Hippocampal and deep gray matter nuclei atrophy is relevant for explaining cognitive impairment in MS: A multicenter study

D. Damjanovic, P. Valsasina, M. A. Rocca, M. L. Stromillo, A. Gallo, C. Enzinger, H. E. Hulst, A. Rovira, N. Muhlert, N. De Stefano, A. Bisecco, F. Fazekas, M. J. Arévalo, T. A. Yousry, M. Filippi

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND AND PURPOSE: The structural MR imaging correlates of cognitive impairment in multiple sclerosis are still debated. This study assessed lesional and atrophy measures of white matter and gray matter involvement in patients with MS acquired in 7 European sites to identify the MR imaging variables most closely associated with cognitive dysfunction. MATERIALS AND METHODS: Brain dual-echo, 3D T1-weighted, and double inversion recovery scans were acquired at 3T from 62 patients with relapsing-remitting MS and 65 controls. Patients with at least 2 neuropsychological tests with abnormal findings were considered cognitively impaired. Focal WM and cortical lesions were identified, and volumetric measures from WM, cortical GM, the hippocampus, and deep GM nuclei were obtained. Age- and site-adjusted models were used to compare lesion and volumetric MR imaging variables between patients with MS who were cognitively impaired and cognitively preserved. A multivariate analysis identified MR imaging variables associated with cognitive scores and disability. RESULTS: Twenty-three patients (38%) were cognitively impaired. Compared with those with who were cognitively preserved, patients with MS with cognitive impairment had higher T2 and T1 lesion volumes and a trend toward a higher number of cortical lesions. Significant brain, cortical GM, hippocampal, deepGMnuclei, andWMatrophy was found in patients with MS with cognitive impairment versus those who were cognitively preserved. Hippocampal and deep GM nuclei atrophy were the best predictors of cognitive impairment, whileWM atrophy was the best predictor of disability. CONCLUSIONS: Hippocampal and deep GM nuclei atrophy are key factors associated with cognitive impairment in MS. These MR imaging measures could be applied in a multicenter context, with cognition as clinical outcome.

Original languageEnglish
Pages (from-to)18-24
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume38
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Cite this

Damjanovic, D., Valsasina, P., Rocca, M. A., Stromillo, M. L., Gallo, A., Enzinger, C., ... Filippi, M. (2017). Hippocampal and deep gray matter nuclei atrophy is relevant for explaining cognitive impairment in MS: A multicenter study. American Journal of Neuroradiology, 38(1), 18-24. https://doi.org/10.3174/ajnr.A4952
Damjanovic, D. ; Valsasina, P. ; Rocca, M. A. ; Stromillo, M. L. ; Gallo, A. ; Enzinger, C. ; Hulst, H. E. ; Rovira, A. ; Muhlert, N. ; De Stefano, N. ; Bisecco, A. ; Fazekas, F. ; Arévalo, M. J. ; Yousry, T. A. ; Filippi, M. / Hippocampal and deep gray matter nuclei atrophy is relevant for explaining cognitive impairment in MS : A multicenter study. In: American Journal of Neuroradiology. 2017 ; Vol. 38, No. 1. pp. 18-24.
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title = "Hippocampal and deep gray matter nuclei atrophy is relevant for explaining cognitive impairment in MS: A multicenter study",
abstract = "BACKGROUND AND PURPOSE: The structural MR imaging correlates of cognitive impairment in multiple sclerosis are still debated. This study assessed lesional and atrophy measures of white matter and gray matter involvement in patients with MS acquired in 7 European sites to identify the MR imaging variables most closely associated with cognitive dysfunction. MATERIALS AND METHODS: Brain dual-echo, 3D T1-weighted, and double inversion recovery scans were acquired at 3T from 62 patients with relapsing-remitting MS and 65 controls. Patients with at least 2 neuropsychological tests with abnormal findings were considered cognitively impaired. Focal WM and cortical lesions were identified, and volumetric measures from WM, cortical GM, the hippocampus, and deep GM nuclei were obtained. Age- and site-adjusted models were used to compare lesion and volumetric MR imaging variables between patients with MS who were cognitively impaired and cognitively preserved. A multivariate analysis identified MR imaging variables associated with cognitive scores and disability. RESULTS: Twenty-three patients (38{\%}) were cognitively impaired. Compared with those with who were cognitively preserved, patients with MS with cognitive impairment had higher T2 and T1 lesion volumes and a trend toward a higher number of cortical lesions. Significant brain, cortical GM, hippocampal, deepGMnuclei, andWMatrophy was found in patients with MS with cognitive impairment versus those who were cognitively preserved. Hippocampal and deep GM nuclei atrophy were the best predictors of cognitive impairment, whileWM atrophy was the best predictor of disability. CONCLUSIONS: Hippocampal and deep GM nuclei atrophy are key factors associated with cognitive impairment in MS. These MR imaging measures could be applied in a multicenter context, with cognition as clinical outcome.",
author = "D. Damjanovic and P. Valsasina and Rocca, {M. A.} and Stromillo, {M. L.} and A. Gallo and C. Enzinger and Hulst, {H. E.} and A. Rovira and N. Muhlert and {De Stefano}, N. and A. Bisecco and F. Fazekas and Ar{\'e}valo, {M. J.} and Yousry, {T. A.} and M. Filippi",
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Damjanovic, D, Valsasina, P, Rocca, MA, Stromillo, ML, Gallo, A, Enzinger, C, Hulst, HE, Rovira, A, Muhlert, N, De Stefano, N, Bisecco, A, Fazekas, F, Arévalo, MJ, Yousry, TA & Filippi, M 2017, 'Hippocampal and deep gray matter nuclei atrophy is relevant for explaining cognitive impairment in MS: A multicenter study' American Journal of Neuroradiology, vol. 38, no. 1, pp. 18-24. https://doi.org/10.3174/ajnr.A4952

Hippocampal and deep gray matter nuclei atrophy is relevant for explaining cognitive impairment in MS : A multicenter study. / Damjanovic, D.; Valsasina, P.; Rocca, M. A.; Stromillo, M. L.; Gallo, A.; Enzinger, C.; Hulst, H. E.; Rovira, A.; Muhlert, N.; De Stefano, N.; Bisecco, A.; Fazekas, F.; Arévalo, M. J.; Yousry, T. A.; Filippi, M.

In: American Journal of Neuroradiology, Vol. 38, No. 1, 01.01.2017, p. 18-24.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Hippocampal and deep gray matter nuclei atrophy is relevant for explaining cognitive impairment in MS

T2 - A multicenter study

AU - Damjanovic, D.

AU - Valsasina, P.

AU - Rocca, M. A.

AU - Stromillo, M. L.

AU - Gallo, A.

AU - Enzinger, C.

AU - Hulst, H. E.

AU - Rovira, A.

AU - Muhlert, N.

AU - De Stefano, N.

AU - Bisecco, A.

AU - Fazekas, F.

AU - Arévalo, M. J.

AU - Yousry, T. A.

AU - Filippi, M.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - BACKGROUND AND PURPOSE: The structural MR imaging correlates of cognitive impairment in multiple sclerosis are still debated. This study assessed lesional and atrophy measures of white matter and gray matter involvement in patients with MS acquired in 7 European sites to identify the MR imaging variables most closely associated with cognitive dysfunction. MATERIALS AND METHODS: Brain dual-echo, 3D T1-weighted, and double inversion recovery scans were acquired at 3T from 62 patients with relapsing-remitting MS and 65 controls. Patients with at least 2 neuropsychological tests with abnormal findings were considered cognitively impaired. Focal WM and cortical lesions were identified, and volumetric measures from WM, cortical GM, the hippocampus, and deep GM nuclei were obtained. Age- and site-adjusted models were used to compare lesion and volumetric MR imaging variables between patients with MS who were cognitively impaired and cognitively preserved. A multivariate analysis identified MR imaging variables associated with cognitive scores and disability. RESULTS: Twenty-three patients (38%) were cognitively impaired. Compared with those with who were cognitively preserved, patients with MS with cognitive impairment had higher T2 and T1 lesion volumes and a trend toward a higher number of cortical lesions. Significant brain, cortical GM, hippocampal, deepGMnuclei, andWMatrophy was found in patients with MS with cognitive impairment versus those who were cognitively preserved. Hippocampal and deep GM nuclei atrophy were the best predictors of cognitive impairment, whileWM atrophy was the best predictor of disability. CONCLUSIONS: Hippocampal and deep GM nuclei atrophy are key factors associated with cognitive impairment in MS. These MR imaging measures could be applied in a multicenter context, with cognition as clinical outcome.

AB - BACKGROUND AND PURPOSE: The structural MR imaging correlates of cognitive impairment in multiple sclerosis are still debated. This study assessed lesional and atrophy measures of white matter and gray matter involvement in patients with MS acquired in 7 European sites to identify the MR imaging variables most closely associated with cognitive dysfunction. MATERIALS AND METHODS: Brain dual-echo, 3D T1-weighted, and double inversion recovery scans were acquired at 3T from 62 patients with relapsing-remitting MS and 65 controls. Patients with at least 2 neuropsychological tests with abnormal findings were considered cognitively impaired. Focal WM and cortical lesions were identified, and volumetric measures from WM, cortical GM, the hippocampus, and deep GM nuclei were obtained. Age- and site-adjusted models were used to compare lesion and volumetric MR imaging variables between patients with MS who were cognitively impaired and cognitively preserved. A multivariate analysis identified MR imaging variables associated with cognitive scores and disability. RESULTS: Twenty-three patients (38%) were cognitively impaired. Compared with those with who were cognitively preserved, patients with MS with cognitive impairment had higher T2 and T1 lesion volumes and a trend toward a higher number of cortical lesions. Significant brain, cortical GM, hippocampal, deepGMnuclei, andWMatrophy was found in patients with MS with cognitive impairment versus those who were cognitively preserved. Hippocampal and deep GM nuclei atrophy were the best predictors of cognitive impairment, whileWM atrophy was the best predictor of disability. CONCLUSIONS: Hippocampal and deep GM nuclei atrophy are key factors associated with cognitive impairment in MS. These MR imaging measures could be applied in a multicenter context, with cognition as clinical outcome.

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DO - 10.3174/ajnr.A4952

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SP - 18

EP - 24

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 1

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