Anatomical brain connectivity can assess cognitive dysfunction in multiple sclerosis

M. Bozzali, B. Spanò, G. J M Parker, G. Giulietti, M. Castelli, B. Basile, S. Rossi, L. Serra, G. Magnani, U. Nocentini, C. Caltagirone, D. Centonze, M. Cercignani

Research output: Contribution to journalArticlepeer-review


Background: Brain disconnection plays a major role in determining cognitive disabilities in multiple sclerosis (MS). We recently developed a novel diffusion-weighted magnetic resonance imaging (DW-MRI) tractography approach, namely anatomical connectivitity mapping (ACM), that quantifies structural brain connectivity. Objective: Use of ACM to assess structural connectivity modifications in MS brains and ascertain their relationship with the patients' Paced-Auditory-Serial-Addition-Test (PASAT) scores. Methods: Relapsing-remitting MS (RRMS) patients (n = 25) and controls (n = 25) underwent MRI at 3T, including conventional images, T1-weighted volumes and DW-MRI. Volumetric scans were coregistered to fractional anisotropy (FA) images, to obtain parenchymal FA maps for both white and grey matter. We initiated probabilistic tractography from all parenchymal voxels, obtaining ACM maps by counting the number of streamlines passing through each voxel, then normalizing by the total number of streamlines initiated. The ACM maps were transformed into standard space, for statistical use. Results: RRMS patients had reduced grey matter volume and FA, consistent with previous literature. Also, we showed reduced ACM in the thalamus and in the head of the caudate nucleus, bilaterally. In our RRMS patients, ACM was associated with PASAT scores in the corpus callosum, right hippocampus and cerebellum. Conclusions: ACM opens a new perspective, clarifying the contribution of anatomical brain disconnection to clinical disabilities in MS.

Original languageEnglish
Pages (from-to)1161-1168
Number of pages8
JournalMultiple Sclerosis Journal
Issue number9
Publication statusPublished - 2013


  • Anatomical connectivity mapping
  • cognitive dysfunction
  • diffusion imaging
  • fractional anisotropy
  • magnetic resonance imaging
  • paced auditory serial addition test
  • relapsing-remitting multiple sclerosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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