What contributes to disability in progressive MS? A brain and cervical cord-matched quantitative MRI study
BACKGROUND: We assessed the ability of a brain-and-cord-matched quantitative magnetic resonance imaging (qMRI) protocol to differentiate patients with progressive multiple sclerosis (PMS) from controls, in terms of normal-appearing (NA) tissue abnormalities, and explain disability.
METHODS: A total of 27 patients and 16 controls were assessed on the Expanded Disability Status Scale (EDSS), 25-foot timed walk (TWT), 9-hole peg (9HPT) and symbol digit modalities (SDMT) tests. All underwent 3T brain and (C2-C3) cord structural imaging and qMRI (relaxometry, quantitative magnetisation transfer, multi-shell diffusion-weighted imaging), using a fast brain-and-cord-matched protocol with brain-and-cord-unified imaging readouts. Lesion and NA-tissue volumes and qMRI metrics reflecting demyelination and axonal loss were obtained. Random forest analyses identified the most relevant volumetric/qMRI measures to clinical outcomes. Confounder-adjusted linear regression estimated the actual MRI-clinical associations.
RESULTS: Several qMRI/volumetric differences between patients and controls were observed (p < 0.01). Higher NA-deep grey matter quantitative-T1 (EDSS: beta = 7.96, p = 0.006; 9HPT: beta = -0.09, p = 0.004), higher NA-white matter orientation dispersion index (TWT: beta = -3.21, p = 0.005; SDMT: beta = -847.10, p < 0.001), lower whole-cord bound pool fraction (9HPT: beta = 0.79, p = 0.001) and higher NA-cortical grey matter quantitative-T1 (SDMT = -94.31, p < 0.001) emerged as particularly relevant predictors of greater disability.
CONCLUSION: Fast brain-and-cord-matched qMRI protocols are feasible and identify demyelination - combined with other mechanisms - as key for disability accumulation in PMS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Multiple sclerosis (Houndmills, Basingstoke, England) - 30(2024), 4-5 vom: 06. Apr., Seite 516-534 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tur, Carmen [VerfasserIn] |
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| Links: |
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| Themen: |
Brain and spinal cord |
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| Anmerkungen: |
Date Completed 12.04.2024 Date Revised 12.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/13524585241229969 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368620859 |
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| 245 | 1 | 0 | |a What contributes to disability in progressive MS? A brain and cervical cord-matched quantitative MRI study |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: We assessed the ability of a brain-and-cord-matched quantitative magnetic resonance imaging (qMRI) protocol to differentiate patients with progressive multiple sclerosis (PMS) from controls, in terms of normal-appearing (NA) tissue abnormalities, and explain disability | ||
| 520 | |a METHODS: A total of 27 patients and 16 controls were assessed on the Expanded Disability Status Scale (EDSS), 25-foot timed walk (TWT), 9-hole peg (9HPT) and symbol digit modalities (SDMT) tests. All underwent 3T brain and (C2-C3) cord structural imaging and qMRI (relaxometry, quantitative magnetisation transfer, multi-shell diffusion-weighted imaging), using a fast brain-and-cord-matched protocol with brain-and-cord-unified imaging readouts. Lesion and NA-tissue volumes and qMRI metrics reflecting demyelination and axonal loss were obtained. Random forest analyses identified the most relevant volumetric/qMRI measures to clinical outcomes. Confounder-adjusted linear regression estimated the actual MRI-clinical associations | ||
| 520 | |a RESULTS: Several qMRI/volumetric differences between patients and controls were observed (p < 0.01). Higher NA-deep grey matter quantitative-T1 (EDSS: beta = 7.96, p = 0.006; 9HPT: beta = -0.09, p = 0.004), higher NA-white matter orientation dispersion index (TWT: beta = -3.21, p = 0.005; SDMT: beta = -847.10, p < 0.001), lower whole-cord bound pool fraction (9HPT: beta = 0.79, p = 0.001) and higher NA-cortical grey matter quantitative-T1 (SDMT = -94.31, p < 0.001) emerged as particularly relevant predictors of greater disability | ||
| 520 | |a CONCLUSION: Fast brain-and-cord-matched qMRI protocols are feasible and identify demyelination - combined with other mechanisms - as key for disability accumulation in PMS | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a brain and spinal cord | |
| 650 | 4 | |a clinical trial | |
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| 700 | 1 | |a Battiston, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Yiannakas, Marios C |e verfasserin |4 aut | |
| 700 | 1 | |a Collorone, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Calvi, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Prados, Ferran |e verfasserin |4 aut | |
| 700 | 1 | |a Kanber, Baris |e verfasserin |4 aut | |
| 700 | 1 | |a Grussu, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Ricciardi, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Pajak, Patrizia |e verfasserin |4 aut | |
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| 700 | 1 | |a Wheeler-Kingshott, Claudia Am Gandini |e verfasserin |4 aut | |
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