Contributions
Abstract: 74
Type: Oral
Abstract Category: Clinical aspects of MS - 2 MS Variants
Background: White Matter (WM) atrophy in Neuromyelitis Optica Spectrum Disorder (NMOSD) is well established, but WM microstructural damage and gray matter (GM) involvement are instead more controversial. The detection of structural and microstructural abnormalities in NMOSD brain tissue could provide useful insights to better understand the pathology in-vivo.
Aims: To compare the regional patterns of volumetric and diffusion tensor imaging (DTI) abnormalities between NMOSD (2015 criteria), isolated recurrent optic neuritis (ON) and recurrent myelitis patients.
Methods: Using a 3 Tesla scanner, structural and DTI brain MRI data were acquired from 20 NMOSD, 10 ON, 12 myelitis patients and 30 healthy controls (HC). Between-group comparisons of regional GM, WM volumes and DTI measures were performed using voxel-based morphometry (SPM12) and Tract Based Spatial Statistics (TBSS) (fsl).
Results: Compared with HC, NMOSD patients showed atrophy of the thalami, right cuneus and floor of the fourth ventricle; ON patients showed atrophy of the optic tracts, cerebellum and left calcarine cortex; myelitis patients showed atrophy of the left thalamus and supplementary motor area (SMA). Compared to both ON and myelitis patients, NMOSD patients had atrophy of the middle occipital gyrus. DTI analysis showed that, compared to HC, NMO patients had a diffuse reduction of axial diffusivity (AD) in all WM skeleton, with a significantly lower fractional anisotropy in the optic radiations, bilaterally. No WM DTI abnormalities were detected in ON and myelitis patients.
Conclusions: In recurrent ON and myelitis, volumetric abnormalities were observed in regions related to the clinical manifestations of such pathologies: visual areas in ON, thalamus and SMA in myelitis patients. Similarly, NMOSD, compared to HC, showed atrophy and microstructural abnormalities in brain regions related to clinical manifestations (optic radiations and visual cortex, even more pronounced than in ON), but also in regions consistent with the higher expression of Aquaporin-4 antibodies (thalami and fourth ventricle). The selective reduction of AD observed in all WM skeleton of our NMOSD cohort might represent an hallmark of diffuse microstructural damage in this condition.
Disclosure:
A. d'Ambrosio, E. Pagani, F. Savoldi, M. Radaelli, and A. Falini have nothing to disclose.
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).
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.
Abstract: 74
Type: Oral
Abstract Category: Clinical aspects of MS - 2 MS Variants
Background: White Matter (WM) atrophy in Neuromyelitis Optica Spectrum Disorder (NMOSD) is well established, but WM microstructural damage and gray matter (GM) involvement are instead more controversial. The detection of structural and microstructural abnormalities in NMOSD brain tissue could provide useful insights to better understand the pathology in-vivo.
Aims: To compare the regional patterns of volumetric and diffusion tensor imaging (DTI) abnormalities between NMOSD (2015 criteria), isolated recurrent optic neuritis (ON) and recurrent myelitis patients.
Methods: Using a 3 Tesla scanner, structural and DTI brain MRI data were acquired from 20 NMOSD, 10 ON, 12 myelitis patients and 30 healthy controls (HC). Between-group comparisons of regional GM, WM volumes and DTI measures were performed using voxel-based morphometry (SPM12) and Tract Based Spatial Statistics (TBSS) (fsl).
Results: Compared with HC, NMOSD patients showed atrophy of the thalami, right cuneus and floor of the fourth ventricle; ON patients showed atrophy of the optic tracts, cerebellum and left calcarine cortex; myelitis patients showed atrophy of the left thalamus and supplementary motor area (SMA). Compared to both ON and myelitis patients, NMOSD patients had atrophy of the middle occipital gyrus. DTI analysis showed that, compared to HC, NMO patients had a diffuse reduction of axial diffusivity (AD) in all WM skeleton, with a significantly lower fractional anisotropy in the optic radiations, bilaterally. No WM DTI abnormalities were detected in ON and myelitis patients.
Conclusions: In recurrent ON and myelitis, volumetric abnormalities were observed in regions related to the clinical manifestations of such pathologies: visual areas in ON, thalamus and SMA in myelitis patients. Similarly, NMOSD, compared to HC, showed atrophy and microstructural abnormalities in brain regions related to clinical manifestations (optic radiations and visual cortex, even more pronounced than in ON), but also in regions consistent with the higher expression of Aquaporin-4 antibodies (thalami and fourth ventricle). The selective reduction of AD observed in all WM skeleton of our NMOSD cohort might represent an hallmark of diffuse microstructural damage in this condition.
Disclosure:
A. d'Ambrosio, E. Pagani, F. Savoldi, M. Radaelli, and A. Falini have nothing to disclose.
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).
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.