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Petracca M, Zaaraoui W, Cocozza S, Vancea R, Howard J, Heinig MM, Fleysher L, Oesingmann N, Ranjeva JP, Inglese M. An MRI evaluation of grey matter damage in African Americans with MS. Mult Scler Relat Disord 2018; 25:29-36. [PMID: 30029018 PMCID: PMC6214725 DOI: 10.1016/j.msard.2018.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/29/2018] [Accepted: 06/13/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Multiple sclerosis (MS) is less prevalent in African Americans (AAs) than Caucasians (CAs) but in the former the disease course tends to be more severe. In order to clarify the MRI correlates of disease severity in AAs, we performed a multimodal brain MRI study to comprehensively assess the extent of grey matter (GM) damage and the degree of functional adaptation to structural damage in AAs with MS. METHODS In this cross-sectional study, we characterized GM damage in terms of focal lesions and volume loss and functional adaptation during the execution of a simple motor task on a sample of 20 AAs and 20 CAs with MS and 20 healthy controls (CTRLs). RESULTS In AAs, we observed a wider range of EDSS scores than CAs, with multisystem involvement being more likely in AAs (p < 0.01). While no significant differences were detected in lesion loads and global brain volumes, AAs showed regional atrophy in the posterior lobules of cerebellum, temporo-occipital and frontal regions in comparison with CAs (p < 0.01), with cerebellar atrophy being the best metric in differentiating AAs from CAs (p = 0.007, AUC = 0.96 and p = 0.005, AUC = 0.96, respectively for right and left cerebellar clusters). In AAs, the functional analysis of cortical activations showed an increase in task-related activation of areas involved in high level processing and a decreased activation in the medial prefrontal cortex compared to CAs. INTERPRETATION In our study, the direct comparison of AAs and CAs points to cerebellar atrophy as the main difference between subgroups.
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Affiliation(s)
- Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Neurosciences, Reproductive and Odonto-stomatological Sciences, University "Federico II", Naples, Italy
| | - Wafaa Zaaraoui
- Aix-Marseille Univ, CNRS, CRMBM UMR, 7339, Marseille, France
| | - Sirio Cocozza
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Roxana Vancea
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Jonathan Howard
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Monika M Heinig
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Lazar Fleysher
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Jean-Philippe Ranjeva
- Aix-Marseille Univ, CNRS, CRMBM UMR, 7339, Marseille, France; UK Biobank, Stockport, Cheshire, SK3 0SA, UK
| | - Matilde Inglese
- Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, (DINOGMI) University of Genova and IRCCS AOU San Martino-IST, Genoa, Italy.
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Cocozza S, Petracca M, Mormina E, Buyukturkoglu K, Podranski K, Heinig MM, Pontillo G, Russo C, Tedeschi E, Russo CV, Costabile T, Lanzillo R, Harel A, Klineova S, Miller A, Brunetti A, Morra VB, Lublin F, Inglese M. Cerebellar lobule atrophy and disability in progressive MS. J Neurol Neurosurg Psychiatry 2017; 88:1065-1072. [PMID: 28844067 DOI: 10.1136/jnnp-2017-316448] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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: 05/16/2017] [Revised: 07/10/2017] [Accepted: 07/23/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To investigate global and lobular cerebellar volumetries in patients with progressive multiple sclerosis (MS), testing the contribution of cerebellar lobular atrophy to both motor and cognitive performances. METHODS Eighty-two patients with progressive MS and 46 healthy controls (HC) were enrolled in this cross-sectional study. Clinical evaluation included motor and cognitive testing: Expanded Disability Status Scale, cerebellar Functional System score, Timed 25-Foot Walk Test, 9-Hole Peg Test (9-HPT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT) and California Verbal Learning Test II (CVLT). Cerebellar volumes were automatically obtained using the Spatially Unbiased Infratentorial Toolbox. A hierarchical multiple linear regression analysis was performed to assess the relationship between MRI variables of supratentorial and cerebellar damage (grey matter fraction, T2 lesion volume, metrics of cerebellar atrophy and cerebellar lesion volume) and motor/cognitive scores. RESULTS Patients with MS exhibited lower cerebellar volumes compared with HC. Regression analysis showed that cerebellar metrics accounted for extra variance in both motor and cognitive performances, with cerebellar lesion volume, cerebellar Lobules VI, Crus I and VIIIa atrophy being independent predictors of 9-HPT, SDMT, BVMT and CVLT performances. CONCLUSIONS Atrophy of specific cerebellar lobules explains different aspects of motor and cognitive disability in patients with progressive MS. Investigation of cerebellar involvement provides further insight into the pathophysiological basis of clinical disability in progressive MS.
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Affiliation(s)
- Sirio Cocozza
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Advanced Biomedical Sciences, University 'Federico II', Naples, Italy
| | - Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Neurosciences, Reproductive and Odonto-stomatological Sciences, University 'Federico II', Naples, Italy
| | - Enricomaria Mormina
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Kornelius Podranski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Monika M Heinig
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Giuseppe Pontillo
- Department of Advanced Biomedical Sciences, University 'Federico II', Naples, Italy
| | - Camilla Russo
- Department of Advanced Biomedical Sciences, University 'Federico II', Naples, Italy
| | - Enrico Tedeschi
- Department of Advanced Biomedical Sciences, University 'Federico II', Naples, Italy
| | - Cinzia Valeria Russo
- Department of Neurosciences, Reproductive and Odonto-stomatological Sciences, University 'Federico II', Naples, Italy
| | - Teresa Costabile
- Department of Neurosciences, Reproductive and Odonto-stomatological Sciences, University 'Federico II', Naples, Italy
| | - Roberta Lanzillo
- Department of Neurosciences, Reproductive and Odonto-stomatological Sciences, University 'Federico II', Naples, Italy
| | - Asaff Harel
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sylvia Klineova
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Aaron Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University 'Federico II', Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neurosciences, Reproductive and Odonto-stomatological Sciences, University 'Federico II', Naples, Italy
| | - Fred Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Matilde Inglese
- Departments of Neurology, Radiology and Neuroscience, Icahn School of Medicine, New York, USA.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Perinatal Sciences, University of Genoa, Genova, Italy.,IRCCS Azienda Ospedale Università San Martino-IST, Genova, Italy
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