Contributions
Abstract: P1109
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Cerebellar damage occurs frequently in Multiple Sclerosis (MS) patients, as impairments of balance and gait. Our group already demonstrated an association between balance impairment with cerebellar functional and structural alterations1-2.Recent studies showed how cerebellar sub-regional atrophy provide an explanation of disability in MS. To date the relationship between a quantitative measure of balance deficit and cerebellar lobular atrophy has never been investigated.
Objective: To evaluate association between balance deficit in patients with MS and atrophy in specific regions of the cerebellum
Method: Thirty-nine patients with MS [F: 30; mean age 35,15 ± 8,6; median EDSS 2,5 (range:1-5.5) and 33 healthy controls (HCs) [F: 20; mean age 33,1±6,5] underwent brain Magnetic Resonance Imaging (MRI) at 3.0 T to obtain PD/T2, 3DT1-weighted images. Patients were evaluated with static posturography to calculate the body's center of pressure displacement with Eyes Open (C-EO) (465±365,4 mm) and Eyes Closed (C-EC) (865,5±559,9 mm). Patients were divided in two groups according to presence of falls or not. On 3DT1 images cerebellar volumes were automatically calculated using the Spatially Unbiased Infratentorial Toolbox (SUIT). Spearman's correlations and stepwise multivariate linear regression were used to explore relationships between variables. Each model was adjusted for sex, age, body mass index, intracranial volume, total and cerebellar lesions volume
Results: Cerebellar volume(anterior, posterior, as well as lobular volumes from I to X)were significantly lower in patients with MS than HCs (p< 0.0001). EDSS was positively associated with C-EO and C-EC (ρ =0.659; ρ =0.639 both p< 0.001, respectively). Fallers showed more severe atrophy of anterior cerebellum (p< 0.05) than non-fallers. C-EO inversely correlated with volume of lobule VIIIb [β =-0,525 p=0,001 (95% CI: from -253,708 to -75,834), while C-EC inversely correlated with volume of lobule I-IV[β =-0.468, p=0.003 (95% CI: from -389,869 to -88,84)]
Conclusions: Our findings indicate the involvement of the sensorimotor cerebellum (anterior cerebellum and lobule VIII) in balance impairment. A specific measure of balance impairment mainly due to cerebellar damage (C-EO) is selectively associated with atrophy of lobule VIII. Consistently, a greater atrophy of the anterior cerebellum is associated with history of falls.
1. Prosperini L. Mult Scler. 2014 Jan;20(1):81 2.Tona F. Radiology. 2018 Apr;287(1)
Disclosure: Dr S Ruggieri has received fee as speaking honoraria from Teva,Merck Serono, Biogen; travel grant from Biogen, Merck Serono; fee as advisory board consultant from Merck Serono and Novartis.
Dr K Bharti has nothing to disclose
Dr L Prosperini has received consulting fees from Biogen, Genzyme, Novartis and Roche; speaker honoraria from Almirall, Biogen, Genzyme, Merck Serono, Novartis and Teva; travel grants from Biogen, Genzyme, Novartis and Teva; research grants from the Italian MS Society (Associazione Italiana Sclerosi Multipla) and Genzyme.
Dr Giannì C has received founding for travel and speaker honoraria from Bracco.
Dr N Petsas has received speaker fees from Biogen Idec and travel grant from Novartis.
Dr S Tommasin has nothing to disclose
Dr De Giglio L has received speaking onoraria from Genzyme and Novartis, travel grant from Biogen, Merk, Teva, consulting fee from Genzyme, Merk and Novartis.
Prof C Pozzilli has received consulting and lecture fees and research funding and travel grants from Almirall, Bayer, Biogen, Genzyme, Merck Serono, Novartis, Roche and Teva.
Prof P Pantano has received founding for travel from Novartis, Genzyme and Bracco and speaker honoraria from Biogen.
Abstract: P1109
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Cerebellar damage occurs frequently in Multiple Sclerosis (MS) patients, as impairments of balance and gait. Our group already demonstrated an association between balance impairment with cerebellar functional and structural alterations1-2.Recent studies showed how cerebellar sub-regional atrophy provide an explanation of disability in MS. To date the relationship between a quantitative measure of balance deficit and cerebellar lobular atrophy has never been investigated.
Objective: To evaluate association between balance deficit in patients with MS and atrophy in specific regions of the cerebellum
Method: Thirty-nine patients with MS [F: 30; mean age 35,15 ± 8,6; median EDSS 2,5 (range:1-5.5) and 33 healthy controls (HCs) [F: 20; mean age 33,1±6,5] underwent brain Magnetic Resonance Imaging (MRI) at 3.0 T to obtain PD/T2, 3DT1-weighted images. Patients were evaluated with static posturography to calculate the body's center of pressure displacement with Eyes Open (C-EO) (465±365,4 mm) and Eyes Closed (C-EC) (865,5±559,9 mm). Patients were divided in two groups according to presence of falls or not. On 3DT1 images cerebellar volumes were automatically calculated using the Spatially Unbiased Infratentorial Toolbox (SUIT). Spearman's correlations and stepwise multivariate linear regression were used to explore relationships between variables. Each model was adjusted for sex, age, body mass index, intracranial volume, total and cerebellar lesions volume
Results: Cerebellar volume(anterior, posterior, as well as lobular volumes from I to X)were significantly lower in patients with MS than HCs (p< 0.0001). EDSS was positively associated with C-EO and C-EC (ρ =0.659; ρ =0.639 both p< 0.001, respectively). Fallers showed more severe atrophy of anterior cerebellum (p< 0.05) than non-fallers. C-EO inversely correlated with volume of lobule VIIIb [β =-0,525 p=0,001 (95% CI: from -253,708 to -75,834), while C-EC inversely correlated with volume of lobule I-IV[β =-0.468, p=0.003 (95% CI: from -389,869 to -88,84)]
Conclusions: Our findings indicate the involvement of the sensorimotor cerebellum (anterior cerebellum and lobule VIII) in balance impairment. A specific measure of balance impairment mainly due to cerebellar damage (C-EO) is selectively associated with atrophy of lobule VIII. Consistently, a greater atrophy of the anterior cerebellum is associated with history of falls.
1. Prosperini L. Mult Scler. 2014 Jan;20(1):81 2.Tona F. Radiology. 2018 Apr;287(1)
Disclosure: Dr S Ruggieri has received fee as speaking honoraria from Teva,Merck Serono, Biogen; travel grant from Biogen, Merck Serono; fee as advisory board consultant from Merck Serono and Novartis.
Dr K Bharti has nothing to disclose
Dr L Prosperini has received consulting fees from Biogen, Genzyme, Novartis and Roche; speaker honoraria from Almirall, Biogen, Genzyme, Merck Serono, Novartis and Teva; travel grants from Biogen, Genzyme, Novartis and Teva; research grants from the Italian MS Society (Associazione Italiana Sclerosi Multipla) and Genzyme.
Dr Giannì C has received founding for travel and speaker honoraria from Bracco.
Dr N Petsas has received speaker fees from Biogen Idec and travel grant from Novartis.
Dr S Tommasin has nothing to disclose
Dr De Giglio L has received speaking onoraria from Genzyme and Novartis, travel grant from Biogen, Merk, Teva, consulting fee from Genzyme, Merk and Novartis.
Prof C Pozzilli has received consulting and lecture fees and research funding and travel grants from Almirall, Bayer, Biogen, Genzyme, Merck Serono, Novartis, Roche and Teva.
Prof P Pantano has received founding for travel from Novartis, Genzyme and Bracco and speaker honoraria from Biogen.