Brain tissue volumes and relaxation rates in multiple sclerosis: implications for cognitive impairment(42 visite) Megna R, Alfano B, Lanzillo R, Costabile T, Comerci M, Vacca G, Carotenuto A, Moccia M, Servillo G, Prinster A, Brescia Morra V, Quarantelli M
*** IBB - CNR *** Biostructure and Bioimaging Institute, National Research Council, Via De Amicis, 95, 80145, Naples, Italy., Department of Neurosciences, Reproductive Science and Odontostomatology, University "Federico II", Naples, Italy., Biostructure and Bioimaging Institute, National Research Council, Via De Amicis, 95, 80145, Naples, Italy. quarante@unina.it.,
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OBJECTIVE: Both normal gray matter atrophy and brain tissue relaxation rates, in addition to total lesion volume, have shown significant correlations with cognitive test scores in multiple sclerosis (MS). Aim of the study was to assess the relative contributions of macro- and microstructural changes of both normal and abnormal brain tissues, probed, respectively, by their volumes and relaxation rates, to the cognitive status and physical disability of MS patients. METHODS: MRI studies from 241 patients with relapsing-remitting MS were retrospectively analyzed by fully automated multiparametric relaxometric segmentation. Ordinal backward regression analysis was applied to the resulting volumes and relaxation rates of both normal (gray matter, normal-appearing white matter and CSF) and abnormal (T2-weighted lesions) brain tissues, controlling for age, sex and disease duration, to identify the main independent contributors to the cognitive status, as measured by the percentage of failed tests at a cognitive test battery (Rao's Brief Repeatable Battery and Stroop test, available in 186 patients), and to the physical disability, as assessed by the Expanded Disability Status Scale (EDSS). RESULTS: The R1 relaxation rate (a putative marker of tissue disruption) of the MS lesions appeared the single most significant contributor to cognitive impairment (p < 0.001). On the contrary, the EDSS appeared mainly affected by the decrease in R2 of the gray matter (p < 0.0001), (possibly influenced by cortical plaques, edema and inflammation). CONCLUSIONS: In RR-MS the tissue damage in white matter lesions appears the single main determinant of the cognitive status of patients, likely through disconnection phenomena, while the physical disability appears related to the involvement of gray matter.
303 Records (244 escludendo Abstract e Conferenze). Impact factor totale: 1068.693 (901.321 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 1123.807 (944.112 escludendo Abstract e Conferenze).
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