Abstract
Objective: We combined double inversion recovery (DIR) and diffusion tensor (DT) magnetic resonance imaging (MRI) to quantify the severity of cortical lesion (CL) microstructural tissue abnormalities in a large cohort of relapse-onset multiple sclerosis (MS) patients and its contribution to cognitive dysfunction. Methods: DIR, DT, dual-echo, and three-dimensional (3D) T1-weighted scans were acquired from 149 MS patients and 40 controls. Cognitively impaired (CI) patients had ⩾2 abnormal neuropsychological tests. Diffusivity values in CLs, cortex, white matter (WM) lesions, and normal-appearing (NA) WM were assessed. Predictors of cognitive impairment were identified using a random forest analysis. Results: Compared to controls, MS patients had lower normalized brain volume (NBV), gray matter volume (GMV), WM volume, lower fractional anisotropy (FA), and higher mean diffusivity in cortex and normal-appearing white matter (NAWM). A total of 44 (29.5%) patients were CI. Compared to cognitively preserved (CP), CI patients had higher T2 WM lesion volume (LV), lower NBV and GMV, and more severe diffusivity abnormalities in WM lesions, cortex, and NAWM. CL measures did not differ between CI and CP patients. Cortex FA, age, disease duration, T2 WM LV, and GMV best predicted MS-related cognitive impairment (C-statistic = 0.88). Conclusion: “Diffuse” GM and NAWM damage and WM lesions, rather than intrinsic CL damage, contribute to cognitive impairment in MS.
| Original language | English |
|---|---|
| Pages (from-to) | 1918-1928 |
| Number of pages | 11 |
| Journal | Multiple Sclerosis |
| Volume | 23 |
| Issue number | 14 |
| DOIs | |
| Publication status | Published - Dec 1 2017 |
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Keywords
- cognitive impairment
- cortical lesions
- diffusion tensor
- MRI
- Multiple sclerosis
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
Cite this
DT MRI microstructural cortical lesion damage does not explain cognitive impairment in MS. / Preziosa, Paolo; Pagani, Elisabetta; Morelli, Maria E.; Copetti, Massimiliano; Martinelli, Vittorio; Pirro, Fiammetta; Falini, Andrea; Comi, Giancarlo; Filippi, Massimo; Rocca, Maria A.
In: Multiple Sclerosis, Vol. 23, No. 14, 01.12.2017, p. 1918-1928.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - DT MRI microstructural cortical lesion damage does not explain cognitive impairment in MS
AU - Preziosa, Paolo
AU - Pagani, Elisabetta
AU - Morelli, Maria E.
AU - Copetti, Massimiliano
AU - Martinelli, Vittorio
AU - Pirro, Fiammetta
AU - Falini, Andrea
AU - Comi, Giancarlo
AU - Filippi, Massimo
AU - Rocca, Maria A.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Objective: We combined double inversion recovery (DIR) and diffusion tensor (DT) magnetic resonance imaging (MRI) to quantify the severity of cortical lesion (CL) microstructural tissue abnormalities in a large cohort of relapse-onset multiple sclerosis (MS) patients and its contribution to cognitive dysfunction. Methods: DIR, DT, dual-echo, and three-dimensional (3D) T1-weighted scans were acquired from 149 MS patients and 40 controls. Cognitively impaired (CI) patients had ⩾2 abnormal neuropsychological tests. Diffusivity values in CLs, cortex, white matter (WM) lesions, and normal-appearing (NA) WM were assessed. Predictors of cognitive impairment were identified using a random forest analysis. Results: Compared to controls, MS patients had lower normalized brain volume (NBV), gray matter volume (GMV), WM volume, lower fractional anisotropy (FA), and higher mean diffusivity in cortex and normal-appearing white matter (NAWM). A total of 44 (29.5%) patients were CI. Compared to cognitively preserved (CP), CI patients had higher T2 WM lesion volume (LV), lower NBV and GMV, and more severe diffusivity abnormalities in WM lesions, cortex, and NAWM. CL measures did not differ between CI and CP patients. Cortex FA, age, disease duration, T2 WM LV, and GMV best predicted MS-related cognitive impairment (C-statistic = 0.88). Conclusion: “Diffuse” GM and NAWM damage and WM lesions, rather than intrinsic CL damage, contribute to cognitive impairment in MS.
AB - Objective: We combined double inversion recovery (DIR) and diffusion tensor (DT) magnetic resonance imaging (MRI) to quantify the severity of cortical lesion (CL) microstructural tissue abnormalities in a large cohort of relapse-onset multiple sclerosis (MS) patients and its contribution to cognitive dysfunction. Methods: DIR, DT, dual-echo, and three-dimensional (3D) T1-weighted scans were acquired from 149 MS patients and 40 controls. Cognitively impaired (CI) patients had ⩾2 abnormal neuropsychological tests. Diffusivity values in CLs, cortex, white matter (WM) lesions, and normal-appearing (NA) WM were assessed. Predictors of cognitive impairment were identified using a random forest analysis. Results: Compared to controls, MS patients had lower normalized brain volume (NBV), gray matter volume (GMV), WM volume, lower fractional anisotropy (FA), and higher mean diffusivity in cortex and normal-appearing white matter (NAWM). A total of 44 (29.5%) patients were CI. Compared to cognitively preserved (CP), CI patients had higher T2 WM lesion volume (LV), lower NBV and GMV, and more severe diffusivity abnormalities in WM lesions, cortex, and NAWM. CL measures did not differ between CI and CP patients. Cortex FA, age, disease duration, T2 WM LV, and GMV best predicted MS-related cognitive impairment (C-statistic = 0.88). Conclusion: “Diffuse” GM and NAWM damage and WM lesions, rather than intrinsic CL damage, contribute to cognitive impairment in MS.
KW - cognitive impairment
KW - cortical lesions
KW - diffusion tensor
KW - MRI
KW - Multiple sclerosis
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U2 - 10.1177/1352458516689147
DO - 10.1177/1352458516689147
M3 - Article
VL - 23
SP - 1918
EP - 1928
JO - Multiple Sclerosis
JF - Multiple Sclerosis
SN - 1352-4585
IS - 14
ER -