Contributions
Abstract: P845
Type: Poster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Objective: To assess cerebellar volumes in progressive (PMS) and relapsing remitting multiple sclerosis (RR-MS) patients, testing the contribution of cerebellar lobular atrophy to both motor and cognitive functions in the two clinical phenotypes.
Background: The occurrence of cerebellar atrophy in MS, especially in progressive patients, is well established, and cerebellar involvement strongly contributes to both motor and cognitive disability. However, the possibility that atrophy of specific lobules could differentially contribute to clinical disability in the different phenotypes has never been investigated.
Methods: Thirty-nine RR-MS, 99 PMS and 79 healthy controls (HC) were enrolled.
Clinical evaluation included: Expanded Disability Status Scale (EDSS), cerebellar Functional System score (FS), Timed 25-Foot Walk Test (T25FW), 9-Hole Peg Test (9-HPT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test (BVMT) and California Verbal Learning Test-II (CVLT). A mean normative z-score was derived for the neuropsychological battery averaging the three individual z-scores. Cerebellar volumes were automatically obtained using the SUIT Toolbox. A hierarchical multiple linear regression analysis was performed to assess the relationship between MRI variables of supratentorial and cerebellar damage and motor/cognitive scores in PMS and RR-MS patients separately.
Results: PMS presented higher motor and cognitive disability compared to RR-MS patients. Both groups exhibited lower cerebellar volumes compared with HC (143.2 ±18.4 ml for HC vs 133.5±16.7 ml and 131.5±16.2 ml for RR-MS and PMS respectively, p< 0.001), while no differences emerged between PMS and RR-MS. Regression analysis showed different patterns of disability prediction in PMS and RR-MS. In particular, cerebellar metrics were independent predictors of motor disability in RR-MS, with lobules I-IV predicting EDSS (p=0.002) and cerebellar FS (p=0.001) and independent predictors of both motor and cognitive disability in PMS, with cerebellar lesion volume, cerebellar lobule VI, Crus I and VIIIa atrophy being independent predictors of 9-HPT (p< 0.0001), SDMT (p< 0.001), BVMT (p< 0.001) and CVLT (p=0.001) performance.
Conclusions: Our study confirms that atrophy of specific cerebellar lobules explains different aspects of motor and cognitive disability in MS patients. Furthermore, we suggest that cerebellar atrophy in PMS and RR-MS patients provides a different contribution to clinical disability.
Disclosure: This study was supported in part by the National Multiple Sclerosis Society (NMSS RG 5120A3/1), Novartis Pharmaceuticals (CFTY20DUSNC15T), and the Noto Foundation to MI.
Dr. Petracca reports a research fellowhip from FISM.
Dr. Cocozza reports personal fees from Sanofi Genzyme.
Dr. Mormina has nothing to disclose.
Dr. Buyukturkoglu has nothing to disclose.
Dr. Podranski has nothing to disclose.
Dr. Heinig has nothing to disclose.
Dr. Pontillo has nothing to disclose.
Dr. Russo has nothing to disclose.
Dr. Tedeschi has nothing to disclose.
Dr. Russo has nothing to disclose.
Dr. Costabile has nothing to disclose.
Dr. Lanzillo reports personal fees from Merck Serono, Biogen, Novartis, Almirall, Genzyme, and TEVA.
Dr. Harel reports grants from NMSS and personal fees from TEVA.
Dr. Klineova reports personal fees from TEVA.
Dr. Miller reports grants and personal fees from Genzyme/Sanofi-Aventis, Biogen Idec, Novartis, Acorda, Questcor, Accordant Health Services, grants from Genentech and Roche and personal fees from Glaxo Smith Kline, EMD Serono (Merck Serono), ONO, Nuron Biotech and TEVA.
Dr. Brunetti reports personal fees from Bayer and Bracco.
Dr. Brescia Morra reports personal fees from Novartis, Biogen, Genzyme, Teva, Almirall, Bayer, and Merck.
Dr. Lublin reports grants and personal fees from Novartis, Biogen Idec, Teva Neuroscience, Sanofi/Genzyme, Celgene, grants from Transparency Life Sciences and personal fees from Bayer Healthcare, EMD Serono, Actelion, Acorda, Questcor/Malinckrodt, Roche/Genentech, Medimmune, Osmotica, Xenoport, Receptos, Forward pharma, BBB Technologies, Akros, TG therapeutics, Abbvie, MedDay and Atara Biotherappeutics.
Dr. Inglese reports grants from Novartis Pharmaceuticals, National Multiple Sclerosis Society, Noto Foundation, NIH and Teva Neuroscience.
Abstract: P845
Type: Poster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Objective: To assess cerebellar volumes in progressive (PMS) and relapsing remitting multiple sclerosis (RR-MS) patients, testing the contribution of cerebellar lobular atrophy to both motor and cognitive functions in the two clinical phenotypes.
Background: The occurrence of cerebellar atrophy in MS, especially in progressive patients, is well established, and cerebellar involvement strongly contributes to both motor and cognitive disability. However, the possibility that atrophy of specific lobules could differentially contribute to clinical disability in the different phenotypes has never been investigated.
Methods: Thirty-nine RR-MS, 99 PMS and 79 healthy controls (HC) were enrolled.
Clinical evaluation included: Expanded Disability Status Scale (EDSS), cerebellar Functional System score (FS), Timed 25-Foot Walk Test (T25FW), 9-Hole Peg Test (9-HPT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test (BVMT) and California Verbal Learning Test-II (CVLT). A mean normative z-score was derived for the neuropsychological battery averaging the three individual z-scores. Cerebellar volumes were automatically obtained using the SUIT Toolbox. A hierarchical multiple linear regression analysis was performed to assess the relationship between MRI variables of supratentorial and cerebellar damage and motor/cognitive scores in PMS and RR-MS patients separately.
Results: PMS presented higher motor and cognitive disability compared to RR-MS patients. Both groups exhibited lower cerebellar volumes compared with HC (143.2 ±18.4 ml for HC vs 133.5±16.7 ml and 131.5±16.2 ml for RR-MS and PMS respectively, p< 0.001), while no differences emerged between PMS and RR-MS. Regression analysis showed different patterns of disability prediction in PMS and RR-MS. In particular, cerebellar metrics were independent predictors of motor disability in RR-MS, with lobules I-IV predicting EDSS (p=0.002) and cerebellar FS (p=0.001) and independent predictors of both motor and cognitive disability in PMS, with cerebellar lesion volume, cerebellar lobule VI, Crus I and VIIIa atrophy being independent predictors of 9-HPT (p< 0.0001), SDMT (p< 0.001), BVMT (p< 0.001) and CVLT (p=0.001) performance.
Conclusions: Our study confirms that atrophy of specific cerebellar lobules explains different aspects of motor and cognitive disability in MS patients. Furthermore, we suggest that cerebellar atrophy in PMS and RR-MS patients provides a different contribution to clinical disability.
Disclosure: This study was supported in part by the National Multiple Sclerosis Society (NMSS RG 5120A3/1), Novartis Pharmaceuticals (CFTY20DUSNC15T), and the Noto Foundation to MI.
Dr. Petracca reports a research fellowhip from FISM.
Dr. Cocozza reports personal fees from Sanofi Genzyme.
Dr. Mormina has nothing to disclose.
Dr. Buyukturkoglu has nothing to disclose.
Dr. Podranski has nothing to disclose.
Dr. Heinig has nothing to disclose.
Dr. Pontillo has nothing to disclose.
Dr. Russo has nothing to disclose.
Dr. Tedeschi has nothing to disclose.
Dr. Russo has nothing to disclose.
Dr. Costabile has nothing to disclose.
Dr. Lanzillo reports personal fees from Merck Serono, Biogen, Novartis, Almirall, Genzyme, and TEVA.
Dr. Harel reports grants from NMSS and personal fees from TEVA.
Dr. Klineova reports personal fees from TEVA.
Dr. Miller reports grants and personal fees from Genzyme/Sanofi-Aventis, Biogen Idec, Novartis, Acorda, Questcor, Accordant Health Services, grants from Genentech and Roche and personal fees from Glaxo Smith Kline, EMD Serono (Merck Serono), ONO, Nuron Biotech and TEVA.
Dr. Brunetti reports personal fees from Bayer and Bracco.
Dr. Brescia Morra reports personal fees from Novartis, Biogen, Genzyme, Teva, Almirall, Bayer, and Merck.
Dr. Lublin reports grants and personal fees from Novartis, Biogen Idec, Teva Neuroscience, Sanofi/Genzyme, Celgene, grants from Transparency Life Sciences and personal fees from Bayer Healthcare, EMD Serono, Actelion, Acorda, Questcor/Malinckrodt, Roche/Genentech, Medimmune, Osmotica, Xenoport, Receptos, Forward pharma, BBB Technologies, Akros, TG therapeutics, Abbvie, MedDay and Atara Biotherappeutics.
Dr. Inglese reports grants from Novartis Pharmaceuticals, National Multiple Sclerosis Society, Noto Foundation, NIH and Teva Neuroscience.