Contributions
Abstract: P789
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Upper limb motor impairment affects a large proportion of multiple sclerosis (MS) patients. The anatomical and functional MRI substrates of abnormal motor performance in MS patients have been only marginally evaluated.
Objectives: In this multiparametric study, we applied advanced structural and functional MRI techniques in a large cohort of MS patients to assess: 1) the differences in regional brain gray matter (gray matter) volumes, white matter (WM) architecture and resting state (RS) functional connectivity (FC) between MS patients and healthy controls (HC); and 2) the correlations between abnormal MRI findings and global disability as well as measures of manual dexterity.
Methods: From 134 HC and 366 right-handed MS patients, brain 3D T1-weighted, diffusion tensor and functional MRI scans were acquired and used to perform voxel-based morphometry, tract-based spatial statistic and independent component analysis. Correlations between altered MRI measures and EDSS and 9 Hole-Peg-Test (9HPT) were investigated. A multivariate analysis was performed to identify the independent predictors of global disability and motor impairment.
Results: Compared with HC, MS patients showed a widespread pattern of GM atrophy involving cortical and sub-cortical regions, distributed reduction of fractional anisotropy (FA) in several WM tracts and decreased RS FC in several brain networks, including the sensorimotor, executive, cerebellar, basal ganglia and default mode networks. The multivariate analysis, identified as predictors of higher EDSS (r2=0.47) decreased FA in the right superior cerebellar peduncle, secondary somatosensory area atrophy, posterior cerebellar atrophy, lower corticospinal tract FA and decreased right precentral gyrus (in the sensorimotor network) RS FC. Worse 9HPT performance was predicted by structural and functional damage within somatosensory and cognitive networks (r2=0.41 for right; r2=0.47 for left).
Conclusions: Specific patterns of GM atrophy, alteration of WM integrity and modifications of RS FC contribute to explain motor impairment in MS patients. The integration of clinical and MRI measures is likely to provide novel pieces of information for a better understanding of MS clinical manifestations.
Funding: partially supported by Fondazione Italiana Sclerosi Multipla (FISM2018/S/3).
Disclosure: C. Cordani, A.Meani, F. Esposito, M. Radaelli, and B. Colombo have nothing to disclose.
G. 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.
M.Filippi is Editor-in-Chief of the Journal of Neurology; received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Genzyme, Sanofi-Aventis, Teva, Merck Serono, and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Abstract: P789
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Upper limb motor impairment affects a large proportion of multiple sclerosis (MS) patients. The anatomical and functional MRI substrates of abnormal motor performance in MS patients have been only marginally evaluated.
Objectives: In this multiparametric study, we applied advanced structural and functional MRI techniques in a large cohort of MS patients to assess: 1) the differences in regional brain gray matter (gray matter) volumes, white matter (WM) architecture and resting state (RS) functional connectivity (FC) between MS patients and healthy controls (HC); and 2) the correlations between abnormal MRI findings and global disability as well as measures of manual dexterity.
Methods: From 134 HC and 366 right-handed MS patients, brain 3D T1-weighted, diffusion tensor and functional MRI scans were acquired and used to perform voxel-based morphometry, tract-based spatial statistic and independent component analysis. Correlations between altered MRI measures and EDSS and 9 Hole-Peg-Test (9HPT) were investigated. A multivariate analysis was performed to identify the independent predictors of global disability and motor impairment.
Results: Compared with HC, MS patients showed a widespread pattern of GM atrophy involving cortical and sub-cortical regions, distributed reduction of fractional anisotropy (FA) in several WM tracts and decreased RS FC in several brain networks, including the sensorimotor, executive, cerebellar, basal ganglia and default mode networks. The multivariate analysis, identified as predictors of higher EDSS (r2=0.47) decreased FA in the right superior cerebellar peduncle, secondary somatosensory area atrophy, posterior cerebellar atrophy, lower corticospinal tract FA and decreased right precentral gyrus (in the sensorimotor network) RS FC. Worse 9HPT performance was predicted by structural and functional damage within somatosensory and cognitive networks (r2=0.41 for right; r2=0.47 for left).
Conclusions: Specific patterns of GM atrophy, alteration of WM integrity and modifications of RS FC contribute to explain motor impairment in MS patients. The integration of clinical and MRI measures is likely to provide novel pieces of information for a better understanding of MS clinical manifestations.
Funding: partially supported by Fondazione Italiana Sclerosi Multipla (FISM2018/S/3).
Disclosure: C. Cordani, A.Meani, F. Esposito, M. Radaelli, and B. Colombo have nothing to disclose.
G. 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.
M.Filippi is Editor-in-Chief of the Journal of Neurology; received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Genzyme, Sanofi-Aventis, Teva, Merck Serono, and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.