Contributions
Abstract: P519
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Motor deficit plays a major role in global clinical disability in multiple sclerosis (MS). Despite its high prevalence and detrimental effects on patients" daily life activities, its structural substrates have yet to be fully elucidated.
Objectives:
1) To assess the influence of structural damage in different sites of the motor system in a cross-sectional evaluation on a cohort of patients with MS.
2) To longitudinally identify which MRI measures can predict the evolution of disability in the following years.
Methods: 58 MS patients underwent clinical examination and 3T MRI [11 male; mean age 36.5 ±7.1 years; median Expanded Disability Status Scale (EDSS) 1.5, (range 0-6); mean 25-Foot Walking Test (25FWT) 5.9±1.6 sec, mean 9-Hole Peg Test Dominant Hand (9HPT-DH) 18.8±3.4 sec, Non Dominant Hand (NDH) 20.4±4.5 sec]. MRI protocol included: T2-W TSE, 3D T1-W and DTI. We calculated the following MRI measures: corticospinal tract (CST) and corpus corpus callosum (CC) fractional anisotropy (FA); deep grey matter (DGM) normalized volumes as thalamus (ThV), caudate (CaV), putamen (PuV), and pallidum (PaV); total and infratentorial lesion load (LL, LLit respectively); normalized spine volume at C2-C3 level (SV). Follow-up (FU) (median FU: 3, range 1-5 years) clinical evaluation was performed on 47 MS patients from the baseline cohort. We carried out univariate correlations of the aforementioned MRI measures with baseline scores and Cox regression analyses to identify MRI variables predictive of future disability.
Results: Cross-sectional analyses showed correlations between EDSS score and ThV, CaV, PuV (0.001 < p < 0.05). Baseline 25FWT was associated with SV, ThV, CaV, (0.001 < p < 0.05). 9HPT-DH exhibited an inverse correlation with LL and all DGM structures (0.001< p0.05), while 9HPT-NDH with LL, LLit, ThV, PaV (0.001< p< 0.05). At FU 18 patients showed worsening exceeding 20% in at least one clinical measure or increasing 1 point in the EDSS score. Baseline volume of the thalamus and LLit were the best predictors of worsening in EDSS (HR: 0.99, p=0.06; HR: 1.01, p=0.02 respectively). CaV predicted worsening in 9HPT-NDH at FU (HR: 0.99, p=0.02).
Conclusion: Our results confirm the fundamental role of subcortical grey matter structures in motor impairment. Thalamic volume appears a good predictor of future disability assessed by EDSS, as caudate volume may predict future limitation in manual dexterity.
Disclosure:
Ruggieri S: nothing to disclose
De Luca F: nothing to disclose
Petsas N has received speaker fee from Biogen Idec-Portugal
Tona F: nothing to disclose
De Giglio L: nothing to disclose
Upadhyay N: nothing to disclose
Prosperini L has received speaker honoraria from Biogen, Genzyme, Novartis and Teva; consulting fees from Biogen and Novartis; research grant from Genzyme andAISM/FISM.
Pozzilli C has received consulting and lecture fees from Bayer Schering, Biogen, Merck-Serono, Novartis, and Sanofi-Aventis; has received research funding from Bayer Schering, Merck Serono, Novartis, and Sanofi-Aventis.
Pantano P has received founding for travel from Novartis, Genzyme and Bracco and speaker honoraria from Biogen.
Abstract: P519
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Motor deficit plays a major role in global clinical disability in multiple sclerosis (MS). Despite its high prevalence and detrimental effects on patients" daily life activities, its structural substrates have yet to be fully elucidated.
Objectives:
1) To assess the influence of structural damage in different sites of the motor system in a cross-sectional evaluation on a cohort of patients with MS.
2) To longitudinally identify which MRI measures can predict the evolution of disability in the following years.
Methods: 58 MS patients underwent clinical examination and 3T MRI [11 male; mean age 36.5 ±7.1 years; median Expanded Disability Status Scale (EDSS) 1.5, (range 0-6); mean 25-Foot Walking Test (25FWT) 5.9±1.6 sec, mean 9-Hole Peg Test Dominant Hand (9HPT-DH) 18.8±3.4 sec, Non Dominant Hand (NDH) 20.4±4.5 sec]. MRI protocol included: T2-W TSE, 3D T1-W and DTI. We calculated the following MRI measures: corticospinal tract (CST) and corpus corpus callosum (CC) fractional anisotropy (FA); deep grey matter (DGM) normalized volumes as thalamus (ThV), caudate (CaV), putamen (PuV), and pallidum (PaV); total and infratentorial lesion load (LL, LLit respectively); normalized spine volume at C2-C3 level (SV). Follow-up (FU) (median FU: 3, range 1-5 years) clinical evaluation was performed on 47 MS patients from the baseline cohort. We carried out univariate correlations of the aforementioned MRI measures with baseline scores and Cox regression analyses to identify MRI variables predictive of future disability.
Results: Cross-sectional analyses showed correlations between EDSS score and ThV, CaV, PuV (0.001 < p < 0.05). Baseline 25FWT was associated with SV, ThV, CaV, (0.001 < p < 0.05). 9HPT-DH exhibited an inverse correlation with LL and all DGM structures (0.001< p0.05), while 9HPT-NDH with LL, LLit, ThV, PaV (0.001< p< 0.05). At FU 18 patients showed worsening exceeding 20% in at least one clinical measure or increasing 1 point in the EDSS score. Baseline volume of the thalamus and LLit were the best predictors of worsening in EDSS (HR: 0.99, p=0.06; HR: 1.01, p=0.02 respectively). CaV predicted worsening in 9HPT-NDH at FU (HR: 0.99, p=0.02).
Conclusion: Our results confirm the fundamental role of subcortical grey matter structures in motor impairment. Thalamic volume appears a good predictor of future disability assessed by EDSS, as caudate volume may predict future limitation in manual dexterity.
Disclosure:
Ruggieri S: nothing to disclose
De Luca F: nothing to disclose
Petsas N has received speaker fee from Biogen Idec-Portugal
Tona F: nothing to disclose
De Giglio L: nothing to disclose
Upadhyay N: nothing to disclose
Prosperini L has received speaker honoraria from Biogen, Genzyme, Novartis and Teva; consulting fees from Biogen and Novartis; research grant from Genzyme andAISM/FISM.
Pozzilli C has received consulting and lecture fees from Bayer Schering, Biogen, Merck-Serono, Novartis, and Sanofi-Aventis; has received research funding from Bayer Schering, Merck Serono, Novartis, and Sanofi-Aventis.
Pantano P has received founding for travel from Novartis, Genzyme and Bracco and speaker honoraria from Biogen.