Contributions
Abstract: P484
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Demyelination is the pathological hallmark of multiple sclerosis (MS). Positron emission tomography (PET) with amyloid tracers (AβT) is a promising tool to evaluate white matter (WM) damage and repair since AT bind to WM and the uptake decreases with demyelination. Reduced CSF β-Amyloid1-42 (Aβ) levels have been suggested as prognostic biomarker in MS.
Objectives: To investigate AβT uptake in damaged WM (DWM) and in normal-appearing WM (NAWM) of MS patients and to evaluate possible correlations between AβT uptake and other clinical and radiological markers of disease progression.
Methods: Twelve patients with MS were recruited and divided according to their disease activity into active and non-active. All participants underwent neurological examination, neuropsychological testing, lumbar puncture, brain magnetic resonance imaging (MRI), and 18F-florbetapir-PET. Aβ levels were determined in CSF samples. MRI and PET images were co-registered and mean standardized uptake values (SUV) were calculated for each patient in the NAWM and in the DWM. WM lesion load was derived using the Lesion Segmentation Tool for Statistical Parametric Mapping (SPM12). To calculate brain volumes, brain segmentation with SPM12 was performed. Non-parametric statistical analyses for between-group comparisons and regression analyses were conducted.
Results: DWM-SUV was lower compared to NAWM-SUV in each patient (p< 0.001). Dividing patients according to their disease activity, we found a reduced NAWM-SUV in active patients compared to non-active (p< 0.05). Considering only active patients, NAWM-SUV correlated with NAWM volume (r=0.82, p=0.01) and NAWM volume resulted the best predictor of NAWM-SUV (r=0.87, p< 0.01). Interestingly, CSF Aβ concentration was a predictor of both NAWM-SUV (r=0.79; p< 0.01) and NAWM volume (r=0.81, p< 0.01). CSF Aβ levels correlated with Expanded Disability Status Scale score (r=-0.72; p< 0.05), Paced Auditory Serial Addition Test (PASAT)-2 (r=0.85; p< 0.01) and PASAT-3 (r=0.71; p< 0.05).
Conclusions: The AβT uptake in the largest lesion of each patient is reduced compared to their NAWM and is lower in active patients compared to non-active, suggesting a link between early WM damage and disease activity. MS patients with a smaller NAWM volume display a lower AβT uptake in the NAWM and lower CSF Aβ levels. These findings suggest a predictive role of CSF Aβ levels in MS disease progression that may be linked to myelin (microscopic) damage.
Disclosure: All authors report no disclosure
Abstract: P484
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Demyelination is the pathological hallmark of multiple sclerosis (MS). Positron emission tomography (PET) with amyloid tracers (AβT) is a promising tool to evaluate white matter (WM) damage and repair since AT bind to WM and the uptake decreases with demyelination. Reduced CSF β-Amyloid1-42 (Aβ) levels have been suggested as prognostic biomarker in MS.
Objectives: To investigate AβT uptake in damaged WM (DWM) and in normal-appearing WM (NAWM) of MS patients and to evaluate possible correlations between AβT uptake and other clinical and radiological markers of disease progression.
Methods: Twelve patients with MS were recruited and divided according to their disease activity into active and non-active. All participants underwent neurological examination, neuropsychological testing, lumbar puncture, brain magnetic resonance imaging (MRI), and 18F-florbetapir-PET. Aβ levels were determined in CSF samples. MRI and PET images were co-registered and mean standardized uptake values (SUV) were calculated for each patient in the NAWM and in the DWM. WM lesion load was derived using the Lesion Segmentation Tool for Statistical Parametric Mapping (SPM12). To calculate brain volumes, brain segmentation with SPM12 was performed. Non-parametric statistical analyses for between-group comparisons and regression analyses were conducted.
Results: DWM-SUV was lower compared to NAWM-SUV in each patient (p< 0.001). Dividing patients according to their disease activity, we found a reduced NAWM-SUV in active patients compared to non-active (p< 0.05). Considering only active patients, NAWM-SUV correlated with NAWM volume (r=0.82, p=0.01) and NAWM volume resulted the best predictor of NAWM-SUV (r=0.87, p< 0.01). Interestingly, CSF Aβ concentration was a predictor of both NAWM-SUV (r=0.79; p< 0.01) and NAWM volume (r=0.81, p< 0.01). CSF Aβ levels correlated with Expanded Disability Status Scale score (r=-0.72; p< 0.05), Paced Auditory Serial Addition Test (PASAT)-2 (r=0.85; p< 0.01) and PASAT-3 (r=0.71; p< 0.05).
Conclusions: The AβT uptake in the largest lesion of each patient is reduced compared to their NAWM and is lower in active patients compared to non-active, suggesting a link between early WM damage and disease activity. MS patients with a smaller NAWM volume display a lower AβT uptake in the NAWM and lower CSF Aβ levels. These findings suggest a predictive role of CSF Aβ levels in MS disease progression that may be linked to myelin (microscopic) damage.
Disclosure: All authors report no disclosure