Structural MRI correlates of cognitive impairment in patients with multiple sclerosis: A Multicenter Study Structural MRI Correlates of Cognitive Impairment in Patients With Multiple Sclerosis: A Multicenter Study Cognitive Impairment and Brain Damage in MS Preziosa et al.

P. Preziosa, Maria Assunta Rocca, E. Pagani, Maria Laura Stromillo, Christian Enzinger, Antonio Gallo, Hanneke E. Hulst, Matteo Atzori, D. Pareto, G. Riccitelli, Massimiliano Copetti, Nicola De Stefano, Franz Fazekas, A. Bisecco, Frederik Barkhof, T. Yousry, Maria J. Arévalo, Massimo Filippi

Research output: Contribution to journalArticle

Abstract

In a multicenter setting, we applied voxel-based methods to different structural MR imaging modalities to define the relative contributions of focal lesions, normal-appearing white matter (NAWM), and gray matter (GM) damage and their regional distribution to cognitive deficits as well as impairment of specific cognitive domains in multiple sclerosis (MS) patients. Approval of the institutional review boards was obtained, together with written informed consent from all participants. Standardized neuropsychological assessment and conventional, diffusion tensor and volumetric brain MRI sequences were collected from 61 relapsing-remitting MS patients and 61 healthy controls (HC) from seven centers. Patients with ≥2 abnormal tests were considered cognitively impaired (CI). The distribution of focal lesions, GM and WM atrophy, and microstructural WM damage were assessed using voxel-wise approaches. A random forest analysis identified the best imaging predictors of global cognitive impairment and deficits of specific cognitive domains. Twenty-three (38%) MS patients were CI. Compared with cognitively preserved (CP), CI MS patients had GM atrophy of the left thalamus, right hippocampus and parietal regions. They also showed atrophy of several WM tracts, mainly located in posterior brain regions and widespread WM diffusivity abnormalities. WM diffusivity abnormalities in cognitive-relevant WM tracts followed by atrophy of cognitive-relevant GM regions explained global cognitive impairment. Variable patterns of NAWM and GM damage were associated with deficits in selected cognitive domains. Structural, multiparametric, voxel-wise MRI approaches are feasible in a multicenter setting. The combination of different imaging modalities is needed to assess and monitor cognitive impairment in MS.

Original languageEnglish
JournalHuman Brain Mapping
DOIs
Publication statusAccepted/In press - 2016

Fingerprint

Multicenter Studies
Multiple Sclerosis
Atrophy
Brain
Relapsing-Remitting Multiple Sclerosis
Parietal Lobe
Research Ethics Committees
Informed Consent
Thalamus
Hippocampus
Cognitive Dysfunction
Gray Matter
White Matter

Keywords

  • Atrophy
  • Cognitive impairment
  • Diffusion tensor MRI
  • Multicenter
  • Multiple sclerosis
  • Voxel-wise analysis

ASJC Scopus subject areas

  • Clinical Neurology
  • Anatomy
  • Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Structural MRI correlates of cognitive impairment in patients with multiple sclerosis : A Multicenter Study Structural MRI Correlates of Cognitive Impairment in Patients With Multiple Sclerosis: A Multicenter Study Cognitive Impairment and Brain Damage in MS Preziosa et al. / Preziosa, P.; Rocca, Maria Assunta; Pagani, E.; Stromillo, Maria Laura; Enzinger, Christian; Gallo, Antonio; Hulst, Hanneke E.; Atzori, Matteo; Pareto, D.; Riccitelli, G.; Copetti, Massimiliano; De Stefano, Nicola; Fazekas, Franz; Bisecco, A.; Barkhof, Frederik; Yousry, T.; Arévalo, Maria J.; Filippi, Massimo.

In: Human Brain Mapping, 2016.

Research output: Contribution to journalArticle

Preziosa, P. ; Rocca, Maria Assunta ; Pagani, E. ; Stromillo, Maria Laura ; Enzinger, Christian ; Gallo, Antonio ; Hulst, Hanneke E. ; Atzori, Matteo ; Pareto, D. ; Riccitelli, G. ; Copetti, Massimiliano ; De Stefano, Nicola ; Fazekas, Franz ; Bisecco, A. ; Barkhof, Frederik ; Yousry, T. ; Arévalo, Maria J. ; Filippi, Massimo. / Structural MRI correlates of cognitive impairment in patients with multiple sclerosis : A Multicenter Study Structural MRI Correlates of Cognitive Impairment in Patients With Multiple Sclerosis: A Multicenter Study Cognitive Impairment and Brain Damage in MS Preziosa et al. In: Human Brain Mapping. 2016.
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abstract = "In a multicenter setting, we applied voxel-based methods to different structural MR imaging modalities to define the relative contributions of focal lesions, normal-appearing white matter (NAWM), and gray matter (GM) damage and their regional distribution to cognitive deficits as well as impairment of specific cognitive domains in multiple sclerosis (MS) patients. Approval of the institutional review boards was obtained, together with written informed consent from all participants. Standardized neuropsychological assessment and conventional, diffusion tensor and volumetric brain MRI sequences were collected from 61 relapsing-remitting MS patients and 61 healthy controls (HC) from seven centers. Patients with ≥2 abnormal tests were considered cognitively impaired (CI). The distribution of focal lesions, GM and WM atrophy, and microstructural WM damage were assessed using voxel-wise approaches. A random forest analysis identified the best imaging predictors of global cognitive impairment and deficits of specific cognitive domains. Twenty-three (38{\%}) MS patients were CI. Compared with cognitively preserved (CP), CI MS patients had GM atrophy of the left thalamus, right hippocampus and parietal regions. They also showed atrophy of several WM tracts, mainly located in posterior brain regions and widespread WM diffusivity abnormalities. WM diffusivity abnormalities in cognitive-relevant WM tracts followed by atrophy of cognitive-relevant GM regions explained global cognitive impairment. Variable patterns of NAWM and GM damage were associated with deficits in selected cognitive domains. Structural, multiparametric, voxel-wise MRI approaches are feasible in a multicenter setting. The combination of different imaging modalities is needed to assess and monitor cognitive impairment in MS.",
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AU - Preziosa, P.

AU - Rocca, Maria Assunta

AU - Pagani, E.

AU - Stromillo, Maria Laura

AU - Enzinger, Christian

AU - Gallo, Antonio

AU - Hulst, Hanneke E.

AU - Atzori, Matteo

AU - Pareto, D.

AU - Riccitelli, G.

AU - Copetti, Massimiliano

AU - De Stefano, Nicola

AU - Fazekas, Franz

AU - Bisecco, A.

AU - Barkhof, Frederik

AU - Yousry, T.

AU - Arévalo, Maria J.

AU - Filippi, Massimo

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N2 - In a multicenter setting, we applied voxel-based methods to different structural MR imaging modalities to define the relative contributions of focal lesions, normal-appearing white matter (NAWM), and gray matter (GM) damage and their regional distribution to cognitive deficits as well as impairment of specific cognitive domains in multiple sclerosis (MS) patients. Approval of the institutional review boards was obtained, together with written informed consent from all participants. Standardized neuropsychological assessment and conventional, diffusion tensor and volumetric brain MRI sequences were collected from 61 relapsing-remitting MS patients and 61 healthy controls (HC) from seven centers. Patients with ≥2 abnormal tests were considered cognitively impaired (CI). The distribution of focal lesions, GM and WM atrophy, and microstructural WM damage were assessed using voxel-wise approaches. A random forest analysis identified the best imaging predictors of global cognitive impairment and deficits of specific cognitive domains. Twenty-three (38%) MS patients were CI. Compared with cognitively preserved (CP), CI MS patients had GM atrophy of the left thalamus, right hippocampus and parietal regions. They also showed atrophy of several WM tracts, mainly located in posterior brain regions and widespread WM diffusivity abnormalities. WM diffusivity abnormalities in cognitive-relevant WM tracts followed by atrophy of cognitive-relevant GM regions explained global cognitive impairment. Variable patterns of NAWM and GM damage were associated with deficits in selected cognitive domains. Structural, multiparametric, voxel-wise MRI approaches are feasible in a multicenter setting. The combination of different imaging modalities is needed to assess and monitor cognitive impairment in MS.

AB - In a multicenter setting, we applied voxel-based methods to different structural MR imaging modalities to define the relative contributions of focal lesions, normal-appearing white matter (NAWM), and gray matter (GM) damage and their regional distribution to cognitive deficits as well as impairment of specific cognitive domains in multiple sclerosis (MS) patients. Approval of the institutional review boards was obtained, together with written informed consent from all participants. Standardized neuropsychological assessment and conventional, diffusion tensor and volumetric brain MRI sequences were collected from 61 relapsing-remitting MS patients and 61 healthy controls (HC) from seven centers. Patients with ≥2 abnormal tests were considered cognitively impaired (CI). The distribution of focal lesions, GM and WM atrophy, and microstructural WM damage were assessed using voxel-wise approaches. A random forest analysis identified the best imaging predictors of global cognitive impairment and deficits of specific cognitive domains. Twenty-three (38%) MS patients were CI. Compared with cognitively preserved (CP), CI MS patients had GM atrophy of the left thalamus, right hippocampus and parietal regions. They also showed atrophy of several WM tracts, mainly located in posterior brain regions and widespread WM diffusivity abnormalities. WM diffusivity abnormalities in cognitive-relevant WM tracts followed by atrophy of cognitive-relevant GM regions explained global cognitive impairment. Variable patterns of NAWM and GM damage were associated with deficits in selected cognitive domains. Structural, multiparametric, voxel-wise MRI approaches are feasible in a multicenter setting. The combination of different imaging modalities is needed to assess and monitor cognitive impairment in MS.

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