Contributions
Abstract: P1035
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Natural history studies have shown that pediatric-onset MS (POMS) reaches irreversible disability, despite slower progression, at a much younger age than adult-onset MS (AOMS). It is unclear whether young adult POMS shows more pronounced brain tissue damage and/or disrupted connectivity with respect to AOMS of similar age and disability
Goals: To assess brain tissue integrity and connectivity in young adult POMS patients with mild disability in comparison with age- and disability-matched AOMS patients
Methods: Multimodal brain MRI was acquired on a 3T MR scanner in POMS (n=15, age=24.8±7 years, duration=9.8±6.2 years) and age-matched AOMS (n=14, age=27.8±3 years, duration=5.2±2.2 years) and NC (n=20, age=27.1±4 years). The two MS groups had similar disability (median EDSS: 1 in both). Anatomical connectivity (AC) along white matter (WM) tracts was assessed with TBSS while intra- and inter-networks functional connectivity (FC) was evaluated with ICA-AROMA/MELODIC/dual regression and with FSLNets. FSLVBM was used to assess local grey matter (GM) volumes. Voxelwise analysis of variance was performed with nonparametric permutation testing (p< 0.01, corrected).
Results: POMS had slightly higher T2-lesion volume (LV) than AOMS (10.7±12 cm3 vs 6.6±4.5 cm3, p=0.8). The two patient groups were similar in global and regional brain volumes. POMS showed altered AC (lower fractional anisotropy and/or higher diffusivities) in comparison to NC (thalamic radiations, inferior fronto-occipital fascicle, inferior longitudinal fascicle, posterior corona radiata [PCR], corpus callosum, fornix) and AOMS (PCR). No between-group differences in intra-network FC were found. However, inter-network FC measures between default mode network (DMN) and secondary visual network were lower in POMS than in both NC (full correlation: -4.06 vs -2.6) and AOMS (partial correlation: -0.82 vs -0.22) whereas no differences were found between AOMS and NC.
Conclusion: POMS show macroscopic tissue damage (i.e., brain lesions and atrophy) comparable with that of AOMS patients of similar age and mild disability, despite longer disease duration. However, POMS show reduced AC along the corticospinal tract, a clinically eloquent tract for physical disability, and reduced long-range FC involving a relevant hub for cognition such as DMN. This connectivity disruption of POMS patients might explain, at a relatively early disease stage, their unfavourable clinical outcome in the long term.
Disclosure: Antonio Giorgio, Jian Zhang, Maria Laura Stromillo, Francesca Rossi, Marzia Mortilla and Bahia Hakiki have nothing to disclose
Emilio Portaccio has served on scientific advisory boards for Biogen Idec, Merck Serono and Genzyme; received speaker"s honoraria from Biogen Idec, Teva, Novartis and Genzyme; and received research support from Merck Serono
Prof. Maria Pia Amato serves on scientific advisory boards for Biogen Idec, Merck Serono and receives speaker honoraria and research support from Biogen Idec, Merck Serono, Novartis, Almirall, Teva and Genzyme.
Prof. Nicola De Stefano has served as an advisor or consultant for Merck Serono and Novartis Pharmaceuticals Corporation. He has served as a speaker or a member of a speakers bureau for Bayer Schering Pharma, Biogen Idec, Inc., BioMS Medical Corp., Merck Serono, Novartis Pharmaceuticals Corporation and Teva Pharmaceutical Industries Ltd
Abstract: P1035
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Natural history studies have shown that pediatric-onset MS (POMS) reaches irreversible disability, despite slower progression, at a much younger age than adult-onset MS (AOMS). It is unclear whether young adult POMS shows more pronounced brain tissue damage and/or disrupted connectivity with respect to AOMS of similar age and disability
Goals: To assess brain tissue integrity and connectivity in young adult POMS patients with mild disability in comparison with age- and disability-matched AOMS patients
Methods: Multimodal brain MRI was acquired on a 3T MR scanner in POMS (n=15, age=24.8±7 years, duration=9.8±6.2 years) and age-matched AOMS (n=14, age=27.8±3 years, duration=5.2±2.2 years) and NC (n=20, age=27.1±4 years). The two MS groups had similar disability (median EDSS: 1 in both). Anatomical connectivity (AC) along white matter (WM) tracts was assessed with TBSS while intra- and inter-networks functional connectivity (FC) was evaluated with ICA-AROMA/MELODIC/dual regression and with FSLNets. FSLVBM was used to assess local grey matter (GM) volumes. Voxelwise analysis of variance was performed with nonparametric permutation testing (p< 0.01, corrected).
Results: POMS had slightly higher T2-lesion volume (LV) than AOMS (10.7±12 cm3 vs 6.6±4.5 cm3, p=0.8). The two patient groups were similar in global and regional brain volumes. POMS showed altered AC (lower fractional anisotropy and/or higher diffusivities) in comparison to NC (thalamic radiations, inferior fronto-occipital fascicle, inferior longitudinal fascicle, posterior corona radiata [PCR], corpus callosum, fornix) and AOMS (PCR). No between-group differences in intra-network FC were found. However, inter-network FC measures between default mode network (DMN) and secondary visual network were lower in POMS than in both NC (full correlation: -4.06 vs -2.6) and AOMS (partial correlation: -0.82 vs -0.22) whereas no differences were found between AOMS and NC.
Conclusion: POMS show macroscopic tissue damage (i.e., brain lesions and atrophy) comparable with that of AOMS patients of similar age and mild disability, despite longer disease duration. However, POMS show reduced AC along the corticospinal tract, a clinically eloquent tract for physical disability, and reduced long-range FC involving a relevant hub for cognition such as DMN. This connectivity disruption of POMS patients might explain, at a relatively early disease stage, their unfavourable clinical outcome in the long term.
Disclosure: Antonio Giorgio, Jian Zhang, Maria Laura Stromillo, Francesca Rossi, Marzia Mortilla and Bahia Hakiki have nothing to disclose
Emilio Portaccio has served on scientific advisory boards for Biogen Idec, Merck Serono and Genzyme; received speaker"s honoraria from Biogen Idec, Teva, Novartis and Genzyme; and received research support from Merck Serono
Prof. Maria Pia Amato serves on scientific advisory boards for Biogen Idec, Merck Serono and receives speaker honoraria and research support from Biogen Idec, Merck Serono, Novartis, Almirall, Teva and Genzyme.
Prof. Nicola De Stefano has served as an advisor or consultant for Merck Serono and Novartis Pharmaceuticals Corporation. He has served as a speaker or a member of a speakers bureau for Bayer Schering Pharma, Biogen Idec, Inc., BioMS Medical Corp., Merck Serono, Novartis Pharmaceuticals Corporation and Teva Pharmaceutical Industries Ltd