oligodendrocyte glycoprotein-induced EAE mice. Exp Neurol 2020; 335:113488. [PMID: 32991933 DOI: 10.1016/j.expneurol.2020.113488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/18/2020] [Accepted: 09/25/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The human myelin oligodendrocyte glycoprotein-induced experimental autoimmune encephalomyelitis (huMOG-EAE) model, generates B-cell driven demyelination in mice, making it a suitable multiple sclerosis model to study B cell depletion. OBJECTIVES We investigated the effect of subcutaneous anti-CD20 antibody treatment on huMOG-EAE gray matter (GM) pathology. METHODS C57Bl/6, 8-week old mice were immunized with 200 huMOG1-125 and treated with 50 μg/mouse of anti-CD20 antibody (n = 16) or isotype control (n = 16). Serial brain volumetric 9.4 T MRI scans was performed at baseline, 1 and 5 wkPI. Disease severity was measured by clinical disability score (CDS) and performance on rotarod test. RESULTS Anti-CD20 antibody significantly reduced brain volume loss compared with the isotype control across all timepoints longitudinally in the basal ganglia (p = 0.01), isocortex (p = 0.025) and thalamus (p = 0.023). The CDS was reduced significantly with anti-CD20 antibody vs. the isotype control at 3 (p = 0.003) and 4 (p = 0.03) wkPI, while a trend was observed at 5 (p = 0.057) and 6 (p = 0.086) wkPI. Performance on rotarod was also improved significantly at 3 (p = 0.007) and 5 (p = 0.01) wkPI compared with the isotype control. At cellular level, anti-CD20 therapy suppressed the percentage of proliferative nuclear antigen positive microglia in huMOG-EAE isocortex (p = 0.016). Flow cytometry confirmed that anti-CD20 antibody strongly depleted the CD19-expressing B cell fraction in peripheral blood mononuclear cells, reducing it from 39.7% measured in isotype control to 1.59% in anti-CD20 treated mice (p < 0.001). CONCLUSIONS Anti-CD20 antibody treatment delayed brain tissue neurodegeneration in GM, and showed clinical benefit on measures of disease severity in huMOG-EAE mice.
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Affiliation(s)
- Suyog Pol
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Serena Liang
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, NY, USA
| | - Ravendra Dhanraj
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Anna Schubart
- Novartis Institutes of BioMedical Research, Department of Transplantation and Immunology, Novartis, Basel, Switzerland
| | - Marilena Preda
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michele Sveinsson
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, NY, USA
| | - Gisbert Weckbecker
- Novartis Institutes of BioMedical Research, Department of Transplantation and Immunology, Novartis, Basel, Switzerland
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, NY, USA.
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9
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McComb M, Krikheli M, Uher T, Browne RW, Srpova B, Oechtering J, Maceski AM, Tyblova M, Jakimovski D, Ramasamy DP, Bergsland N, Krasensky J, Noskova L, Fialova L, Weinstock-Guttman B, Havrdova EK, Vaneckova M, Zivadinov R, Horakova D, Kuhle J, Ramanathan M. Neuroprotective associations of apolipoproteins A-I and A-II with neurofilament levels in early multiple sclerosis. J Clin Lipidol 2020; 14:675-684.e2. [DOI: 10.1016/j.jacl.2020.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 12/16/2022]
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Ghione E, Bergsland N, Dwyer MG, Hagemeier J, Jakimovski D, Ramasamy DP, Hojnacki D, Lizarraga AA, Kolb C, Eckert S, Weinstock-Guttman B, Zivadinov R. Disability Improvement Is Associated with Less Brain Atrophy Development in Multiple Sclerosis. AJNR Am J Neuroradiol 2020; 41:1577-1583. [PMID: 32763899 DOI: 10.3174/ajnr.a6684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 06/01/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE It is unknown whether deceleration of brain atrophy is associated with disability improvement in patients with MS. Our aim was to investigate whether patients with MS with disability improvement develop less brain atrophy compared with those who progress in disability or remain stable. MATERIALS AND METHODS We followed 980 patients with MS for a mean of 4.8 ± 2.4 years. Subjects were divided into 3 groups: progress in disability (n = 241, 24.6%), disability improvement (n = 101, 10.3%), and stable (n = 638, 65.1%) at follow-up. Disability improvement and progress in disability were defined on the basis of the Expanded Disability Status Scale score change using standardized guidelines. Stable was defined as nonoccurrence of progress in disability or disability improvement. Normalized whole-brain volume was calculated using SIENAX on 3D T1WI, whereas the lateral ventricle was measured using NeuroSTREAM on 2D-T2-FLAIR images. The percentage brain volume change and percentage lateral ventricle volume change were calculated using SIENA and NeuroSTREAM, respectively. Differences among groups were investigated using ANCOVA, adjusted for age at first MR imaging, race, T2 lesion volume, and corresponding baseline structural volume and the Expanded Disability Status Scale. RESULTS At first MR imaging, there were no differences among progress in disability, disability improvement, and the stable groups in whole-brain volume (P = .71) or lateral ventricle volume (P = .74). During follow-up, patients with disability improvement had the lowest annualized percentage lateral ventricle volume change (1.6% ± 2.7%) followed by patients who were stable (2.1% ± 3.7%) and had progress in disability (4.1% ± 5.5%), respectively (P < .001). The annualized percentage brain volume change values were -0.7% ± 0.7% for disability improvement, -0.8% ± 0.7% for stable, and -1.1% ± 1.1% for progress in disability (P = .001). CONCLUSIONS Patients with MS who improve in their clinical disability develop less brain atrophy across time compared with those who progress.
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Affiliation(s)
- E Ghione
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
| | - N Bergsland
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
- IRCCS (N.B.), Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - M G Dwyer
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
- Center for Biomedical Imaging at the Clinical Translational Science Institute (M.G.D., R.Z.),University at Buffalo, State University of New York, Buffalo, New York
| | - J Hagemeier
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D Jakimovski
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D P Ramasamy
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D Hojnacki
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - A A Lizarraga
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - C Kolb
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - S Eckert
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - B Weinstock-Guttman
- Department of Neurology (D.H., A.A.L., C.K., S.E., B.W.-G.), Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences
| | - R Zivadinov
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., D.P.R., R.Z.), Buffalo Neuroimaging Analysis Center
- Center for Biomedical Imaging at the Clinical Translational Science Institute (M.G.D., R.Z.),University at Buffalo, State University of New York, Buffalo, New York
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11
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Jakimovski D, Bergsland N, Dwyer MG, Traversone J, Hagemeier J, Fuchs TA, Ramasamy DP, Weinstock-Guttman B, Benedict RHB, Zivadinov R. Cortical and Deep Gray Matter Perfusion Associations With Physical and Cognitive Performance in Multiple Sclerosis Patients. Front Neurol 2020; 11:700. [PMID: 32765407 PMCID: PMC7380109 DOI: 10.3389/fneur.2020.00700] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/09/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Reports suggest presence of cerebral hypoperfusion in multiple sclerosis (MS). Currently there are no studies that examine if the cerebral MS perfusion is affected by presence of cardiovascular comorbidities. Objective: To investigate associations between cerebral perfusion and disease outcomes in MS patients with and without comorbid cardiovascular diseases (CVD). Materials: One hundred three MS patients (75.7% female) with average age of 54.4 years and 21.1 years of disease duration underwent 3T MRI dynamic susceptibility contrast (DSC) imaging and were tested with Expanded Disability Status Scale, Multiple Sclerosis Severity Score (MSSS), Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9HPT) and Symbol Digit Modalities Test (SDMT). Structural and perfusion-based normalized measures of cerebral blood flow (nCBF), cerebral blood volume (nCBV) and mean transit time (MTT) of global, tissue-specific and deep gray matter (DGM) areas were derived. CBV and CBF were normalized by the normal-appearing white matter counterpart. Results: In linear step-wise regression analysis, age- and sex-adjusted, MSSS (R 2 = 0.186) was associated with whole brain volume (WBV) (β = -0.244, p = 0.046) and gray matter (GM) nCBF (β = -0.22, p = 0.035). T25FW (R 2 = 0.278) was associated with WBV (β = -0.289, p = 0.012) and hippocampus nCBV (β = -0.225, p = 0.03). 9HPT (R 2 = 0.401) was associated with WBV (β = 0.195, p = 0.049) and thalamus MTT (β = -0.198, p=0.032). After adjustment for years of education, SDMT (R 2 = 0.412) was explained by T2-lesion volume (β = -0.305, p = 0.001), and GM nCBV (β = 0.236, p = 0.013). No differences in MTT, nCBF nor nCBV measures between patients with (n = 42) and without CVD (n = 61) were found. Perfusion-measures were also not able to distinguish CVD status in a logistic regression model. Conclusion: Decreased GM and deep GM perfusion is associated with poorer MS outcomes, but not with presence of CVD.
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Affiliation(s)
- Dejan Jakimovski
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.,IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Michael G Dwyer
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - John Traversone
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Jesper Hagemeier
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Tom A Fuchs
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.,Department of Neurology, Jacobs Multiple Sclerosis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Multiple Sclerosis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - Ralph H B Benedict
- Department of Neurology, Jacobs Multiple Sclerosis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.,Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, United States
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12
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Ashton K, Fuchs TA, Oship D, Zivadinov R, Jakimovski D, Bergsland N, Ramasamy DP, Vaughn C, Weinstock-Guttman B, Benedict RHB, Dwyer MG. Diagnosis of depression in multiple sclerosis is predicted by frontal-parietal white matter tract disruption. J Neurol 2020; 268:169-177. [PMID: 32754832 DOI: 10.1007/s00415-020-10110-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Persons with multiple sclerosis (PwMS) are at an elevated risk of depression. Decreased Conscientiousness may affect patient outcomes in PwMS. Low Conscientiousness has a strong correlation with depression. Previous work has also reported that white matter (WM) tract disruption in frontal-parietal networks explains reduced Conscientiousness in PwMS. OBJECTIVE We hypothesized that Conscientiousness-associated WM tract disruption predicts new-onset depression over 5 years in PwMS and evaluated this by assessing the predictive power of mean Conscientiousness associated frontal-parietal network (CFPN) disruption in PwMS for clinically diagnosed depression over 5 years. METHODS This longitudinal retrospective analysis included 53 PwMS who were not previously diagnosed as depressed. All participants underwent structural MRI. Medical records were reviewed to evaluate diagnosis of depression for these patients over 5 years. WM tract damage between pairs of gray matter regions in the CFPN was measured using diffusion imaging. The relationship between CFPN disruption and depression was analyzed using logistic regression. RESULTS Participants with MS had a mean age of 46.0 years (SD = 11.2). 22.6% (n = 12) acquired a diagnosis of clinical depression over the 5-year period. Baseline disruption in the CFPN was a significant predictor (ROC AUC = 61.8%). of new-onset clinical depression, accounting for age, sex, lateral ventricular volume, disease modifying treatment, and lesion volume. CONCLUSION Baseline CFPN disruption is associated with progression to clinical depression over 5 years in PwMS. Development of new WM pathology within this network may be a risk factor for depression.
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Affiliation(s)
- Kira Ashton
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA
- Department of Neurology, Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
- Center for Behavioral Neuroscience, American University, Washington, DC, USA
| | - Tom A Fuchs
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA
- Department of Neurology, Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Devon Oship
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA
- Department of Neurology, Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA
- Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Dejan Jakimovski
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA
| | - Caila Vaughn
- Department of Neurology, Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA
- Department of Neurology, Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Ralph H B Benedict
- Department of Neurology, Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Michael G Dwyer
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), 100 High St., Buffalo, NY, 14226, USA.
- Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA.
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13
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Jakimovski D, Zivadinov R, Bergsland N, Ramasamy DP, Hagemeier J, Weinstock-Guttman B, Kolb C, Hojnacki D, Dwyer MG. Sex-Specific Differences in Life Span Brain Volumes in Multiple Sclerosis. J Neuroimaging 2020; 30:342-350. [PMID: 32392376 DOI: 10.1111/jon.12709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Numerous sex-specific differences in multiple sclerosis (MS) susceptibility, disease manifestation, disability progression, inflammation, and neurodegeneration have been previously reported. Previous magnetic resonance imaging (MRI) studies have shown structural differences between female and male MS brain volumes. To determine sex-specific global and tissue-specific brain volume throughout the MS life span in a real-world large MRI database. METHODS A total of 2,199 MS patients (female/male ratio of 1,651/548) underwent structural MRI imaging on either a 1.5-T or 3-T scanner. Global and tissue-specific volumes of whole brain (WBV), white matter, and gray matter (GMV) were determined by utilizing Structural Image Evaluation using Normalisation of Atrophy Cross-sectional (SIENAX). Lateral ventricular volume (LVV) was determined with the Neurological Software Tool for REliable Atrophy Measurement (NeuroSTREAM). General linear models investigated sex and age interactions, and post hoc comparative sex analyses were performed. RESULTS Despite being age-matched with female MS patents, a greater proportion of male MS patients were diagnosed with progressive MS and had lower normalized WBV (P < .001), GMV (P < .001), and greater LVV (P < .001). In addition to significant stand-alone main effects, an interaction between sex and age had an additional effect on the LVV (F-statistics = 4.53, P = .033) and GMV (F-statistics = 4.59, P = .032). The sex and age interaction was retained in both models of LVV (F-statistics = 3.31, P = .069) and GMV (F-statistics = 6.1, P = .003) when disease subtype and disease-modifying treatment (DMT) were also included. Although male MS patients presented with significantly greater LVV and lower GMV during the early and midlife period when compared to their female counterparts (P < .001 for LVV and P < .019 for GMV), these differences were nullified in 60+ years old patients. Similar findings were seen within a subanalysis of MS patients that were not on any DMT at the time of enrollment. CONCLUSION There are sex-specific differences in the LVV and GMV over the MS life span.
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Affiliation(s)
- Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.,Translational Imaging Center at Clinical Translational Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.,IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Bianca Weinstock-Guttman
- Jacobs MS Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY
| | - Channa Kolb
- Jacobs MS Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY
| | - David Hojnacki
- Jacobs MS Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
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14
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Jakimovski D, Bergsland N, Dwyer MG, Hagemeier J, Ramasamy DP, Szigeti K, Guttuso T, Lichter D, Hojnacki D, Weinstock-Guttman B, Benedict RHB, Zivadinov R. Long-standing multiple sclerosis neurodegeneration: volumetric magnetic resonance imaging comparison to Parkinson's disease, mild cognitive impairment, Alzheimer's disease, and elderly healthy controls. Neurobiol Aging 2020; 90:84-92. [PMID: 32147244 DOI: 10.1016/j.neurobiolaging.2020.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 12/16/2022]
Abstract
Multiple sclerosis (MS) exhibits neurodegeneration driven disability progression. We compared the extent of neurodegeneration among 112 long-standing MS patients, 37 Parkinson's disease (PD) patients, 34 amnestic mild cognitive impairment (aMCI) patients, 37 Alzheimer's disease (AD) patients, and 184 healthy controls. 3T MRI volumes of whole brain (WBV), white matter (WMV), gray matter (GMV), cortical (CV), deep gray matter (DGM), and nuclei-specific volumes of thalamus, caudate, putamen, globus pallidus, and hippocampus were derived with SIENAX and FIRST software. Аge and sex-adjusted analysis of covariance was used. WBV was not significantly different between diseases. MS had significantly lower WMV compared to other disease groups (p < 0.021). Only AD had smaller GMV and CV when compared to MS (both p < 0.001). MS had smaller DGM volume than PD and aMCI (p < 0.001 and p = 0.026, respectively) and lower thalamic volume when compared to all other neurodegenerative diseases (p < 0.008). Long-standing MS exhibits comparable global atrophy with lower WMV and thalamic volume when compared to other classical neurodegenerative diseases.
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Affiliation(s)
- Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Kinga Szigeti
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Thomas Guttuso
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - David Lichter
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - David Hojnacki
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Ralph H B Benedict
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.
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15
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Genovese AV, Hagemeier J, Bergsland N, Jakimovski D, Dwyer MG, Ramasamy DP, Lizarraga AA, Hojnacki D, Kolb C, Weinstock-Guttman B, Zivadinov R. Atrophied Brain T2 Lesion Volume at MRI Is Associated with Disability Progression and Conversion to Secondary Progressive Multiple Sclerosis. Radiology 2019; 293:424-433. [PMID: 31549947 PMCID: PMC6823621 DOI: 10.1148/radiol.2019190306] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 07/06/2019] [Accepted: 08/09/2019] [Indexed: 12/13/2022]
Abstract
Background Atrophied T2 lesion volume at MRI is an imaging measure that reflects the replacement of T2 lesions by cerebrospinal fluid spaces in patients with multiple sclerosis (MS). Purpose To investigate the association of atrophied T2 lesion volume and development of disability progression (DP) and conversion to secondary progressive MS (SPMS). Materials and Methods This retrospective study included 1612 participants recruited from 2006 to 2016 and followed up for 5 years with clinical and MRI examinations. Accumulation of T2 lesion volume, atrophied T2 lesion volume, percentage brain volume change (PBVC), and percentage ventricular volume change (PVVC) were measured. Disability progression and secondary progressive conversion were defined by using standardized guidelines. Analysis of covariance (ANCOVA) adjusted for age and Cox regression adjusted for age and sex were used to compare study groups and explore associations between MRI and clinical outcomes. Results A total of 1314 patients with MS (1006 women; mean age, 46 years ± 11 [standard deviation]) and 124 patients with clinically isolated syndrome (100 women; mean age, 39 years ± 11) along with 147 healthy control subjects (97 women; mean age, 42 years ± 13) were evaluated. A total of 336 of 1314 (23%) patients developed DP, and in 67 of 1213 (5.5%) the disease converted from clinically isolated syndrome (CIS) or relapsing-remitting MS (RRMS) to SPMS. Patients with conversion to DP had higher atrophied T2 lesion volume (+34.4 mm3; 95% confidence interval [CI]: 17.2 mm3, 51.5 mm3; d = 0.27; P < .001) and PBVC (-0.21%; 95% CI: -0.36%, -0.05%; d = 0.19; P = .042) but not PVVC (0.36%; 95% CI: -0.93%, 1.65%; d = 0.04; P = .89) or T2 lesion volume change (-64.5 mm3; 95% CI: -315.2 mm3, 186.3 mm3; d = 0.03; P = .67) when compared with DP nonconverters. ANCOVA showed that atrophied T2 lesion volume was associated with conversion from CIS or RRMS to SPMS (+26.4 mm3; 95% CI: 4.2 mm3, 56.9 mm3; d = 0.23; P = .002) but not PBVC (-0.14%; 95% CI: -0.46%, 0.18%; d = 0.11; P = .66), PVVC (+0.18%; 95% CI: -2.49%, 2.72%; d = 0.01; P = .75), or T2 lesion volume change (-46.4 mm3; 95% CI: -460.8 mm3, 367.9 mm3; d = 0.03; P = .93). At Cox regression analysis, only atrophied T2 lesion volume was associated with the DP (hazard ratio, 1.23; P < .001) and conversion to SPMS (hazard ratio, 1.16; P = .008). Conclusion Atrophied brain T2 lesion volume is a robust MRI marker of MS disability progression and conversion into a secondary progressive disease course. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Chiang in this issue.
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Affiliation(s)
- Antonia Valentina Genovese
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Jesper Hagemeier
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Niels Bergsland
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Dejan Jakimovski
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Michael G. Dwyer
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Deepa P. Ramasamy
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Alexis A. Lizarraga
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - David Hojnacki
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Channa Kolb
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Bianca Weinstock-Guttman
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
| | - Robert Zivadinov
- From the Buffalo Neuroimaging Analysis Center (A.V.G., J.H., N.B.,
D.J., M.G.D., D.P.R., R.Z.) and Jacobs MS Center (A.A.L., D.H., C.K.),
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, State University of New York, 100 High St, Buffalo, NY
14203; Institute of Radiology, Department of Clinical Surgical Diagnostic and
Pediatric Sciences, University of Pavia, Pavia, Italy (A.V.G.); and Center for
Biomedical Imaging at Clinical Translational Science Institute (M.G.D., B.W.,
R.Z.), University at Buffalo, State University of New York, Buffalo, NY
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16
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Zivadinov R, Polak P, Schweser F, Bergsland N, Hagemeier J, Dwyer MG, Ramasamy DP, Baker JG, Leddy JJ, Willer BS. Multimodal Imaging of Retired Professional Contact Sport Athletes Does Not Provide Evidence of Structural and Functional Brain Damage. J Head Trauma Rehabil 2019; 33:E24-E32. [PMID: 30080799 DOI: 10.1097/htr.0000000000000422] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Long-term consequences of playing professional football and hockey on brain function and structural neuronal integrity are unknown. OBJECTIVES To investigate multimodal metabolic and structural brain magnetic resonance imaging (MRI) differences in retired professional contact sport athletes compared with noncontact sport athletes. METHODS Twenty-one male contact sport athletes and 21 age-matched noncontact sport athletes were scanned on a 3 tesla (3T) MRI using a multimodal imaging approach. The MRI outcomes included presence, number, and volume of focal white matter signal abnormalities, volumes of global and regional tissue-specific brain structures, diffusion-tensor imaging tract-based spatial statistics measures of mean diffusivity and fractional anisotropy, quantitative susceptibility mapping of deep gray matter, presence, number, and volume of cerebral microbleeds, MR spectroscopy N-acetyl-aspartate, glutamate, and glutamine concentrations relative to creatine and phosphor creatine of the corpus callosum, and perfusion-weighted imaging mean transit time, cerebral blood flow, and cerebral blood volume outcomes. Subjects were also classified as having mild cognitive impairment. RESULTS No significant differences were found for structural or functional MRI measures between contact sport athletes and noncontact sport athletes. CONCLUSIONS This multimodal imaging study did not show any microstructural, metabolic brain tissue injury differences in retired contact versus non-contact sport athletes.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology (Drs Zivadinov, Polak, Schweser, Bergsland, Hagemeier, Dwyer, and Ramasamy), MR Imaging Clinical and Translational Research Center (Drs Zivadinov and Schweser), Department of Orthopaedics (Drs Baker and Leddy), Department of Nuclear Medicine (Dr Baker), and Department of Psychiatry (Dr Willer), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo
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17
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Ziliotto N, Zivadinov R, Baroni M, Marchetti G, Jakimovski D, Bergsland N, Ramasamy DP, Weinstock-Guttman B, Straudi S, Manfredini F, Ramanathan M, Bernardi F. Plasma levels of protein C pathway proteins and brain magnetic resonance imaging volumes in multiple sclerosis. Eur J Neurol 2019; 27:235-243. [PMID: 31408242 DOI: 10.1111/ene.14058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/05/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE The involvement of protein C (PC) pathway components in multiple sclerosis (MS) has scarcely been explored. The aim was to investigate their levels in relation to clinical and neurodegenerative magnetic resonance imaging (MRI) outcomes in patients. METHODS In all, 138 MS patients and 42 healthy individuals were studied. PC, protein S (PS) and soluble endothelial protein C receptor (sEPCR) were evaluated by multiplex assays and enzyme-linked immunosorbent assay. Regression analyses between 3 T MRI outcomes and PC pathway components were performed. ancova was used to compare MRI volumes based on protein level quartiles. Partial correlation was assessed amongst levels of PC pathway components and hemostasis protein levels, including soluble thrombomodulin (sTM), heparin cofactor II (HCII), plasminogen activator inhibitor 1 (PAI-1) and factor XII (FXII). The variation of PC concentration across four time points was evaluated in 32 additional MS patients. RESULTS There was an association between PC concentration, mainly reflecting the zymogen PC, and MRI measures for volumes of total gray matter (GM) (P = 0.003), thalamus (P = 0.007), cortex (P = 0.008), deep GM (P = 0.009) and whole brain (P = 0.026). Patients in the highest PC level quartile were characterized by the lowest GM volumes. Correlations of PC-HCII, PC-FXII and sEPCR-sTM values were detectable in MS patients, whilst PC-PS and PS-PAI-1 correlations were present in healthy individuals only. CONCLUSIONS Protein C plasma concentrations might be associated with neurodegenerative MRI outcomes in MS. Several differences in correlation amongst protein plasma levels suggest dysregulation of PC pathway components in MS patients. The stability of PC concentration over time supports a PC investigation in relation to GM atrophy in MS.
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Affiliation(s)
- N Ziliotto
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy.,Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | - R Zivadinov
- Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA.,Neurology, State University of New York, Buffalo, NY, USA
| | - M Baroni
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - G Marchetti
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - D Jakimovski
- Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | - N Bergsland
- Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | - D P Ramasamy
- Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | | | - S Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - F Manfredini
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - M Ramanathan
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - F Bernardi
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
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18
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Fuchs TA, Benedict RHB, Bartnik A, Choudhery S, Li X, Mallory M, Oship D, Yasin F, Ashton K, Jakimovski D, Bergsland N, Ramasamy DP, Weinstock-Guttman B, Zivadinov R, Dwyer MG. Preserved network functional connectivity underlies cognitive reserve in multiple sclerosis. Hum Brain Mapp 2019; 40:5231-5241. [PMID: 31444887 PMCID: PMC6864900 DOI: 10.1002/hbm.24768] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/26/2019] [Accepted: 08/08/2019] [Indexed: 12/27/2022] Open
Abstract
Cognitive reserve is one's mental resilience or resistance to the effects of structural brain damage. Reserve effects are well established in people with multiple sclerosis (PwMS) and Alzheimer's disease, but the neural basis of this phenomenon is unclear. We aimed to investigate whether preservation of functional connectivity explains cognitive reserve. Seventy‐four PwMS and 29 HCs underwent neuropsychological assessment and 3 T MRI. Structural damage measures included gray matter (GM) atrophy and network white matter (WM) tract disruption between pairs of GM regions. Resting‐state functional connectivity was also assessed. PwMS exhibited significantly impaired cognitive processing speed (t = 2.14, p = .037) and visual/spatial memory (t = 2.72, p = .008), and had significantly greater variance in functional connectivity relative to HCs within relevant networks (p < .001, p < .001, p = .016). Higher premorbid verbal intelligence, a proxy for cognitive reserve, predicted relative preservation of functional connectivity despite accumulation of GM atrophy (standardized‐β = .301, p = .021). Furthermore, preservation of functional connectivity attenuated the impact of structural network WM tract disruption on cognition (β = −.513, p = .001, for cognitive processing speed; β = −.209, p = .066, for visual/spatial memory). The data suggests that preserved functional connectivity explains cognitive reserve in PwMS, helping to maintain cognitive capacity despite structural damage.
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Affiliation(s)
- Tom A Fuchs
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Ralph H B Benedict
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Alexander Bartnik
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Sanjeevani Choudhery
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Xian Li
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Matthew Mallory
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Devon Oship
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Faizan Yasin
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Kira Ashton
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Dejan Jakimovski
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Niels Bergsland
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Deepa P Ramasamy
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Robert Zivadinov
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Michael G Dwyer
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
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19
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Zivadinov R, Bergsland N, Hagemeier J, Ramasamy DP, Dwyer MG, Schweser F, Kolb C, Weinstock-Guttman B, Hojnacki D. Cumulative gadodiamide administration leads to brain gadolinium deposition in early MS. Neurology 2019; 93:e611-e623. [PMID: 31285398 PMCID: PMC6709999 DOI: 10.1212/wnl.0000000000007892] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 04/02/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Frequent administration of gadolinium-based contrast agents in multiple sclerosis (MS) may increase signal intensity (SI) unenhanced T1-weighted imaging MRI throughout the brain. We evaluated the association between lifetime cumulative doses of gadodiamide administration and increased SI within the dentate nucleus (DN), globus pallidus (GP), and thalamus in patients with early MS. METHODS A total of 203 patients with MS (107 with baseline and follow-up MRI assessments) and 262 age- and sex-matched controls were included in this retrospective, longitudinal, 3T MRI-reader-blinded study. Patients with MS had disease duration <2 years at baseline and received exclusively gadodiamide at all MRI time points. SI ratio (SIR) to pons and CSF of lateral ventricle volume (CSF-LVV) were assessed. Analysis of covariance and correlation analyses, adjusted for age, sex, and region of interest volume, were used. RESULTS The mean follow-up time was 55.4 months, and the mean number of gadolinium-based contrast agents administrations was 9.2. At follow-up, 49.3% of patients with MS and no controls showed DN T1 hyperintensity (p < 0.001). The mean SIR of DN (p < 0.001) and of GP (p = 0.005) to pons and the mean SIR of DN, GP, and thalamus to CSF-LVV were higher in patients with MS compared to controls (p < 0.001). SIR of DN to pons was associated with number of gadodiamide doses (p < 0.001). No associations between SIR of DN, GP, and thalamus and clinical and MRI outcomes of disease severity were detected over the follow-up. CONCLUSIONS DN, GP, and thalamus gadolinium deposition in early MS is associated with lifetime cumulative gadodiamide administration without clinical or radiologic correlates of more aggressive disease.
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Affiliation(s)
- Robert Zivadinov
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York.
| | - Niels Bergsland
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Jesper Hagemeier
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Deepa P Ramasamy
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Michael G Dwyer
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Ferdinand Schweser
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Channa Kolb
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Bianca Weinstock-Guttman
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - David Hojnacki
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
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Dwyer MG, Bergsland N, Ramasamy DP, Weinstock‐Guttman B, Barnett MH, Wang C, Tomic D, Silva D, Zivadinov R. Salient Central Lesion Volume: A Standardized Novel Fully Automated Proxy for Brain FLAIR Lesion Volume in Multiple Sclerosis. J Neuroimaging 2019; 29:615-623. [DOI: 10.1111/jon.12650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Michael G. Dwyer
- Buffalo Neuroimaging Analysis Center, Department of NeurologyJacobs School of Medicine and Biomedical Sciences Buffalo NY
- Center for Biomedical ImagingClinical Translational Science Institute Buffalo NY
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of NeurologyJacobs School of Medicine and Biomedical Sciences Buffalo NY
| | - Deepa P. Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of NeurologyJacobs School of Medicine and Biomedical Sciences Buffalo NY
| | - Bianca Weinstock‐Guttman
- Jacobs Comprehensive Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at BuffaloState University of New York Buffalo NY
| | - Michael H. Barnett
- Sydney Neuroimaging Analysis CentreBrain and Mind Centre Sydney NSW Australia
- Department of NeurologyRoyal Prince Alfred Hospital Sydney NSW Australia
| | - Chenyu Wang
- Sydney Neuroimaging Analysis CentreBrain and Mind Centre Sydney NSW Australia
| | | | | | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of NeurologyJacobs School of Medicine and Biomedical Sciences Buffalo NY
- Center for Biomedical ImagingClinical Translational Science Institute Buffalo NY
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21
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Fuchs TA, Benedict RH, Wilding G, Wojcik C, Jakimovski D, Bergsland N, Ramasamy DP, Weinstock-Guttman B, Zivadinov R, Dwyer MG. Trait Conscientiousness predicts rate of brain atrophy in multiple sclerosis. Mult Scler 2019; 26:1433-1436. [PMID: 31219390 DOI: 10.1177/1352458519858605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conscientiousness is a core personality trait with favorable prognosis in neuropsychiatric disease. OBJECTIVE We aimed to determine whether baseline Conscientiousness predicts future brain atrophy in multiple sclerosis (MS) after accounting for demographic and basic clinical characteristics. METHODS Trait Conscientiousness, clinical features, and Expanded Disability Status Scale (EDSS) were obtained at baseline. Lateral ventricle volume (LVV) was measured longitudinally. In a retrospective general linear mixed effects model, data from 424 patients were analyzed (mean 6 time-points, up to 15 years). RESULTS/CONCLUSION We observed significant age and Conscientiousness by time-from-baseline interactions indicating that younger age and higher Conscientiousness are associated with reduced progression of brain atrophy.
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Affiliation(s)
- Tom A Fuchs
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/ Jacobs Multiple Sclerosis Center for Treatment and Research, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Ralph Hb Benedict
- Jacobs Multiple Sclerosis Center for Treatment and Research, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Gregory Wilding
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Curtis Wojcik
- Jacobs Multiple Sclerosis Center for Treatment and Research, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/ Jacobs Multiple Sclerosis Center for Treatment and Research, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/ Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/ Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
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22
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Ghione E, Bergsland N, Dwyer MG, Hagemeier J, Jakimovski D, Paunkoski I, Ramasamy DP, Carl E, Hojnacki D, Kolb C, Weinstock-Guttman B, Zivadinov R. Aging and Brain Atrophy in Multiple Sclerosis. J Neuroimaging 2019; 29:527-535. [PMID: 31074192 DOI: 10.1111/jon.12625] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/15/2019] [Accepted: 04/17/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Brain atrophy accelerates at the age of 60 in healthy individuals (HI) and at disease onset in multiple sclerosis (MS) patients. Whether there is an exacerbating effect of aging superimposed on MS-related brain atrophy is unknown. We estimated the aging effect on lateral ventricular volume (LVV) and whole brain volume (WBV) changes in MS patients. METHODS 1,982 MS patients (mean follow-up: 4.8 years) and 351 HI (mean follow-up: of 3.1 years), aged from 20 to 79 years old (yo), were collected retrospectively. Percent LVV change (PLVVC) and percent brain volume change (PBVC) on 1.5T and 3T MRI scanners (median of 3.9 scans per subject) were calculated. These were determined between all-time points and subjects were divided in six-decade age groups. MRI differences between age groups were calculated using analysis of covariance (ANCOVA). RESULTS Compared to HI, at first MRI, MS patients had significantly increased LVV in the age groups: 30-39 yo, 40-49 yo, 50-59 yo, 60-69 yo (all P < .0001), and 70-79 yo (P = .029), and decreased WBV in the age groups: 20-29 yo (P = .024), 30-39 yo (P = .031), 40-49 yo, and 50-59 yo (all P < .0001). Annualized PLVVC was significantly different between the age groups 20-59 and 60-79 yo in MS patients (P = .005) and HI (P < .0001), as was for PBVC in MS patients (P = .001), but not for HI (P = .521). There was a significant aging interaction effect in the annualized PLVVC (P = .001) between HI and MS patients, which was not observed for the annualized PBVC (P = .380). CONCLUSIONS Development of brain atrophy manifests progressively in MS patients, and occurs with a different pattern, as compared to aging HI. PLVVC increased across age in HI as compared to MS, while PBVC decreased across ages in both HI and MS.
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Affiliation(s)
- Emanuele Ghione
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.,Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Ivo Paunkoski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Ellen Carl
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - David Hojnacki
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Channa Kolb
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Bianca Weinstock-Guttman
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.,Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY
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23
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Zivadinov R, Bergsland N, Carl E, Ramasamy DP, Hagemeier J, Dwyer MG, Lizarraga AA, Kolb C, Hojnacki D, Weinstock-Guttman B. Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study. J Clin Med 2019; 8:jcm8030344. [PMID: 30870983 PMCID: PMC6463015 DOI: 10.3390/jcm8030344] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/28/2019] [Accepted: 03/07/2019] [Indexed: 02/08/2023] Open
Abstract
Background: Pathologic changes in cortical gray matter (GM) and leptomeninges contribute to disability worsening in patients with multiple sclerosis (MS), but there is little evidence whether disease-modifying treatments can slow down cortical pathology in MS. Objectives: To investigate the effect of teriflunomide (TFM) and dimethyl fumarate (DMF) in reducing cortical pathology, as determined by percentage cortical volume change (PCVC) and leptomeningeal contrast enhancement (LMCE) on MRI. Methods: This was a retrospective, single-center, observational study that selected 60 TFM- and 60 DMF-treated MS patients over 24 months. Results: TFM had a lower rate of PCVC compared to DMF over 24 months (−0.2% vs. −2.94%, p = 0.004). Similar results were observed for percentage GM volume change over 0–12 (p = 0.044) and 0–24 (−0.44% vs. −3.12%, p = 0.015) months. No significant differences were found between the TFM and DMF groups in the frequency and number of LMCE foci over the follow-up. TFM showed a numerically lower rate of whole brain atrophy over 24 months (p = 0.077), compared to DMF. No significant clinical or MRI lesion differences between TFM and DMF were detected over follow-up. Conclusions: These findings suggest that TFM has a superior effect on the preservation of cortical GM volume, compared to DMF.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
- Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - Ellen Carl
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
- Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - Alexis A Lizarraga
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - Channa Kolb
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - David Hojnacki
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
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24
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Zivadinov R, Horakova D, Bergsland N, Hagemeier J, Ramasamy DP, Uher T, Vaneckova M, Havrdova E, Dwyer MG. A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients with Relapsing-Remitting MS. AJNR Am J Neuroradiol 2019; 40:446-452. [PMID: 30819766 DOI: 10.3174/ajnr.a5987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/15/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Disappearance of T2 lesions into CSF spaces is frequently observed in patients with MS. Our aim was to investigate temporal changes of cumulative atrophied brain T2 lesion volume and 10-year confirmed disability progression. MATERIALS AND METHODS We studied 176 patients with relapsing-remitting MS who underwent MR imaging at baseline, 6 months, and then yearly for 10 years. Occurrence of new/enlarging T2 lesions, changes in T2 lesion volume, and whole-brain, cortical and ventricle volumes were assessed yearly between baseline and 10 years. Atrophied T2 lesion volume was calculated by combining baseline lesion masks with follow-up CSF partial volume maps. Ten-year confirmed disability progression was confirmed after 48 weeks. ANCOVA detected MR imaging outcome differences in stable (n = 76) and confirmed disability progression (n = 100) groups at different time points; hierarchic regression determined the unique additive variance explained by atrophied T2 lesion volume regarding the association with confirmed disability progression, in addition to other MR imaging metrics. Cox regression investigated the association of early MR imaging outcome changes and time to development of confirmed disability progression. RESULTS The separation of stable-versus-confirmed disability progression groups became significant even in the first 6 months for atrophied T2 lesion volume (140% difference, Cohen d = 0.54, P = .004) and remained significant across all time points (P ≤ .007). The hierarchic model, including all other MR imaging outcomes during 10 years predicting confirmed disability progression, improved significantly after adding atrophied T2 lesion volume (R 2 = 0.27, R 2 change 0.11, P = .009). In Cox regression, atrophied T2 lesion volume in 0-6 months (hazard ratio = 4.23, P = .04) and 0-12 months (hazard ratio = 2.41, P = .022) was the only significant MR imaging predictor of time to confirmed disability progression. CONCLUSIONS Atrophied T2 lesion volume is a robust and early marker of disability progression in relapsing-remitting MS.
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Affiliation(s)
- R Zivadinov
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York .,Center for Biomedical Imaging at Clinical Translational Research Center (R.Z.), State University of New York, Buffalo, New York
| | - D Horakova
- Department of Neurology and Center of Clinical Neuroscience (D.H., T.U., E.H.)
| | - N Bergsland
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - J Hagemeier
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - D P Ramasamy
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - T Uher
- Department of Neurology and Center of Clinical Neuroscience (D.H., T.U., E.H.)
| | - M Vaneckova
- Department of Radiology (M.V.), First Faculty of Medicine, Charles and General University Hospital in Prague, Prague, Czech Republic
| | - E Havrdova
- Department of Neurology and Center of Clinical Neuroscience (D.H., T.U., E.H.)
| | - M G Dwyer
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R., M.G.D.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
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25
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Jakimovski D, Weinstock-Guttman B, Gandhi S, Guan Y, Hagemeier J, Ramasamy DP, Fuchs TA, Browne RW, Bergsland N, Dwyer MG, Ramanathan M, Zivadinov R. Dietary and lifestyle factors in multiple sclerosis progression: results from a 5-year longitudinal MRI study. J Neurol 2019; 266:866-875. [PMID: 30758665 DOI: 10.1007/s00415-019-09208-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/14/2019] [Accepted: 01/19/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Evidence regarding the role, if any, of dietary and lifestyle factors in the pathogenesis of multiple sclerosis (MS) is poorly understood. OBJECTIVE To assess the effect of lifestyle-based risk factors linked to cardiovascular disease (CVD) on clinical and MRI-derived MS outcomes. METHODS The study enrolled 175 MS or clinically isolated syndrome (CIS) patients and 42 age- and sex-matched healthy controls (HCs) who were longitudinally followed for 5.5 years. The 20-year CVD risk was calculated by Healthy Heart Score (HHS) prediction model which includes age, smoking, body mass index, dietary intake, exercise, and alcohol consumption. Baseline and follow-up MRI scans were obtained and cross-sectional and longitudinal changes of T2-lesion volume (LV), whole brain volume (WBV), white matter volume (WMV), gray matter volume (GMV), and lateral ventricular volume (LVV) were calculated. RESULTS After correcting for disease duration, the baseline HHS values of the MS group were associated with baseline GMV (rs = - 0.20, p = 0.01), and longitudinal LVV change (rs = 0.19, p = 0.01). The association with LVV remained significant after adjusting for baseline LVV volumes (rs = 0.2, p = 0.008) in MS patients. The diet component of the HHS was associated with the 5-year T2-LV accrual (rs = - 0.191, p = 0.04) in MS. In the HC group, the HHS was associated with LVV (rs = 0.58, p < 0.001), GMV (rs = - 0.57, p < 0.001), WBV (rs = - 0.55, p = 0.001), T2-LV (rs = 0.41, p = 0.027), and WMV (rs = - 0.38, p = 0.042). Additionally, the HC HHS was associated with the 5-year change in LVV (rs = 0.54, p = 0.001) and in WBV (rs = - 0.45, p = 0.011). CONCLUSION Lifestyle risk factors contribute to accelerated central brain atrophy in MS patients, whereas unhealthier diet is associated with MS lesion accrual. Despite the lower overall effect when compared to HCs, lifestyle-based modifications may still provide a beneficial effect on reducing brain atrophy in MS patients.
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Affiliation(s)
- Dejan Jakimovski
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Multiple Sclerosis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Sirin Gandhi
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Yi Guan
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Jesper Hagemeier
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Tom A Fuchs
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Richard W Browne
- Department of Biotechnical and Clinical Laboratory Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Michael G Dwyer
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
- Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA.
- Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.
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Fuchs TA, Vaughn CB, Benedict RH, Weinstock-Guttman B, Choudhery S, Carolus K, Rooney P, Ashton K, P. Ramasamy D, Jakimovski D, Zivadinov R, Dwyer MG. Lower self-report fatigue in multiple sclerosis is associated with localized white matter tract disruption between amygdala, temporal pole, insula, and other connected structures. Mult Scler Relat Disord 2019; 27:298-304. [DOI: 10.1016/j.msard.2018.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 11/26/2022]
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27
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Ziliotto N, Zivadinov R, Jakimovski D, Bergsland N, Ramasamy DP, Weinstock-Guttman B, Ramanathan M, Marchetti G, Bernardi F. Are Plasma Levels of Vascular Adhesion Protein-1 Associated Both with Cerebral Microbleeds in Multiple Sclerosis and Intracerebral Haemorrhages in Stroke? Thromb Haemost 2018; 119:175-178. [PMID: 30597511 DOI: 10.1055/s-0038-1676346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nicole Ziliotto
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy.,Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States.,Center for Biomedical Imaging, Clinical Translational Science Institute, State University of New York at Buffalo, Buffalo, New York, United States
| | - Dejan Jakimovski
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, New York, United States
| | - Giovanna Marchetti
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Francesco Bernardi
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
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Ghione E, Bergsland N, Dwyer MG, Hagemeier J, Jakimovski D, Paunkoski I, Ramasamy DP, Silva D, Carl E, Hojnacki D, Kolb C, Weinstock-Guttman B, Zivadinov R. Brain Atrophy Is Associated with Disability Progression in Patients with MS followed in a Clinical Routine. AJNR Am J Neuroradiol 2018; 39:2237-2242. [PMID: 30467212 DOI: 10.3174/ajnr.a5876] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/08/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE The assessment of brain atrophy in a clinical routine is not performed routinely in multiple sclerosis. Our aim was to determine the feasibility of brain atrophy measurement and its association with disability progression in patients with MS followed in a clinical routine for 5 years. MATERIALS AND METHODS A total of 1815 subjects, 1514 with MS and 137 with clinically isolated syndrome and 164 healthy individuals, were collected retrospectively. Of 11,794 MR imaging brain scans included in the analysis, 8423 MRIs were performed on a 3T, and 3371 MRIs, on a 1.5T scanner. All patients underwent 3D T1WI and T2-FLAIR examinations at all time points of the study. Whole-brain volume changes were measured by percentage brain volume change/normalized brain volume change using SIENA/SIENAX on 3D T1WI and percentage lateral ventricle volume change using NeuroSTREAM on T2-FLAIR. RESULTS Percentage brain volume change failed in 36.7% of the subjects; percentage normalized brain volume change, in 19.2%; and percentage lateral ventricle volume change, in 3.3% because of protocol changes, poor scan quality, artifacts, and anatomic variations. Annualized brain volume changes were significantly different between those with MS and healthy individuals for percentage brain volume change (P < .001), percentage normalized brain volume change (P = .002), and percentage lateral ventricle volume change (P = .01). In patients with MS, mixed-effects model analysis showed that disability progression was associated with a 21.9% annualized decrease in percentage brain volume change (P < .001) and normalized brain volume (P = .002) and a 33% increase in lateral ventricle volume (P = .004). CONCLUSIONS All brain volume measures differentiated MS and healthy individuals and were associated with disability progression, but the lateral ventricle volume assessment was the most feasible.
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Affiliation(s)
- E Ghione
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center
| | - N Bergsland
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center
| | - M G Dwyer
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center.,Center for Biomedical Imaging at Clinical Translational Research Center (M.G.D., R.Z.), State University of New York, Buffalo, New York
| | - J Hagemeier
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D Jakimovski
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center
| | - I Paunkoski
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D P Ramasamy
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D Silva
- Novartis Pharmaceuticals AG (D.S.), Basel, Switzerland
| | - E Carl
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center
| | - D Hojnacki
- Jacobs Comprehensive MS Treatment and Research Center (D.H., C.K., B.W.-G.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - C Kolb
- Jacobs Comprehensive MS Treatment and Research Center (D.H., C.K., B.W.-G.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - B Weinstock-Guttman
- Jacobs Comprehensive MS Treatment and Research Center (D.H., C.K., B.W.-G.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - R Zivadinov
- From the Department of Neurology (E.G., N.B., M.G.D., J.H., D.J., I.P., D.P.R., E.C., R.Z.), Buffalo Neuroimaging Analysis Center .,Center for Biomedical Imaging at Clinical Translational Research Center (M.G.D., R.Z.), State University of New York, Buffalo, New York
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Jakimovski D, Topolski M, Kimura K, Marr K, Gandhi S, Ramasamy DP, Bergsland N, Hagemeier J, Weinstock-Guttman B, Zivadinov R. Abnormal venous postural control: multiple sclerosis-specific change related to gray matter pathology or age-related neurodegenerative phenomena? Clin Auton Res 2018; 29:329-338. [PMID: 30120624 DOI: 10.1007/s10286-018-0555-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/03/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Autonomic nervous system dysfunction has been previously observed in multiple sclerosis (MS) patients. OBJECTIVE To assess associations between magnetic resonance imaging-detected neuroinflammatory and neurodegenerative pathology and postural venous flow changes indicative of autonomic nervous system function. METHODS We used a standardized 3T magnetic resonance imaging protocol to scan 138 patients with MS and 49 healthy controls. Lesion volume and brain volumes were assessed. The cerebral venous flow (CVF) was examined by color-Doppler sonography in supine and upright positions and the difference was calculated as ΔCVF. Based on ΔCVF, subjects were split into absolute or quartile groups. Student's t test, χ2-test, and analysis of covariance adjusted for age and sex were used accordingly. Benjamini-Hochberg procedure corrected the p-values for multiple comparisons. RESULTS No differences were found between healthy controls and patients with MS in both supine and upright Doppler-derived CVF, nor in prevalence of abnormal postural venous control. Patients with absolute negative ΔCVF had higher disability scores (p = 0.013), lower gray matter (p = 0.039) and cortical (p = 0.044) volumes. The negative ΔCVF MS group also showed numerically worse bladder/bowel function when compared to the positive ΔCVF (2.3 vs. 1.5, p = 0.052). Similarly, the lowest quartile ΔCVF MS group had higher T1-lesion volumes (p = 0.033), T2-lesion volumes (p = 0.032), and lower deep gray matter (p = 0.043) and thalamus (p = 0.033) volumes when compared to those with higher ΔCVF quartiles. CONCLUSION No difference in postural venous outflow between patients with MS and healthy controls was found. However, when the abnormal ΔCVF is present within the MS population, it may be associated with more inflammatory and neurodegenerative pathology. Further studies should explore whether the orthostatic venous changes are an aging or an MS-related phenomenon and if the etiology is due to impaired autonomic nervous system functioning.
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Affiliation(s)
- Dejan Jakimovski
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Matthew Topolski
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Kana Kimura
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Karen Marr
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Sirin Gandhi
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Jesper Hagemeier
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs MS Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA. .,Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.
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Ziliotto N, Bernardi F, Jakimovski D, Baroni M, Marchetti G, Bergsland N, Ramasamy DP, Weinstock-Guttman B, Schweser F, Zamboni P, Ramanathan M, Zivadinov R. Hemostasis biomarkers in multiple sclerosis. Eur J Neurol 2018; 25:1169-1176. [PMID: 29758118 DOI: 10.1111/ene.13681] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 05/03/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND PURPOSE The aim was to investigate the plasma levels of hemostasis components in multiple sclerosis (MS) and their association with clinical and magnetic resonance imaging (MRI) outcomes. METHODS In all, 138 MS patients [85 with relapsing-remitting MS (RR-MS) and 53 with progressive MS (P-MS) with a mean age of 54 years; 72.5% female; median Expanded Disability Status Scale 3.5; mean disease duration 21 years] and 42 age- and sex-matched healthy individuals (HI) were studied. All subjects were examined with 3 T MRI and clinical examinations. Plasma levels of hemostasis factors [procoagulant, factor XII (FXII)] and inhibitors [tissue factor pathway inhibitor (TFPI), thrombomodulin, heparin cofactor II, a disintegrin-like and metalloprotease with thrombospondin type 1 motif 13 (ADAMTS13) and plasminogen activator inhibitor 1 (PAI-1)] were evaluated by magnetic Luminex assays and enzyme-linked immunosorbent assay. Associations between hemostasis plasma levels and clinical and MRI outcomes were assessed. RESULTS Lower ADAMTS13 levels were found in MS patients compared to HI (P = 0.008) and in MS patients presenting with cerebral microbleeds compared to those without (P = 0.034). Higher PAI-1 levels were found in MS patients compared to HI (P = 0.02). TFPI levels were higher in the P-MS subgroup compared to RR-MS patients (P = 0.011) and compared to HI (P = 0.002). No significant associations between hemostasis plasma levels and clinical or MRI outcomes were found. CONCLUSIONS Decreased ADAMTS13, particularly in MS patients with cerebral microbleeds, which deserves further investigation, and increased PAI-1 and TFPI levels were observed in MS patients, which deserves further investigation. No relationship between hemostasis plasma levels and measures of disease severity was detected.
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Affiliation(s)
- N Ziliotto
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - F Bernardi
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - D Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - M Baroni
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - G Marchetti
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - N Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - D P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - B Weinstock-Guttman
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - F Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - P Zamboni
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - M Ramanathan
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - R Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
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Dwyer MG, Bergsland N, Ramasamy DP, Jakimovski D, Weinstock-Guttman B, Zivadinov R. Atrophied Brain Lesion Volume: A New Imaging Biomarker in Multiple Sclerosis. J Neuroimaging 2018; 28:490-495. [DOI: 10.1111/jon.12527] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Michael G. Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; The State University of New York; Buffalo NY
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; The State University of New York; Buffalo NY
| | - Deepa P. Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; The State University of New York; Buffalo NY
| | - Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; The State University of New York; Buffalo NY
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; The State University of New York; Buffalo NY
| | - Robert Zivadinov
- Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo; The State University of New York; Buffalo NY
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Zivadinov R, Ramasamy DP, Hagemeier J, Kolb C, Bergsland N, Schweser F, Dwyer MG, Weinstock-Guttman B, Hojnacki D. Evaluation of Leptomeningeal Contrast Enhancement Using Pre-and Postcontrast Subtraction 3D-FLAIR Imaging in Multiple Sclerosis. AJNR Am J Neuroradiol 2018; 39:642-647. [PMID: 29439125 DOI: 10.3174/ajnr.a5541] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/28/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND PURPOSE Leptomeningeal contrast enhancement is found in patients with multiple sclerosis, though reported rates have varied. The use of 3D-fluid-attenuated inversion recovery pre- and postcontrast subtraction imaging may more accurately determine the frequency of leptomeningeal contrast enhancement. The purpose of this study was to investigate the frequency of leptomeningeal contrast enhancement using the pre- and postcontrast subtraction approach and to evaluate 3 different methods of assessing the presence of leptomeningeal contrast enhancement. MATERIALS AND METHODS We enrolled 258 consecutive patients with MS (212 with relapsing-remitting MS, 32 with secondary-progressive MS, and 14 with clinically isolated syndrome) who underwent both pre- and 10-minute postcontrast 3D-FLAIR sequences after a single dose of gadolinium injection on 3T MR imaging. The analysis included leptomeningeal contrast-enhancement evaluation on 3D-FLAIR postcontrast images in native space (method A), on pre- and postcontrast 3D-FLAIR images in native space (method B), and on pre-/postcontrast 3D-FLAIR coregistered and subtracted images (method C, used as the criterion standard). RESULTS In total, 51 (19.7%) patients with MS showed the presence of leptomeningeal contrast enhancement using method A; 39 (15.1%), using method B; and 39 (15.1%), using method C (P = .002). Compared with method C as the criterion standard, method A showed 89.8% sensitivity and 92.7% specificity, while method B showed 84.6% sensitivity and 97.3% specificity (P < .001) at the patient level. Reproducibility was the highest using method C (κ agreement, r = 088, P < .001). The mean time to analyze the 3D-FLAIR images was significantly lower with method C compared with methods A and B (P < .001). CONCLUSIONS 3D-FLAIR postcontrast imaging offers a sensitive method for detecting leptomeningeal contrast enhancement in patients with MS. However, the use of subtraction imaging helped avoid false-positive cases, decreased reading time, and increased the accuracy of leptomeningeal contrast-enhancement foci detection in a clinical routine.
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Affiliation(s)
- R Zivadinov
- From the Department of Neurology (R.Z., D.P.R., J.H., N.B., F.S., M.G.D.), Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences
- Department of Neurology (R.Z., C.K., D.H.), Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, State University of New York, Buffalo, New York
| | - D P Ramasamy
- From the Department of Neurology (R.Z., D.P.R., J.H., N.B., F.S., M.G.D.), Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences
| | - J Hagemeier
- From the Department of Neurology (R.Z., D.P.R., J.H., N.B., F.S., M.G.D.), Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences
| | - C Kolb
- Department of Neurology (R.Z., C.K., D.H.), Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, State University of New York, Buffalo, New York
| | - N Bergsland
- From the Department of Neurology (R.Z., D.P.R., J.H., N.B., F.S., M.G.D.), Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences
| | - F Schweser
- From the Department of Neurology (R.Z., D.P.R., J.H., N.B., F.S., M.G.D.), Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences
| | - M G Dwyer
- From the Department of Neurology (R.Z., D.P.R., J.H., N.B., F.S., M.G.D.), Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences
| | - B Weinstock-Guttman
- Translational Imaging Center at Clinical Translational Science Institute (B.W.-G.)
| | - D Hojnacki
- Department of Neurology (R.Z., C.K., D.H.), Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, State University of New York, Buffalo, New York
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Zivadinov R, Bergsland N, Hagemeier J, Tavazzi E, Ramasamy DP, Durfee J, Cherneva M, Carl E, Carl J, Kolb C, Hojnacki D, Weinstock-Guttman B. Effect of switching from glatiramer acetate 20 mg/daily to glatiramer acetate 40 mg three times a week on gray and white matter pathology in subjects with relapsing multiple sclerosis: A longitudinal DTI study. J Neurol Sci 2018; 387:152-156. [PMID: 29571854 DOI: 10.1016/j.jns.2018.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Glatiramer acetate (GA) 40 mg × 3/weekly was approved for the treatment of relapsing-remitting multiple sclerosis (RRMS). While the beneficial effect of GA 20 mg/daily in MS patients on non-conventional MRI measures has been demonstrated, the effect of GA 40 mg × 3/weekly at the microstructural tissue level has yet to be explored. OBJECTIVE To investigate the effect of switching from GA 20 mg/daily to GA 40 mg × 3/weekly on the evolution of microstructural changes in the thalamus and normal appearing white matter (NAWM), using diffusion tensor imaging (DTI). METHODS In this observational, longitudinal, cross-over, 34-month MRI study, we recruited 150 RRMS patients that underwent MRI 12-18 months before switching (pre-index), during the switch (index) and 12-18 months after switching (post-index) from GA 20 mg/daily to GA 40 mg × 3/weekly. Regional DTI metrics and tract-based spatial statistics (TBSS) analyses were performed. Mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD) and fractional anisotropy (FA) were measured in thalamus and NAWM. RESULTS Regional DTI measures, measures of whole brain, white and gray matter, and thalamus volumes, as well as lesion volume, showed no significant changes. However, the voxel-wise TBSS analysis showed increased FA both in the NAWM and thalamus, as well as increased MD and AD in NAWM, and decreased RD in NAWM (p < .05). Areas of increased FA and MD as well as decreased RD in the NAWM, and increased AD both in the NAWM and thalamus were detected between index to post-index (p < .05). CONCLUSIONS This study confirms a comparable effect of GA 40 mg × 3/weekly to GA 20 mg/daily on DTI measures over 34 months.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, NY, USA.
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Eleonora Tavazzi
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jackie Durfee
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Mariya Cherneva
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Ellen Carl
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jillian Carl
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Channa Kolb
- Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; Department of Neurology, University of Buffalo, Buffalo, NY, USA
| | - David Hojnacki
- Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; Department of Neurology, University of Buffalo, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; Department of Neurology, University of Buffalo, Buffalo, NY, USA
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Zivadinov R, Ramasamy DP, Vaneckova M, Gandhi S, Chandra A, Hagemeier J, Bergsland N, Polak P, Benedict RHB, Hojnacki D, Weinstock-Guttman B. Leptomeningeal contrast enhancement is associated with progression of cortical atrophy in MS: A retrospective, pilot, observational longitudinal study. Mult Scler 2016; 23:1336-1345. [DOI: 10.1177/1352458516678083] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Leptomeningeal contrast enhancement (LM CE) has been recently described in multiple sclerosis (MS) patients as a potential in vivo marker of cortical pathology. Objectives: To investigate the association of LM CE and development of cortical atrophy in 50 MS patients (27 relapsing-remitting (RR) and 23 secondary-progressive (SP)) followed for 5 years. Methods: The presence and number of LM CE foci were assessed only at the 5-year follow-up using three-dimensional (3D) fluid-attenuated inversion recovery magnetic resonance imaging (MRI) sequence obtained 10 minutes after single dose of gadolinium injection on 3T scanner. The percentage change in whole brain, cortical and deep gray matter (GM) volumes, and lesion volume (LV) was measured between baseline and the 5-year follow-up. Results: In total, 25 (50%) of MS patients had LM CE at the 5-year follow-up. Significantly more SPMS patients (12, 85.7%) had multiple LM CE foci, compared to those with RRMS (2, 18.2%) ( p = 0.001). MS patients with LM CE showed significantly greater percentage decrease in total GM (−3.6% vs −2%, d = 0.80, p = 0.006) and cortical (−3.4% vs −1.8%, d = 0.84, p = 0.007) volumes and greater percentage increase in ventricular cerebrospinal fluid (vCSF) volume (22.8% vs 9.9%, d = 0.90, p = 0.003) over the follow-up, compared to those without. Conclusion: In this retrospective, pilot, observational longitudinal study, the presence of LM CE was associated with progression of cortical atrophy over 5 years.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA/MR Imaging Clinical Translational Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
| | - Manuela Vaneckova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Sirin Gandhi
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
| | - Avinash Chandra
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA/IRCCS “S. Maria Nascente,” Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Paul Polak
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
| | - Ralph HB Benedict
- Jacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
| | - David Hojnacki
- Jacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo—The State University of New York, Buffalo, NY, USA
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Weinstock-Guttman B, Hagemeier J, Kavak KS, Saini V, Patrick K, Ramasamy DP, Nadeem M, Carl E, Hojnacki D, Zivadinov R. Randomised natalizumab discontinuation study: taper protocol may prevent disease reactivation. J Neurol Neurosurg Psychiatry 2016; 87:937-43. [PMID: 26780938 DOI: 10.1136/jnnp-2015-312221] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/09/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare two modes of natalizumab cessation interventions: immediate versus tapered down, as measured by serial MRI and the occurrence of relapses during a 12-month period. BACKGROUND Weighing progressive multifocal encephalopathy risk associated with ≥24 months of natalizumab therapy against the benefits of disease control, we initiated a natalizumab discontinuation study. METHODS A phase IV, 12-month, single-blinded randomised (MRI) study. Fifty relapsing patients with multiple sclerosis (MS) who had been on natalizumab therapy ≥24 months and were contemplating natalizumab discontinuation were enrolled. Participants were randomised to either the immediate discontinuation group (IDG) or the tapered group (TG). IDG discontinued natalizumab at once and initiated another disease modifying therapy (DMT) following the last natalizumab infusion, while the TG received two more natalizumab infusions, at 6 and 8 weeks (14 weeks from study entry) before initiating another DMT. Standardised MRI was performed at baseline, 6 and 12 months from the last natalizumab infusion. RESULTS A higher rate of relapses in the IDG (n=28) compared to the TG (n=8) over 12 months from the last infusion (p=0.007) was observed, most relapses occurred within 3 months of discontinuation (20 vs 7 relapses, p=0.012). The IDG showed a higher number of new T2 lesions within 6-12 months of discontinuation (p=0.025), a higher mean absolute T2-LV change from 0 to 12 months (1.1 vs 0.1 mL, p=0.024) and a higher number of new T1-hypointense lesions over 0-12 months (p=0.005) as well as from baseline to 6 months (p=0.026) compared to the TG. CONCLUSIONS Natalizumab discontinuation therapy was associated with development of new disease activity. Our tapered protocol showed benefits, as patients in the TG experienced less relapses and lower accumulation of MRI lesions compared to those in the IDG.
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Affiliation(s)
- Bianca Weinstock-Guttman
- Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, New York, USA Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA
| | - Jesper Hagemeier
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Katelyn S Kavak
- Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, New York, USA
| | - Vasu Saini
- Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, New York, USA
| | - Kara Patrick
- Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, New York, USA
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Muhammad Nadeem
- Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, New York, USA
| | - Ellen Carl
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - David Hojnacki
- Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, New York, USA
| | - Robert Zivadinov
- Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
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Zivadinov R, Ramasamy DP, Benedict RRH, Polak P, Hagemeier J, Magnano C, Dwyer MG, Bergsland N, Bertolino N, Weinstock-Guttman B, Kolb C, Hojnacki D, Utriainen D, Haacke EM, Schweser F. Cerebral Microbleeds in Multiple Sclerosis Evaluated on Susceptibility-weighted Images and Quantitative Susceptibility Maps: A Case-Control Study. Radiology 2016; 281:884-895. [PMID: 27308776 DOI: 10.1148/radiol.2016160060] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose To assess cerebral microbleed (CMB) prevalence in patients with multiple sclerosis (MS) and clinically isolated syndrome (CIS) and associations with clinical outcomes. Materials and Methods CMBs are associated with aging and neurodegenerative disorders. The prevalence of CMBs has not previously been well established. In this study, 445 patients with MS (266 with relapsing-remitting MS, 138 with secondary progressive MS, and 41 with primary progressive MS), 45 patients with CIS, 51 patients with other neurological diseases, and 177 healthy control subjects (HCs) underwent 3-T magnetic resonance (MR) imaging and clinical examinations. A subset of 168 patients with MS and 50 HCs underwent neuropsychological testing. Number of CMBs was assessed on susceptibility-weighted minimum intensity projections by using the Microbleed Anatomic Rating Scale; volume was calculated by using quantitative susceptibility maps. Differences between groups were analyzed with the χ2 test, Fisher exact test, Student t test, and analysis of variance; associations of CMBs with clinical and other MR imaging outcomes were explored with correlation and regression analyses. Because CMB frequency increases with age, prevalence was investigated in participants at least 50 years of age and younger than 50 years. Results Significantly more patients with MS than HCs had CMBs (19.8% vs 7.4%, respectively; P = .01) in the group at least 50 years old. A trend toward greater presence of CMBs was found in patients with MS (P = .016) and patients with CIS who were younger than 50 years (P = .039) compared with HCs. In regression analysis adjusted for age, hypertension, and normalized brain volume, increased number of CMBs was significantly associated with increased physical disability in the MS population (R2 = 0.23, P < .0001). In correlation analysis, increased number of CMBs was significantly associated with deteriorated auditory and verbal learning and memory (P = .006) and visual information processing speed trends (P = .049) in patients with MS. Conclusion Monitoring CMBs may be relevant in patients with MS and CIS at higher risk for developing cognitive and physical disability. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Robert Zivadinov
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Deepa P Ramasamy
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Ralph R H Benedict
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Paul Polak
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Jesper Hagemeier
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Christopher Magnano
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Michael G Dwyer
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Niels Bergsland
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Nicola Bertolino
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Bianca Weinstock-Guttman
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Channa Kolb
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - David Hojnacki
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - David Utriainen
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - E Mark Haacke
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
| | - Ferdinand Schweser
- From the Buffalo Neuroimaging Analysis Ctr, Dept of Neurology (R.Z., D.P.R., P.P., J.H., C.M., M.G.D., N. Bergsland, N. Bertolino, F.S.), MR Imaging Clinical and Translational Research Ctr (R.Z., C.M., F.S.), and Jacobs Multiple Sclerosis Ctr, Dept of Neurology (R.R.H.B., B.W.G., C.K., D.H.), Jacobs School of Medicine and Biomedical Sciences, Univ at Buffalo, The State Univ of New York, 100 High St, Buffalo, NY 14203; GE Healthcare, Waukesha, Wis (C.M.); Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy (N. Bergsland); Magnetic Resonance Innovations, Detroit, Mich (D.U.); Dept of Radiology, Wayne State Univ, Detroit, Mich (E.M.H.); School of Biomedical Engineering, McMaster Univ, Hamilton, Ontario, Canada (E.M.H.); and Shanghai Key Laboratory of Magnetic Resonance, East China Normal Univ, Shanghai, China (E.M.H.)
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Beggs CB, Magnano C, Belov P, Krawiecki J, Ramasamy DP, Hagemeier J, Zivadinov R. Internal Jugular Vein Cross-Sectional Area and Cerebrospinal Fluid Pulsatility in the Aqueduct of Sylvius: A Comparative Study between Healthy Subjects and Multiple Sclerosis Patients. PLoS One 2016; 11:e0153960. [PMID: 27135831 PMCID: PMC4852898 DOI: 10.1371/journal.pone.0153960] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 04/06/2016] [Indexed: 12/25/2022] Open
Abstract
Objectives Constricted cerebral venous outflow has been linked with increased cerebrospinal fluid (CSF) pulsatility in the aqueduct of Sylvius in multiple sclerosis (MS) patients and healthy individuals. This study investigates the relationship between CSF pulsatility and internal jugular vein (IJV) cross-sectional area (CSA) in these two groups, something previously unknown. Methods 65 relapsing-remitting MS patients (50.8% female; mean age = 43.8 years) and 74 healthy controls (HCs) (54.1% female; mean age = 43.9 years) were investigated. CSF flow quantification was performed on cine phase-contrast MRI, while IJV-CSA was calculated using magnetic resonance venography. Statistical analysis involved correlation, and partial least squares correlation analysis (PLSCA). Results PLSCA revealed a significant difference (p<0.001; effect size = 1.072) between MS patients and HCs in the positive relationship between CSF pulsatility and IJV-CSA at C5-T1, something not detected at C2-C4. Controlling for age and cardiovascular risk factors, statistical trends were identified in HCs between: increased net positive CSF flow (NPF) and increased IJV-CSA at C5-C6 (left: r = 0.374, p = 0.016; right: r = 0.364, p = 0.019) and C4 (left: r = 0.361, p = 0.020); and increased net negative CSF flow and increased left IJV-CSA at C5-C6 (r = -0.348, p = 0.026) and C4 (r = -0.324, p = 0.039), whereas in MS patients a trend was only identified between increased NPF and increased left IJV-CSA at C5-C6 (r = 0.351, p = 0.021). Overall, correlations were weaker in MS patients (p = 0.015). Conclusions In healthy adults, increased CSF pulsatility is associated with increased IJV-CSA in the lower cervix (independent of age and cardiovascular risk factors), suggesting a biomechanical link between the two. This relationship is altered in MS patients.
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Affiliation(s)
- Clive B. Beggs
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
- Research Institute for Sport, Physical Activity and Leisure, Carnegie Faculty, Leeds Beckett University, Leeds, West Yorkshire, United Kingdom
- * E-mail:
| | - Christopher Magnano
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
| | - Pavel Belov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
| | - Jacqueline Krawiecki
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
| | - Deepa P. Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
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Zivadinov R, Uher T, Hagemeier J, Vaneckova M, Ramasamy DP, Tyblova M, Bergsland N, Seidl Z, Dwyer MG, Krasensky J, Havrdova E, Horakova D. A serial 10-year follow-up study of brain atrophy and disability progression in RRMS patients. Mult Scler 2016; 22:1709-1718. [PMID: 26883943 DOI: 10.1177/1352458516629769] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/07/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND We explored the evolution of brain atrophy in relation to development of confirmed disability progression (CDP) on serial 1.5T magnetic resonance imaging (MRI) scans over a 10-year period in 181 patients with early relapsing-remitting multiple sclerosis (RRMS). METHODS At 10-year follow-up, they were divided into those with (100) or without (76) CDP (confirmed after 48 weeks). Changes in whole brain (WB), cortical, gray matter (GM), white matter, and ventricular cerebrospinal fluid (vCSF) volumes were calculated on three-dimensional T1-weighted (3D-T1) scans between all available time points. RESULTS In multiple sclerosis (MS) patients with CDP compared to those without, the greatest effect size percentage volume change from baseline to follow-up was detected for WB (d = 0.55, -7.5% vs -5.2%, p < 0.001), followed by vCSF (d = 0.51, +41.1% vs +25.7%, p < 0.001), cortical (d = 0.49, -7.7% vs -6.2%, p = 0.001), and GM (d = 0.40, -7.1% vs -5.8%, p = 0.006) volumes. Mixed-effects model analysis, adjusted for age, sex, and treatment change, showed significant interactions between CDP status and percentage changes for WB and vCSF (p < 0.001), cortical (p = 0.02), and GM (p = 0.04) volumes. CONCLUSIONS WB and cortical atrophy, and enlargement of vCSF spaces are associated with development of CDP on serial yearly MRI assessments over a period of 10 years.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA/MR Imaging Clinical Translational Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Tomas Uher
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA/Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Manuela Vaneckova
- Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Michaela Tyblova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA/IRCCS "S. Maria Nascente," Don Carlo Gnocchi Foundation, Milan, Italy
| | - Zdenek Seidl
- Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Jan Krasensky
- Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic
| | - Eva Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic
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Kappus N, Weinstock-Guttman B, Hagemeier J, Kennedy C, Melia R, Carl E, Ramasamy DP, Cherneva M, Durfee J, Bergsland N, Dwyer MG, Kolb C, Hojnacki D, Ramanathan M, Zivadinov R. Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis. J Neurol Neurosurg Psychiatry 2016; 87:181-7. [PMID: 25722366 DOI: 10.1136/jnnp-2014-310051] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/04/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS). OBJECTIVES To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes. METHODS In a prospective study, 326 patients with relapsing-remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status. RESULTS Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p = 0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥ 2 CV risks (p = 0.003), while the frequency of ≥ 3 CV risks was 18.8% in the MS group and 8.6% in the HCs group (p = 0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes (p < 0.05), while overweight/obesity was associated with increased T1-LV (p < 0.39) and smoking with decreased whole brain volume (p = 0.049). Increased lateral ventricle volume was associated with heart disease (p = 0.029) in CIS. CONCLUSIONS Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy.
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Affiliation(s)
- Natalie Kappus
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Jesper Hagemeier
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Cheryl Kennedy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Rebecca Melia
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Ellen Carl
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Mariya Cherneva
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Jacqueline Durfee
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy
| | - Michael G Dwyer
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Channa Kolb
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - David Hojnacki
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York, USA
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
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40
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Zivadinov R, Cerza N, Hagemeier J, Carl E, Badgett D, Ramasamy DP, Weinstock-Guttman B, Ramanathan M. Humoral response to EBV is associated with cortical atrophy and lesion burden in patients with MS. Neurol Neuroimmunol Neuroinflamm 2016; 3:e190. [PMID: 26770996 PMCID: PMC4708926 DOI: 10.1212/nxi.0000000000000190] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/30/2015] [Indexed: 11/17/2022]
Abstract
Objective: Because dysregulated Epstein-Barr virus (EBV)-infected B cells may induce meningeal inflammation, which contributes to cortical pathology in multiple sclerosis (MS), we investigated associations between antibody responses to EBV and development of cortical pathology in MS. Methods: We included 539 patients with MS (369 with relapsing-remitting MS, 135 with secondary progressive MS, and 35 with primary progressive MS), 66 patients with clinically isolated syndrome (CIS), 63 patients with other neurologic diseases (OND), and 178 age- and sex-matched healthy controls (HC). All participants were scanned on 3T MRI. Serum samples were analyzed for IgG antibodies against EBV viral capsid antigen (VCA) and EBV nuclear antigen-1 (EBNA-1), and their quartiles were determined on the whole study sample. Differences between the study groups were assessed using analysis of covariance adjusted for multiple comparisons. Results: More than 30% of patients with MS and CIS presented with the highest quartile of anti-EBV-VCA and -EBNA-1 status compared to ≤10% of HC (p < 0.001). The figures were 9 (14.3%) and 7 (12.3%) for patients with OND. Patients with MS with the highest quartile of anti-EBV-VCA showed significantly increased T2 lesion volume (p = 0.001), T1 lesion number (p = 0.002), and T1 lesion volume (p = 0.04) and decreased gray matter (p = 0.041) and cortical (p = 0.043) volumes compared to patients with MS with lower quartiles. No significant differences of MRI outcomes in patients with CIS, patients with OND, and HC with lower or highest quartiles of anti-EBV-VCA and -EBNA-1 were detected. Conclusions: Humoral response to anti-EBV-VCA and -EBNA-1 is associated with more advanced cortical atrophy, accumulation of chronic T1 black holes, and focal white matter lesions in patients with MS.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Nicole Cerza
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Ellen Carl
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Darlene Badgett
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Bianca Weinstock-Guttman
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Murali Ramanathan
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
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Dwyer MG, Zivadinov R, Tao Y, Zhang X, Kennedy C, Bergsland N, Ramasamy DP, Durfee J, Hojnacki D, Weinstock-Guttman B, Hayward B, Dangond F, Markovic-Plese S. Immunological and short-term brain volume changes in relapsing forms of multiple sclerosis treated with interferon beta-1a subcutaneously three times weekly: an open-label two-arm trial. BMC Neurol 2015; 15:232. [PMID: 26559139 PMCID: PMC4642690 DOI: 10.1186/s12883-015-0488-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 10/31/2015] [Indexed: 12/23/2022] Open
Abstract
Background Brain volume atrophy is observed in relapsing–remitting multiple sclerosis (RRMS). Methods Brain volume changes were evaluated in 23 patients with RRMS treated with interferon β-1a 44 μg given subcutaneously (SC) three times a week (tiw) and 15 healthy controls. Percentages of whole brain and tissue-specific volume change were measured from baseline (0 months) to 3 months, from 3 to 6 months, and from baseline to 6 months using SIENAX Multi Time Point (SX-MTP) algorithms. Immunological status of patients was also determined and correlations between subsets of T cells and changes in brain volume were assessed. Results Interferon β-1a 44 μg SC tiw in 23 patients with RRMS resulted in significant reductions in whole brain and gray matter tissue volume early in the treatment course (baseline to 3 months; mean change; –0.95 %; P = 0.030, –1.52 %; P = 0.004, respectively), suggesting a short-term treatment-induced pseudoatrophy effect. From baseline to 6 months, there were significant correlations observed between decreased T- cell expression of IL-17 F and decreased whole brain and brain tissue-specific volume. Conclusions These findings are consistent with the interpretation of the pseudoatrophy effect as resolution of inflammation following treatment initiation with interferon β-1a 44 μg SC tiw, rather than disease-related tissue loss. Trial registration ClinicalTrials.gov; NCT01085318
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Affiliation(s)
- Michael G Dwyer
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA. .,Department of Biomedical Informatics, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA.
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA. .,Department of Neurology, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA.
| | - Yazhong Tao
- Department of Neurology, Microbiology and Immunology, University of North Carolina at Chapel Hill, 125 Mason Farm Rd., 6109D Neuroscience Research Bldg, CB #7125, Chapel Hill, NC, 27599, USA.
| | - Xin Zhang
- Department of Neurology, Microbiology and Immunology, University of North Carolina at Chapel Hill, 125 Mason Farm Rd., 6109D Neuroscience Research Bldg, CB #7125, Chapel Hill, NC, 27599, USA.
| | - Cheryl Kennedy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA.
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA.
| | - Deepa P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA.
| | - Jackie Durfee
- Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA.
| | - David Hojnacki
- Department of Neurology, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA.
| | - Bianca Weinstock-Guttman
- Department of Neurology, State University of New York at Buffalo, 100 High St, Buffalo, NY, 14203, USA.
| | - Brooke Hayward
- EMD Serono, Inc., One Technology Pl, Rockland, MA, 02370, USA.
| | | | - Silva Markovic-Plese
- Department of Neurology, Microbiology and Immunology, University of North Carolina at Chapel Hill, 125 Mason Farm Rd., 6109D Neuroscience Research Bldg, CB #7125, Chapel Hill, NC, 27599, USA.
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42
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Zivadinov R, Dwyer MG, Ramasamy DP, Davis MD, Steinerman JR, Khan O. The Effect of Three Times a Week Glatiramer Acetate on Cerebral T1 Hypointense Lesions in Relapsing-Remitting Multiple Sclerosis. J Neuroimaging 2015; 25:989-95. [PMID: 26394270 PMCID: PMC5054834 DOI: 10.1111/jon.12293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 08/02/2015] [Accepted: 08/03/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND PURPOSE Two definitions of T1 hypointense (T1H) lesions can be derived from pre‐contrast images: those that may or may not have a corresponding gadolinium‐enhancing correlate on post‐contrast images (T1H total), and those that are simultaneously non‐gadolinium‐enhancing on post‐contrast scans (T1H non‐enhancing). To determine the differences in lesion evolution between these two T1H definitions, we examined the effect of glatiramer acetate 40 mg/mL three times weekly subcutaneous injection (GA40) on the number of new or enlarging T1H total and T1H non‐enhancing lesions in patients with relapsing‐remitting multiple sclerosis (RRMS). METHODS The Phase III GALA study randomized 1404 RRMS subjects 2:1 to receive GA40 or placebo for 12 months. MRI scans were obtained at baseline and at months 6 and 12. Cumulative numbers of T1H total and of T1H non‐enhancing lesions were analyzed using an adjusted negative binomial regression model. A total of 1,357 patients had MRI data collected at either the month 6 or month 12 visit. RESULTS Among the 1,357 patients with MRI scans performed at either the month 6 or month 12 visit, 883 treated with GA40 developed an adjusted cumulative mean of 1.72 T1H total lesions versus 2.62 in 440 placebo controls (risk ratio, .66; 95% CI, .54‐.80; P < .0001). On T1H non‐enhanced scans, GA40‐treated patients developed an adjusted cumulative mean of 1.35 T1H non‐enhancing lesions versus 1.91 in placebo controls (risk ratio, .71; CI, .58‐.87; P = .0009). CONCLUSIONS GA40 significantly reduced the number of new or enlarging T1H total lesions and T1H non‐enhancing lesions compared with placebo. Although the treatment effect magnitude was comparable with both definitions, the use of T1H non‐enhancing lesions may be more relevant for more uniform standardization in future clinical trials.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | | | | | - Omar Khan
- The Sastry Foundation Advanced Imaging Laboratory & Multiple Sclerosis Center, Department of Neurology, Wayne State University School of Medicine, Detroit, MI
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Modica CM, Bergsland N, Dwyer MG, Ramasamy DP, Carl E, Zivadinov R, Benedict RH. Cognitive reserve moderates the impact of subcortical gray matter atrophy on neuropsychological status in multiple sclerosis. Mult Scler 2015; 22:36-42. [PMID: 25921038 DOI: 10.1177/1352458515579443] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 03/08/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cognitive decline is characterized in multiple sclerosis (MS), but the rate and severity vary. The reserve hypothesis proposes that baseline neurological differences impact cognitive outcome in neurodegenerative disease. OBJECTIVE To elucidate how brain reserve and cognitive reserve influence subcortical gray matter (SCGM) atrophy and cognitive decline in MS over 3 years. METHODS Seventy-one MS patients and 23 normal controls underwent magnetic resonance imaging and cognitive assessment at baseline and 3-year follow-up. The influence of reserve on cognitive processing speed (CPS) and memory was examined. RESULTS SCGM volume and cognitive scores were lower in MS than normal controls (P⩽0.001). Accounting for baseline, comparison of follow-up means yielded a difference between groups in SCGM volume (P<0.001) but not cognition (NS). Cognitive reserve (P=0.005), but not brain reserve, contributed to CPS, with only low cognitive reserve MS subjects showing decline in CPS (P=0.029). SCGM change predicted CPS outcome in MS with low cognitive reserve (P=0.002) but not high cognitive reserve. There were no effects in the domain of memory. CONCLUSIONS SCGM atrophy occurs in normal controls, but significantly more so in MS. While CPS did not change in normal controls, low cognitive reserve was associated with CPS decline in MS. High cognitive reserve protect MS patients from cognitive decline related to SCGM atrophy.
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Affiliation(s)
- Claire M Modica
- Neuroscience Program, University at Buffalo School of Medicine, USA/Buffalo Neuroimaging Analysis Center, University at Buffalo School of Medicine, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, University at Buffalo School of Medicine, USA/IRCCS 'S Maria Nascente', Don Gnocchi Foundation, Italy
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, University at Buffalo School of Medicine, USA/Department of Biomedical Informatics, University at Buffalo, USA
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, University at Buffalo School of Medicine, USA
| | - Ellen Carl
- Buffalo Neuroimaging Analysis Center, University at Buffalo School of Medicine, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, University at Buffalo School of Medicine, USA/Department of Neurology, University at Buffalo School of Medicine, USA/MR Imaging Clinical Translational Research Center, University at Buffalo, USA
| | - Ralph Hb Benedict
- Department of Neurology, University at Buffalo School of Medicine, USA
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Uher T, Horakova D, Kalincik T, Bergsland N, Tyblova M, Ramasamy DP, Seidl Z, Vaneckova M, Krasensky J, Havrdova E, Zivadinov R. Early magnetic resonance imaging predictors of clinical progression after 48 months in clinically isolated syndrome patients treated with intramuscular interferon β-1a. Eur J Neurol 2015; 22:1113-23. [PMID: 25904020 DOI: 10.1111/ene.12716] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 02/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Our aim was to identify early imaging surrogate markers of clinical progression in patients after the first demyelinating event suggestive of multiple sclerosis treated with weekly intramuscular interferon β-1a. In a prospective observational study, the predictive role of baseline and 6-month changes in magnetic resonance imaging outcomes was investigated with respect to relapse activity and development of confirmed disability progression in patients after 48 months. METHODS This study examined 210 patients. Multivariate Cox proportional hazard models were used to analyse predictors of relapse activity and confirmed disability progression after 48 months. RESULTS Greater T2 lesion volume [hazard ratio (HR) 1.81; P = 0.005] and the presence of contrast-enhancing lesions (HR 2.13; P < 0.001) at baseline were significantly associated with increased cumulative risk of a second clinical attack over 48 months. A greater decrease of the corpus callosum volume (HR 2.74; P = 0.001) and greater lateral ventricle volume enlargement (HR 2.43; P = 0.002) at 6 months relative to baseline were associated with increased cumulative risk of a second clinical attack between months 6 and 48. In addition, increased risk of confirmed disability progression over 48 months in patients with greater lateral ventricle volume enlargement between baseline and 6 months (HR 4.70; P = 0.001) was detected. CONCLUSIONS A greater T2 lesion volume, the presence of contrast-enhancing lesions at baseline, decrease of corpus callosum volume and lateral ventricle volume enlargement over the first 6 months in patients after the first demyelinating event treated with weekly intramuscular interferon β-1a may assist in identification of patients with the highest risk of a second clinical attack and progression of disability.
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Affiliation(s)
- T Uher
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic.,Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - D Horakova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - T Kalincik
- Department of Medicine, Melbourne Brain Centre, University of Melbourne, Melbourne, Australia.,Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - N Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,IRCCS 'S. Maria Nascente', Don Gnocchi Foundation, Milan, Italy
| | - M Tyblova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - D P Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Z Seidl
- Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - M Vaneckova
- Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - J Krasensky
- Department of Radiology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - E Havrdova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - R Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
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Beggs CB, Magnano C, Shepherd SJ, Belov P, Ramasamy DP, Hagemeier J, Zivadinov R. Dirty-Appearing White Matter in the Brain is Associated with Altered Cerebrospinal Fluid Pulsatility and Hypertension in Individuals without Neurologic Disease. J Neuroimaging 2015; 26:136-43. [DOI: 10.1111/jon.12249] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/04/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Clive B. Beggs
- Centre for Infection Control and Biophysics; University of Bradford; Bradford UK
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Christopher Magnano
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Simon J. Shepherd
- Centre for Infection Control and Biophysics; University of Bradford; Bradford UK
| | - Pavel Belov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Deepa P. Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Jesper Hagemeier
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
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46
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Mak E, Dwyer MG, Ramasamy DP, Au WL, Tan LCS, Zivadinov R, Kandiah N. White Matter Hyperintensities and Mild Cognitive Impairment in Parkinson's Disease. J Neuroimaging 2015; 25:754-60. [PMID: 25753576 DOI: 10.1111/jon.12230] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 01/27/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES The clinical implications of white matter hyperintensities (WMH) in non-demented Parkinson's disease (PD) have not been thoroughly examined. To address this, we investigated the spatial distribution of WMH and their regional predilection in non-demented patients with mild PD. METHODS Cognitive assessments classified the sample into patients with mild cognitive impairment (PD-MCI, n = 25) and patients with no cognitive impairment (PD-NCI, n = 65) based on the recent formal Movement Disorder Task Force diagnostic criteria. The mean age was 65.1 ± 7.7 years, disease duration was 5.3 ± 3.9 years, and Hoehn and Yahr stage was 1.9 ± .4. WMHs were outlined on T2-weighted imaging using a semi-automated technique. The spatial distribution of WMHs were compared between PD-MCI and PD-NCI using voxel-wise lesion probability maps (LPM). General linear models examined the associations between spatially specific WMHs and cognitive domains. RESULTS LPM analyses showed significant differences in the spatial distribution of WMH in PD-MCI compared to PD-NCI in widespread regions of the brain (P < .05). PD-MCI demonstrated significantly greater total and periventricular WMHs compared to PD-NCI (P ≤ .02). Spatial distribution of WMHs was also significantly associated with global cognition, performance on the Frontal Assessment Battery and Fruit Fluency (P < .05). CONCLUSIONS Voxel-wise LPM analysis revealed differences in the spatial distribution of WMH between PD-MCI and PD-NCI patients, particularly in the periventricular regions. A more widespread extent of WMH might be indicative of cognitive deterioration. Our findings warrant further longitudinal investigation into the importance of WMH spatial distribution as a predictor for conversion from PD to PD with dementia.
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Affiliation(s)
- Elijah Mak
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.,Department of Neurology, National Neuroscience Institute, Singapore
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Wing Lok Au
- Department of Neurology, National Neuroscience Institute, Singapore.,Duke-NUS Graduate Medical School, Singapore
| | - Louis C S Tan
- Department of Neurology, National Neuroscience Institute, Singapore.,Duke-NUS Graduate Medical School, Singapore
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.,MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore.,Duke-NUS Graduate Medical School, Singapore
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Uher T, Benedict RH, Horakova D, Bergsland N, Dusankova JB, Tyblova M, Ramasamy DP, Seidl Z, Vaneckova M, Krasensky J, Havrdova E, Zivadinov R. Relationship between gray matter volume and cognitive learning in CIS patients on disease-modifying treatment. J Neurol Sci 2014; 347:229-34. [DOI: 10.1016/j.jns.2014.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/23/2014] [Accepted: 10/01/2014] [Indexed: 12/26/2022]
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Chung CP, Beggs C, Wang PN, Bergsland N, Shepherd S, Cheng CY, Ramasamy DP, Dwyer MG, Hu HH, Zivadinov R. Jugular venous reflux and white matter abnormalities in Alzheimer's disease: a pilot study. J Alzheimers Dis 2014; 39:601-9. [PMID: 24217278 DOI: 10.3233/jad-131112] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To determine whether jugular venous reflux (JVR) is associated with cerebral white matter changes (WMCs) in individuals with Alzheimer's disease (AD), we studied 12 AD patients 24 mild cognitive impairment (MCI) patients, and 17 elderly age- and gender-matched controls. Duplex ultrasonography and 1.5T MRI scanning was applied to quantify cerebral WMCs [T2 white matter (WM) lesion and dirty-appearing-white-matter (DAWM)]. Subjects with severe JVR had more frequently hypertension (p = 0.044), more severe WMC, including increased total (p = 0.047) and periventricular DAWM volumes (p = 0.008), and a trend for increased cerebrospinal fluid volumes (p = 0.067) compared with the other groups. A significantly decreased (65.8%) periventricular DAWM volume (p = 0.01) in the JVR-positive AD individuals compared with their JVR-negative counterparts was detected. There was a trend for increased periventricular and subcortical T2 WMC lesion volumes in the JVR-positive AD individuals compared with their JVR-negative counterparts (p = 0.073). This phenomenon was not observed in either the control or MCI groups. In multiple regression analysis, the increased periventricular WMC lesion volume and decreased DAWM volume resulted in 85.7% sensitivity and 80% specificity for distinguishing between JVR-positive and JVR-negative AD patients. These JVR-WMC association patterns were not seen in the control and MCI groups. Therefore, this pilot study suggests that there may be an association between JVR and WMCs in AD patients, implying that cerebral venous outflow impairment might play a role in the dynamics of WMCs formation in AD patients, particularly in the periventricular regions. Further longitudinal studies are needed to confirm and validate our findings.
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Affiliation(s)
- Chih-Ping Chung
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurology, National Yang Ming University of Medicine, Taipei, Taiwan
| | - Clive Beggs
- Centre for Infection Control and Biophysics, University of Bradford, Bradford, UK
| | - Pei-Ning Wang
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurology, National Yang Ming University of Medicine, Taipei, Taiwan
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, Buffalo, NY, USA
| | - Simon Shepherd
- Centre for Infection Control and Biophysics, University of Bradford, Bradford, UK
| | - Chun-Yu Cheng
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurology, National Yang Ming University of Medicine, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, Buffalo, NY, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, Buffalo, NY, USA
| | - Han-Hwa Hu
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurology, National Yang Ming University of Medicine, Taipei, Taiwan
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, Buffalo, NY, USA
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Jacobsen C, Hagemeier J, Myhr KM, Nyland H, Lode K, Bergsland N, Ramasamy DP, Dalaker TO, Larsen JP, Farbu E, Zivadinov R. Brain atrophy and disability progression in multiple sclerosis patients: a 10-year follow-up study. J Neurol Neurosurg Psychiatry 2014; 85:1109-15. [PMID: 24554101 DOI: 10.1136/jnnp-2013-306906] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To identify MRI biomarkers associated with long-term disability progression in patients with multiple sclerosis (MS), and to define the rate of evolution of global, tissue-specific and regional atrophy in patients with MS over long-term. METHODS MRI of the brain and clinical neurological assessment was performed in 81 patients at time of first visit and after 5 and 10 years of follow-up. MRI was acquired on 1.5 T scanners. T1-lesion and T2-lesion volumes (LVs) were calculated. Global and tissue-specific atrophy changes were longitudinally assessed, using a direct measurement approach, by calculating percentage volume changes between different time points. Regional tissue volumes for the subcortical deep grey matter (SDGM) structures were also obtained. Disability progression was defined as an increase in Expanded Disability Status Scale of ≥ 1.0 compared to baseline at 5-year and 10-year follow-up. RESULTS Over 5 years, patients with disability progression showed significantly increased loss of whole brain (-3.8% vs -2.0%, p<0.001), cortical (-3.4% vs -1.8%, p=0.009) and putamen volume changes (-10.6% vs -3.8%, p=0.003) compared to patients with no disability progression. No significant change in white matter (WM) volume was observed when comparing progressing and non-progressing patients. Over 10 years, there was a trend for greater decrease in whole brain volume (-5.5% vs -3.7%, p=0.015) in the progressing patients. No significant changes in LV measures were detected between the patients with and without disability progression. CONCLUSION This long-term study shows that whole brain, cortical and putamen atrophy occurs throughout the 10-year follow-up of this MS cohort and is more pronounced in the group that showed disability progression at 5, but not at 10 years of follow-up. Overall, GM atrophy showed better association with disease progression than WM atrophy over 5-year and 10-year follow-up.
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Affiliation(s)
- Cecilie Jacobsen
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, University at Buffalo, State University of New York, Buffalo, New York, USA Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Jesper Hagemeier
- Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Kjell-Morten Myhr
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Bergen, Norway
| | - Harald Nyland
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Bergen, Norway
| | - Kirsten Lode
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway
| | - Niels Bergsland
- Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Deepa P Ramasamy
- Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Turi O Dalaker
- Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Radiology, Stavanger University Hospital, Stavanger, Norway
| | - Jan Petter Larsen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Elisabeth Farbu
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Robert Zivadinov
- Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, University at Buffalo, State University of New York, Buffalo, New York, USA MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
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50
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Browne RW, Weinstock-Guttman B, Zivadinov R, Horakova D, Bodziak ML, Tamaño-Blanco M, Badgett D, Tyblova M, Vaneckova M, Seidl Z, Krasensky J, Bergsland N, Ramasamy DP, Hagemeier J, Qu J, Havrdova E, Ramanathan M. Serum lipoprotein composition and vitamin D metabolite levels in clinically isolated syndromes: Results from a multi-center study. J Steroid Biochem Mol Biol 2014; 143:424-33. [PMID: 24950029 DOI: 10.1016/j.jsbmb.2014.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/09/2014] [Accepted: 06/11/2014] [Indexed: 12/21/2022]
Abstract
CONTEXT High serum cholesterol is adversely associated with clinical and imaging disease progression outcomes in multiple sclerosis (MS) and in clinically isolated syndrome (CIS), the earliest stage of MS. Low vitamin D levels are associated with an increased risk of disease progression. OBJECTIVES To investigate the mechanisms mediating the adverse effects of cholesterol in CIS and to determine the role of the nexus between the vitamin D3 (D3) and cholesterol pathways. DESIGN Multi-center, prospective, longitudinal prospective study. SETTING University hospital multiple sclerosis centers. INTERVENTION Serum samples were obtained prior to any treatment from study subjects. METHODS Serum obtained prior to any treatment from 172 CIS patients enrolled in a multi-center, prospective, longitudinal study (119 females: 53 males, age: 28.1 ± SD 8.1 years) were analyzed for high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (ApoAI), ApoAII, ApoB, ApoE, and lipoprotein-a. Levels of 25-hydroxy vitamin D3 (25(OH)D3), 1,25-dihydroxy D3, and 24,25-dihydroxy D3 were measured using liquid chromatography-mass spectrometry. RESULTS Greater levels of HDL-C biomarkers (e.g., HDL-C itself, ApoAI, ApoAII and paroxonase arylesterase activity) and LDL-C biomarkers (e.g., LDL-C itself, Apo B) were associated with greater 25(OH)D3. The effects of HDL-C biomarkers were stronger than those of LDL-C. Free cholesterol and cholesteryl ester levels were positively associated with higher 25(OH)D3 levels. Cholesterol palmitate was particularly potent. The nexus between the D3 and cholesterol pathways was proximal to, or in linkage disequilibrium with, 7-dehydrocholesterol reductase DHCR7 rs1790349, endothelial lipase LIPG rs4939883 and proprotein convertase subtilisin/kexin type 9 PCSK9 rs11206510. CONCLUSIONS The associations between cholesterol biomarkers and vitamin D metabolite levels in CIS are consistent with the biochemical inter-dependence between the two pathways. Cholesterol biomarkers should be considered for inclusion as covariates when assessing vitamin D levels in CIS.
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Affiliation(s)
- Richard W Browne
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, NY, USA
| | | | - Robert Zivadinov
- Department of Neurology, State University of New York, Buffalo, NY, USA; Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Mary Lou Bodziak
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, NY, USA
| | - Miriam Tamaño-Blanco
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Darlene Badgett
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Michaela Tyblova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Manuela Vaneckova
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Zdenek Seidl
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jan Krasensky
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA; IRCCS, S. Maria Nascente, Don Gnocchi Foundation, Milan, Italy
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Jun Qu
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Eva Havrdova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Murali Ramanathan
- Department of Neurology, State University of New York, Buffalo, NY, USA; Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA.
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