Contributions
Abstract: P807
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: Peak width of skeletonized mean diffusivity (PSMD) is a new, fully automated, MRI-based biomarker that showed clinically relevant changes in cerebral small vessel diseases (SVD).
Objective: To explore the clinical relevance of PSMD in the brain of patients with MS with respect to patients with a SVD such as CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy).
Methods: We assessed a total of 103 subjects of whom 50 MS (age: 43±9.4-years, 47 relapsing-remitting, 3 primary progressive, median EDSS= 2 [1-5.5], 64% cognitively impaired on the Rao Battery), 25 CADASIL (age: 46.9±10.5-years, mild disability), and 28 normal controls (NC, age: 45.2±12.3-years). MRI data were acquired on a 1.5 T scanner. PSMD was computed from DTI data through “skeletonization” of WM tracts and histogram analysis.
Results: As expected, CADASIL had higher lesion volume (LV) than MS (24.4±17.4 cm3 vs 8.80±8.33 cm3, p≤0.001). Both patient groups showed higher (p≤0.001) PSMD (4.6±1.2 x10-4 mm2/s in MS, 3.9±1.2 x10-4 mm2/s in CADASIL) than NC (2.8±0.3 x10-4 mm2/s). After correction for LV, PSMD was higher in MS than CADASIL (p=0.011). PSMD correlated with LV in the two patient groups (r=0.8, p≤0.001 in MS; r=0.6, p=0.002 in CADASIL) and in MS also with disease duration (r=0.4, p=0.011) and Symbol Digit Modalities Test (SDMT, r=0.6 p≤0.001). Using a binary logistic regression, we found that the combination of PSMD and LV reached the maximum ability of discrimination between MS and CADASIL (AUC=0.86, R2=0.5).
Conclusions: Global microstructural WM damage, occurring in both MS and CADASIL, showed to be more pronounced in MS, despite the lower LV, likely due to a more severe neuropathological involvement of the normal-appearing WM. PSMD can thus represent a new marker for a robust quantification of global microscopic brain damage in MS, potentially useful for the clinical management of patients.
Disclosure: Claudia Vinciguerra, Antonio Giorgio, Jian Zhang, Ilaria Di Donato, Maria Laura Stromillo, Riccardo Tappa Brocci, Antonio Federico and Maria Teresa Dotti have nothing to disclose.
Nicola De Stefano has received honoraria from Biogen-Idec, Genzyme, Merck Serono, Novartis, Roche and Teva for consulting services, speaking and travel support. He serves on advisory boards for Merck Serono, Novartis, Biogen-Idec, Roche, and Genzyme, he has received research grant support from the Italian MS Society.
Abstract: P807
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: Peak width of skeletonized mean diffusivity (PSMD) is a new, fully automated, MRI-based biomarker that showed clinically relevant changes in cerebral small vessel diseases (SVD).
Objective: To explore the clinical relevance of PSMD in the brain of patients with MS with respect to patients with a SVD such as CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy).
Methods: We assessed a total of 103 subjects of whom 50 MS (age: 43±9.4-years, 47 relapsing-remitting, 3 primary progressive, median EDSS= 2 [1-5.5], 64% cognitively impaired on the Rao Battery), 25 CADASIL (age: 46.9±10.5-years, mild disability), and 28 normal controls (NC, age: 45.2±12.3-years). MRI data were acquired on a 1.5 T scanner. PSMD was computed from DTI data through “skeletonization” of WM tracts and histogram analysis.
Results: As expected, CADASIL had higher lesion volume (LV) than MS (24.4±17.4 cm3 vs 8.80±8.33 cm3, p≤0.001). Both patient groups showed higher (p≤0.001) PSMD (4.6±1.2 x10-4 mm2/s in MS, 3.9±1.2 x10-4 mm2/s in CADASIL) than NC (2.8±0.3 x10-4 mm2/s). After correction for LV, PSMD was higher in MS than CADASIL (p=0.011). PSMD correlated with LV in the two patient groups (r=0.8, p≤0.001 in MS; r=0.6, p=0.002 in CADASIL) and in MS also with disease duration (r=0.4, p=0.011) and Symbol Digit Modalities Test (SDMT, r=0.6 p≤0.001). Using a binary logistic regression, we found that the combination of PSMD and LV reached the maximum ability of discrimination between MS and CADASIL (AUC=0.86, R2=0.5).
Conclusions: Global microstructural WM damage, occurring in both MS and CADASIL, showed to be more pronounced in MS, despite the lower LV, likely due to a more severe neuropathological involvement of the normal-appearing WM. PSMD can thus represent a new marker for a robust quantification of global microscopic brain damage in MS, potentially useful for the clinical management of patients.
Disclosure: Claudia Vinciguerra, Antonio Giorgio, Jian Zhang, Ilaria Di Donato, Maria Laura Stromillo, Riccardo Tappa Brocci, Antonio Federico and Maria Teresa Dotti have nothing to disclose.
Nicola De Stefano has received honoraria from Biogen-Idec, Genzyme, Merck Serono, Novartis, Roche and Teva for consulting services, speaking and travel support. He serves on advisory boards for Merck Serono, Novartis, Biogen-Idec, Roche, and Genzyme, he has received research grant support from the Italian MS Society.