Contributions
Abstract: P822
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Background: A large proportion of pediatric MS patients experiences cognitive deficits, with a prominent involvement of linguistic abilities in addition to memory, attention, and executive functions.
Aims: By applying diffusion tensor (DT) MRI, we aim at describing brain structural network architecture in pediatric MS patients and to detect structural connectivity abnormalities underlying cognitive dysfunction across the different cognitive domains.
Methods: DT and dual-echo MRI scans were obtained using a 3.0 T scanner from 53 pediatric MS patients and 26 age- and sex-matched healthy controls (HC). Whole-brain networks were constructed using graph theory. Between-group differences of global and local network connectivity metrics were investigated. Partial correlations between network metrics and Z-scores for each of cognitive domain and a global Z-score of cognitive function controlling for age and sex were performed.
Results: All global network metrics showed significant differences between pediatric MS patients and HC. Compared to HC, pediatric MS patients lost hubs in the right superior frontal gyrus (SFG), middle occipital gyrus, caudate nucleus and cerebellum crus II and in the left precentral gyrus, temporal pole, thalamus and cerebellum crus I. Global cognitive functioning showed significant positive correlation with the strength of connections of hubs located in the right superior parietal lobe and the precuneus bilaterally. Impairment in language functions, as well as verbal memory impairment were significantly related to reduced strength of the hubs located in frontal and temporal, while visual-spatial memory, attention and information processing speed impairment appeared were associated to a reduced strength in several hubs located in frontal, parietal and occipital lobes.
Conclusions: This study showed abnormalities in global network metrics in pediatric MS patients with limited differences in hubs distribution, indicating a partial preservation of brain network architecture. Our findings suggest that cognitive impairment is mainly associated to a globally reduced strength of connections of the nodes identified as hubs, likely due to diffuse normal appearing white matter damage, more than to a local damage, resulting in alteration and loss of efficiency in information transmission.
Partially supported by a grant from Italian Ministry of Health (GR-2009-1529671) and FISM (FISM2011/R/19 & FISM 2012/R/8).
Disclosure:
Drs De Meo, Pagani, Moiola, Veggiotti, Vacchi, Fiorino, Pippolo, Pera, 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. A Ghezzi has received honoraria for speaking from Biogen, Merck Serono, Novartis, and Sanofi-Aventis; for consultancy from Merck Serono, Teva, and Novartis; and support for participation in national and international congresses from Bayer-Schering, Biogen-Dompè, Merck Serono, Novartis, and Sanofi-Aventis. Ruggero Capra received consulting fees from Novartis,Merck Serono, BiogenIdec and lecture fees fromBayer, BiogenIdec, Dompé, Genzyme and Sanofi-Aventis. Maria P Amato serves on scientific advisory boards for Biogen-Idec, Merck Serono, Bayer Schering and Sanofi Aventis and receives research support and honoraria for speaking from Biogen-Idec, Merck Serono, Bayer Schering and Sanofi Aventis. 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. 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).
Abstract: P822
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Background: A large proportion of pediatric MS patients experiences cognitive deficits, with a prominent involvement of linguistic abilities in addition to memory, attention, and executive functions.
Aims: By applying diffusion tensor (DT) MRI, we aim at describing brain structural network architecture in pediatric MS patients and to detect structural connectivity abnormalities underlying cognitive dysfunction across the different cognitive domains.
Methods: DT and dual-echo MRI scans were obtained using a 3.0 T scanner from 53 pediatric MS patients and 26 age- and sex-matched healthy controls (HC). Whole-brain networks were constructed using graph theory. Between-group differences of global and local network connectivity metrics were investigated. Partial correlations between network metrics and Z-scores for each of cognitive domain and a global Z-score of cognitive function controlling for age and sex were performed.
Results: All global network metrics showed significant differences between pediatric MS patients and HC. Compared to HC, pediatric MS patients lost hubs in the right superior frontal gyrus (SFG), middle occipital gyrus, caudate nucleus and cerebellum crus II and in the left precentral gyrus, temporal pole, thalamus and cerebellum crus I. Global cognitive functioning showed significant positive correlation with the strength of connections of hubs located in the right superior parietal lobe and the precuneus bilaterally. Impairment in language functions, as well as verbal memory impairment were significantly related to reduced strength of the hubs located in frontal and temporal, while visual-spatial memory, attention and information processing speed impairment appeared were associated to a reduced strength in several hubs located in frontal, parietal and occipital lobes.
Conclusions: This study showed abnormalities in global network metrics in pediatric MS patients with limited differences in hubs distribution, indicating a partial preservation of brain network architecture. Our findings suggest that cognitive impairment is mainly associated to a globally reduced strength of connections of the nodes identified as hubs, likely due to diffuse normal appearing white matter damage, more than to a local damage, resulting in alteration and loss of efficiency in information transmission.
Partially supported by a grant from Italian Ministry of Health (GR-2009-1529671) and FISM (FISM2011/R/19 & FISM 2012/R/8).
Disclosure:
Drs De Meo, Pagani, Moiola, Veggiotti, Vacchi, Fiorino, Pippolo, Pera, 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. A Ghezzi has received honoraria for speaking from Biogen, Merck Serono, Novartis, and Sanofi-Aventis; for consultancy from Merck Serono, Teva, and Novartis; and support for participation in national and international congresses from Bayer-Schering, Biogen-Dompè, Merck Serono, Novartis, and Sanofi-Aventis. Ruggero Capra received consulting fees from Novartis,Merck Serono, BiogenIdec and lecture fees fromBayer, BiogenIdec, Dompé, Genzyme and Sanofi-Aventis. Maria P Amato serves on scientific advisory boards for Biogen-Idec, Merck Serono, Bayer Schering and Sanofi Aventis and receives research support and honoraria for speaking from Biogen-Idec, Merck Serono, Bayer Schering and Sanofi Aventis. 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. 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).