Contributions
Abstract: P1073
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Background: Cognitive impairment (CI) is frequent in neuromyelitis optica spectrum disorders (NMOSD).
Objectives: In this study, we explored resting state (RS) functional connectivity (FC) abnormalities in the main cognitive networks of NMOSD patients.
Methods: We acquired RS fMRI from 25 NMOSD patients and 30 healthy controls (HC); patients also underwent extensive neuropsychological evaluation. Patients with at least two abnormal tests (defined as a score more than 2 SDs below the normative value) were classified CI. A cognitive impairment index (CII) was also calculated to evaluate the global extent of cognitive impairment. Independent component analysis (ICA) was performed to identify the main RS networks. Between-group comparisons and correlations analysis between RS FC and CII were performed using SPM12 (p< 0.001, uncorrected).
Results: Nine NMOSD (36%) were CI. CI NMOSD were older (55.1±6.5) compared to CP NMOSD (36.8±8.4) (p< 0.001). ICA identified 3 default mode (DMN), 2 salience (SN), 2 executive control (ECN) and 2 working memory (WMN) networks. In the DMN, the NMOSD group and CP NMOSD patients shared higher RS FC vs HC in the precuneus, parahippocampal gyrus and vermis of the cerebellum; the posterior cingulum and the middle occipital gyrus showed higher RS FC vs HC in NMOSD group but lower RS FC vs HC in CI NMOSD. CI NMOSD patients had also lower RS FC vs HC in the cuneus and middle temporal gyrus. In the SN, the NMOSD group and CP NMOSD patients shared higher RS FC vs HC in the supplementary motor area and anterior cingulum. The NMOSD group and CI NMOSD patients shared higher RS FC vs HC in the insula and middle cingulum. In the right WMN, the NMOSD group and CP NMOSD patients shared higher RS FC in the right precentral gyrus. In the left WMN, the NMOSD group and CP NMOSD patients shared lower RS FC in the superior frontal gyrus; the angular gyrus showed lower RS FC vs HC in the NMOSD group but higher RS FC vs HC in CP NMOSD. In the ECN, NMOSD patients showed higher RS FC vs HC in the precuneus. In NMOSD patients, a lower global CII correlated with a lower RS FC in the cuneus of the DMN.
Conclusions: Cortical reorganization occurs in NMOSD patients in cognitive RSNs. Increased RS FC contributes to better cognitive performance, probably reflecting an adaptive mechanism. Conversely, reduced RS FC is likely to be a maladaptive mechanism associated with impaired cognitive functions.
Disclosure:
F. Savoldi, P. Valsasina, G.C. Riccitelli, M. Radaelli, A. Falini have nothing to disclose.
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Teva Neurosciences and Genzyme and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
P. Preziosa received speakers honoraria from Biogen Idec, Novartis, and ExceMED.
G. Comi has received compensation for consulting services for Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Chugai, Receptos, and Forward Pharma, and compensation for speaking activities for Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, and Roche.
M. Filippi is Editor-in-Chief of the Journal of Neurology; serves on a scientific advisory board for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, 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: P1073
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Background: Cognitive impairment (CI) is frequent in neuromyelitis optica spectrum disorders (NMOSD).
Objectives: In this study, we explored resting state (RS) functional connectivity (FC) abnormalities in the main cognitive networks of NMOSD patients.
Methods: We acquired RS fMRI from 25 NMOSD patients and 30 healthy controls (HC); patients also underwent extensive neuropsychological evaluation. Patients with at least two abnormal tests (defined as a score more than 2 SDs below the normative value) were classified CI. A cognitive impairment index (CII) was also calculated to evaluate the global extent of cognitive impairment. Independent component analysis (ICA) was performed to identify the main RS networks. Between-group comparisons and correlations analysis between RS FC and CII were performed using SPM12 (p< 0.001, uncorrected).
Results: Nine NMOSD (36%) were CI. CI NMOSD were older (55.1±6.5) compared to CP NMOSD (36.8±8.4) (p< 0.001). ICA identified 3 default mode (DMN), 2 salience (SN), 2 executive control (ECN) and 2 working memory (WMN) networks. In the DMN, the NMOSD group and CP NMOSD patients shared higher RS FC vs HC in the precuneus, parahippocampal gyrus and vermis of the cerebellum; the posterior cingulum and the middle occipital gyrus showed higher RS FC vs HC in NMOSD group but lower RS FC vs HC in CI NMOSD. CI NMOSD patients had also lower RS FC vs HC in the cuneus and middle temporal gyrus. In the SN, the NMOSD group and CP NMOSD patients shared higher RS FC vs HC in the supplementary motor area and anterior cingulum. The NMOSD group and CI NMOSD patients shared higher RS FC vs HC in the insula and middle cingulum. In the right WMN, the NMOSD group and CP NMOSD patients shared higher RS FC in the right precentral gyrus. In the left WMN, the NMOSD group and CP NMOSD patients shared lower RS FC in the superior frontal gyrus; the angular gyrus showed lower RS FC vs HC in the NMOSD group but higher RS FC vs HC in CP NMOSD. In the ECN, NMOSD patients showed higher RS FC vs HC in the precuneus. In NMOSD patients, a lower global CII correlated with a lower RS FC in the cuneus of the DMN.
Conclusions: Cortical reorganization occurs in NMOSD patients in cognitive RSNs. Increased RS FC contributes to better cognitive performance, probably reflecting an adaptive mechanism. Conversely, reduced RS FC is likely to be a maladaptive mechanism associated with impaired cognitive functions.
Disclosure:
F. Savoldi, P. Valsasina, G.C. Riccitelli, M. Radaelli, A. Falini have nothing to disclose.
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Teva Neurosciences and Genzyme and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
P. Preziosa received speakers honoraria from Biogen Idec, Novartis, and ExceMED.
G. Comi has received compensation for consulting services for Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Chugai, Receptos, and Forward Pharma, and compensation for speaking activities for Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, and Roche.
M. Filippi is Editor-in-Chief of the Journal of Neurology; serves on a scientific advisory board for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, 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).