Author Of 4 Presentations
P0121 - Objective measurement of speech correlates with disease status and quality of life in people with MS without dysarthria (ID 1681)
Abstract
Background
Objective measurement of speech has shown promising results to monitor disease state in Multiple Sclerosis (MS). Yet, it is not clear if changes in speech can be detected before overt dysarthria.
Objectives
In this study, we characterize the relationship between disease severity and objective speech metrics exclusively in people with no perceivable dysarthria.
Methods
An acoustic composite score was calculated using regression modelling of speech data from 119 people with MS (pwMS, 75% female), irrespective of dysarthria presence. That score was then tested in pwMS without dysarthria, as determined by blinded perceptual rating, for correlations with the Expanded Disability Status Scale (EDSS), brain volume and lesion load from magnetic resonance imaging, and quality of life scores from the Multiple Sclerosis Impact Scale (MSIS-29) .
Results
PwMS without dysarthria (n=77) were more likely to be female (82% vs 62%, p=0.017), were on average 5.7 years younger (age mean ± standard deviation 53.5±11.4, p=0.009), had MS for 2.5 years shorter (11±8.5 years, p=0.034) and scored EDSS 1.7 step lower (2.7±1.9, p<0.001) than pwMS with dysarthria (n=42). The acoustic composite score correlated with EDSS scores (r=0.45, p<0.001) and quality of life (r=0.4, p=0.01) in pwMS without perceivable dysarthria, but not with brain volume or lesion load.
Conclusions
Acoustic analysis offers a valuable insight into the subclinical development of speech impairment in MS. These results highlight the potential of automated analysis of speech to assist in monitoring disease progression and treatment response.
P0572 - Evaluation of cerebellar function scores in relation to cerebellar axonal loss in multiple sclerosis. (ID 933)
Abstract
Background
Damage to the cerebellum is common in people with multiple sclerosis (pwMS) and associated with a worse prognosis and, cerebellar relapses are associated with poorer recovery and earlier onset of progressive disease. Studies examining the importance of the cerebellum are hampered by incomplete characterisation of cerebellar damage and its relation to cerebellar function.
Objectives
We aim to examine axonal loss in the cerebellum using diffusion imaging and compare the degree of cerebellar axonal loss with cerebellar dysfunction in pwMS.
Methods
We prospectively recruited 55 pwMS and 14 healthy controls (HC). Clinical assessments included scale for the assessment and rating of ataxia (SARA) and Bain tremor ratings. Subjects underwent 3-tesla volumetric, lesion and diffusion magnetic resonance imaging. Cerebellar axonal loss was examined with fibre-specific markers. Fibre density and cross-section (FDC) accounts for microscopic and macroscopic changes in a fibre bundle.
Results
Significant loss of cerebellar FDC was found in pwMS compared to HC (p=0.03). Lower FDC was associated with increased SARA (r=-0.42, p<0.01) and tremor severity (rho=-0.35, p=0.01). Cerebellar lesion volume correlated with SARA (r=0.49, p<0.01) and tremor severity (rho=0.41, p=0.01). Cerebellar volume showed no correlation with cerebellar clinical assessments.
Conclusions
Fibre-specific measures of cerebellar pathology could provide a functionally relevant marker of cerebellar damage in pwMS. Future trials using fibre-specific markers are needed to further characterise cerebellar pathology and understand its significance in disease progression.
P0582 - High resolution functional mapping of upper and lower limb sensorimotor function in minimally disabled people with multiple sclerosis using 7T MRI (ID 1050)
Abstract
Background
In multiple sclerosis (MS) upper and lower limbs can be affected, but impairments only moderately relate to each other. Previous motor task studies have focussed predominantly on imaging hand function at clinical field strengths, preventing the detection of subtle changes and differentiation of mechanisms underlying subtle motor impairment.
Objectives
To investigate functional brain changes related to upper and/or lower limb motor task performance in minimally disabled MS patients using ultra-high field MRI.
Methods
Twenty-eight MS patients and seventeen healthy controls underwent visually-guided force-matching fMRI tasks using either hand or foot. Task performance (force error and lag) and activation level during upper and lower limb movements were compared between groups. Correlations were assessed between task activation and behavioural performance.
Results
During lower limb force tracking, MS patients showed significantly (p<0.01) longer lag, higher force error, higher primary motor and premotor cortex activation and lower cerebellar Crus I/II activation, compared to controls. No differences were seen in upper limb performance or activation. Upper and lower limb task performance was related to the level of activation in cerebellar, visual and motor areas in MS patients.
Conclusions
Altered lower limb movements and brain activation with preserved upper limb function and activation in minimally disabled patients suggests partially divergent functional mechanisms underlying upper and lower limb disability.
P0626 - Quantitative Susceptibility Mapping at 7 Tesla detects ongoing active lesions in relapse-free RRMS patients (ID 1540)
Abstract
Background
Microglia are iron-rich cells, found surrounding multiple sclerosis (MS) lesions in areas of active inflammation. Quantitative Susceptibility Mapping (QSM) can detect this increased iron and thus could be a novel MRI biomarker for microglia-associated inflammation in the brain. The proportion of patients with active inflammation is currently unknown, as is the proportion of MS lesions seen on conventional MRI sequences that are active across patients. Ultra-high field MRI (7 Tesla +) provides superior signal to noise and susceptibility contrast making it the optimal method for detecting iron in MS lesions and tracking active inflammation.
Objectives
To compare the number of lesions with positive QSM signal indicating active inflammation with lesion size and number in patients with relapsing-remitting MS (RRMS) using 7T MRI.
Methods
21 people with RRMS (mean ± SD age = 42 ± 11 yrs; sex: 2m/19f; mean ± SD disease duration = 5.5 ± 3.2 yrs; all EDSS < 4; no relapses in previous 12 months) were scanned using MP2RAGE anatomical and multi-echo gradient echo sequences on a Siemens 7T MAGNETOM MRI scanner. MP2RAGE was used to identify lesions and then co-registered to QSM (calculated from gradient echo phase images using an in-house pipeline). The number of lesions with an average QSM value over 0 (QSM+), indicating the presence of iron associated with active inflammation, were compared to the total number and total volume (log10 transformed) of lesions across patients using linear regression.
Results
The number of lesions in patients ranged from 3 to 92 (mean ± SD = 33 ± 25) and volumes ranged from 26 to 14505 mm3 (mean ± SD = 2554 ± 3445 mm3). Across all patients, the average proportion of QSM+ lesions was 0.61 (95% CI = 0.50-0.72, R2=0.87, p<0.0001), and for each log10 cubic millimeter change in the lesion volume, there were an additional 15 QSM+ lesions (95% CI = 7.0-24, R2=0.43, p=0.0012). There were no associations between the proportion of QSM+ lesions and any disease or demographic variables.
Conclusions
Irrespective of disease severity or duration, the proportion of QSM+ lesions was highly consistent. Based on the assumption that QSM+ lesions are undergoing active inflammation, our results indicate that around ~60% of lesions in RRMS patients could be active.
Presenter Of 1 Presentation
P0572 - Evaluation of cerebellar function scores in relation to cerebellar axonal loss in multiple sclerosis. (ID 933)
Abstract
Background
Damage to the cerebellum is common in people with multiple sclerosis (pwMS) and associated with a worse prognosis and, cerebellar relapses are associated with poorer recovery and earlier onset of progressive disease. Studies examining the importance of the cerebellum are hampered by incomplete characterisation of cerebellar damage and its relation to cerebellar function.
Objectives
We aim to examine axonal loss in the cerebellum using diffusion imaging and compare the degree of cerebellar axonal loss with cerebellar dysfunction in pwMS.
Methods
We prospectively recruited 55 pwMS and 14 healthy controls (HC). Clinical assessments included scale for the assessment and rating of ataxia (SARA) and Bain tremor ratings. Subjects underwent 3-tesla volumetric, lesion and diffusion magnetic resonance imaging. Cerebellar axonal loss was examined with fibre-specific markers. Fibre density and cross-section (FDC) accounts for microscopic and macroscopic changes in a fibre bundle.
Results
Significant loss of cerebellar FDC was found in pwMS compared to HC (p=0.03). Lower FDC was associated with increased SARA (r=-0.42, p<0.01) and tremor severity (rho=-0.35, p=0.01). Cerebellar lesion volume correlated with SARA (r=0.49, p<0.01) and tremor severity (rho=0.41, p=0.01). Cerebellar volume showed no correlation with cerebellar clinical assessments.
Conclusions
Fibre-specific measures of cerebellar pathology could provide a functionally relevant marker of cerebellar damage in pwMS. Future trials using fibre-specific markers are needed to further characterise cerebellar pathology and understand its significance in disease progression.