Contributions
Abstract: P539
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: The cerebellum plays a role in a wide variety of complex behaviors. Many evidences support a topographic division into “motor” and “non-motor” regions localized in the anterior and posterior cerebellum, respectively.
Aims: To assess the role of cerebellar sub-regions in determining motor and cognitive impairment in MS patients. To our knowledge, this is the first attempt to investigate motor and cognitive impact of structural cerebellar sub-regional involvement in a large MS cohort.
Methods: Cerebellar segmentation and lobular parcellation were performed on the 3D-T1 brain images from 95 MS patients and 32 healthy controls (HC) using the SUIT tool from SPM12. For all subjects, we also obtained normalized cerebral volumes and scores of motor performance (Nine Hole Peg Test [9-HPT]). MS patients also underwent a cognitive evaluation (Symbol Digit Modalities Test [SDMT], Paced Auditory Serial Addition Test [PASAT]). A linear regression analysis was used to assess the correlations between MRI derived volumes and both motor and cognitive scores. All results were considered significant (p< 0.05) after correction for multiple comparisons.
Results: Compared to HC, MS patients showed a significant lower total brain, white (WM) and grey matter (GM) volume. Only secondary progressive (SP) MS patients showed significant lower cerebellar volumes compared to HC. No significant differences in the cerebellar volumes were found between MS patients and HC. In MS patients, better 9-HPT performance correlated with higher cerebellar volumes, mostly in the anterior region (lobules I-V) (p=0.0003), whereas better cognitive performance correlated with higher cerebellar volumes, mostly (p< 0.0001) in the posterior-inferior region (lobules VI-X). No correlations were found between clinical/cognitive parameters and normalized cerebral (total brain, white and grey matter) volumes.
Conclusions: Motor and cognitive performances in MS seem to be more influenced by cerebellar than cerebral volumes. Cerebellar posterior-inferior volume accounted for variance in cognitive measures, whereas anterior cerebellar volume accounted for variance in motor performance, supporting a critical contribution of regional cerebellar damage to the clinical manifestations of MS.
This study has been partially supported by a grant from FISM 2011/R/19 and Italian Ministry of Health (GR-2009-1529671).
Disclosure:
Drs d´Ambrosio, Pagani, Riccitelli, Colombo, Rodegher, and Falini have nothing to disclose.
Dr Rocca received speakers honoraria from Biogen Idec, Novartis and ExceMed and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Prof. Filippi is Editor-in-Chief of the Journal of Neurology; serves on scientific advisory boards for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Excemed, Novartis, and Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Teva Pharmaceutical Industries, Novartis, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, Cure PSP, Alzheimer´s Drug Discovery Foundation (ADDF), the Jacques and Gloria Gossweiler Foundation (Switzerland), and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
Prof. Comi has received consulting fees for participating on advisory boards from Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Actelion and honorarium for speaking activities for Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Biogen, Excemed.
Abstract: P539
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: The cerebellum plays a role in a wide variety of complex behaviors. Many evidences support a topographic division into “motor” and “non-motor” regions localized in the anterior and posterior cerebellum, respectively.
Aims: To assess the role of cerebellar sub-regions in determining motor and cognitive impairment in MS patients. To our knowledge, this is the first attempt to investigate motor and cognitive impact of structural cerebellar sub-regional involvement in a large MS cohort.
Methods: Cerebellar segmentation and lobular parcellation were performed on the 3D-T1 brain images from 95 MS patients and 32 healthy controls (HC) using the SUIT tool from SPM12. For all subjects, we also obtained normalized cerebral volumes and scores of motor performance (Nine Hole Peg Test [9-HPT]). MS patients also underwent a cognitive evaluation (Symbol Digit Modalities Test [SDMT], Paced Auditory Serial Addition Test [PASAT]). A linear regression analysis was used to assess the correlations between MRI derived volumes and both motor and cognitive scores. All results were considered significant (p< 0.05) after correction for multiple comparisons.
Results: Compared to HC, MS patients showed a significant lower total brain, white (WM) and grey matter (GM) volume. Only secondary progressive (SP) MS patients showed significant lower cerebellar volumes compared to HC. No significant differences in the cerebellar volumes were found between MS patients and HC. In MS patients, better 9-HPT performance correlated with higher cerebellar volumes, mostly in the anterior region (lobules I-V) (p=0.0003), whereas better cognitive performance correlated with higher cerebellar volumes, mostly (p< 0.0001) in the posterior-inferior region (lobules VI-X). No correlations were found between clinical/cognitive parameters and normalized cerebral (total brain, white and grey matter) volumes.
Conclusions: Motor and cognitive performances in MS seem to be more influenced by cerebellar than cerebral volumes. Cerebellar posterior-inferior volume accounted for variance in cognitive measures, whereas anterior cerebellar volume accounted for variance in motor performance, supporting a critical contribution of regional cerebellar damage to the clinical manifestations of MS.
This study has been partially supported by a grant from FISM 2011/R/19 and Italian Ministry of Health (GR-2009-1529671).
Disclosure:
Drs d´Ambrosio, Pagani, Riccitelli, Colombo, Rodegher, and Falini have nothing to disclose.
Dr Rocca received speakers honoraria from Biogen Idec, Novartis and ExceMed and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Prof. Filippi is Editor-in-Chief of the Journal of Neurology; serves on scientific advisory boards for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Excemed, Novartis, and Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Teva Pharmaceutical Industries, Novartis, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, Cure PSP, Alzheimer´s Drug Discovery Foundation (ADDF), the Jacques and Gloria Gossweiler Foundation (Switzerland), and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
Prof. Comi has received consulting fees for participating on advisory boards from Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Actelion and honorarium for speaking activities for Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Biogen, Excemed.