Author Of 1 Presentation
PS07.05 - Leptomeningeal, dura mater and meningeal vessel wall enhancements in multiple sclerosis
Abstract
Background
Leptomeningeal inflammation (LMI) in multiple sclerosis (MS) can be putatively identified by leptomeningeal contrast enhancement (LMCE) on gadolinium-enhanced 3D T2-fluid attenuated inversion recovery (FLAIR) magnetic resonance (MR) images. Dura mater (DME), inclusive falx cerebri (FCE) enhancement and meningeal vessel wall enhancement (VWE) represent two other meningeal enhancement patterns in MS that have not been extensively studied.
Objectives
To investigate the frequency of LMCE, DME/FCE and VWE in patients with MS and their associations with demographic, clinical and MRI characteristics in a longitudinal retrospective study.
Methods
217 MS patients (193 relapsing-remitting MS, 24 progressive MS) were assessed at baseline and over 18 months follow-up using 3T 3D FLAIR pre- and post-contrast and subtraction images. Lesion and brain volume outcomes were additionally calculated. Analysis of covariance (ANCOVA) and regression models were used to assess the relationship between MRI variables and clinical variables, controlling for age.
Results
24% of MS patients revealed LMCE, and 47% and 24% revealed DME/FCE and VWE, respectively. LMCE presence correlated with age and higher ventricular cerebrospinal fluid (vCSF) volume. More LMCE positive subjects (38%) showed additional VWE, compared to LMCE negative subjects (20%, p=0.055). DME/FCE presence was associated with higher T1/T2 lesion load, higher vCSF volume and decreased total deep gray matter (GM) and hippocampus volumes. All three meningeal enhancement patterns showed a high persistence in shape and size at follow-up.
Conclusions
Different patterns of meningeal enhancement, i.e. LMCE, DME/FCE and VWE can be identified by gadolinium-enhanced 3D FLAIR MR imaging. LMCE positive patients show a trend for higher frequency of VWE than LMCE negative patients. DME/FCE is the most frequent meningeal enhancement pattern in MS, which correlates with imaging markers of lesion burden and brain atrophy and may indicate abnormal lymphatic drainage in these patients.
Presenter Of 1 Presentation
PS07.05 - Leptomeningeal, dura mater and meningeal vessel wall enhancements in multiple sclerosis
Abstract
Background
Leptomeningeal inflammation (LMI) in multiple sclerosis (MS) can be putatively identified by leptomeningeal contrast enhancement (LMCE) on gadolinium-enhanced 3D T2-fluid attenuated inversion recovery (FLAIR) magnetic resonance (MR) images. Dura mater (DME), inclusive falx cerebri (FCE) enhancement and meningeal vessel wall enhancement (VWE) represent two other meningeal enhancement patterns in MS that have not been extensively studied.
Objectives
To investigate the frequency of LMCE, DME/FCE and VWE in patients with MS and their associations with demographic, clinical and MRI characteristics in a longitudinal retrospective study.
Methods
217 MS patients (193 relapsing-remitting MS, 24 progressive MS) were assessed at baseline and over 18 months follow-up using 3T 3D FLAIR pre- and post-contrast and subtraction images. Lesion and brain volume outcomes were additionally calculated. Analysis of covariance (ANCOVA) and regression models were used to assess the relationship between MRI variables and clinical variables, controlling for age.
Results
24% of MS patients revealed LMCE, and 47% and 24% revealed DME/FCE and VWE, respectively. LMCE presence correlated with age and higher ventricular cerebrospinal fluid (vCSF) volume. More LMCE positive subjects (38%) showed additional VWE, compared to LMCE negative subjects (20%, p=0.055). DME/FCE presence was associated with higher T1/T2 lesion load, higher vCSF volume and decreased total deep gray matter (GM) and hippocampus volumes. All three meningeal enhancement patterns showed a high persistence in shape and size at follow-up.
Conclusions
Different patterns of meningeal enhancement, i.e. LMCE, DME/FCE and VWE can be identified by gadolinium-enhanced 3D FLAIR MR imaging. LMCE positive patients show a trend for higher frequency of VWE than LMCE negative patients. DME/FCE is the most frequent meningeal enhancement pattern in MS, which correlates with imaging markers of lesion burden and brain atrophy and may indicate abnormal lymphatic drainage in these patients.
Author Of 1 Presentation
P0566 - Diffusion tensor imaging of the nucleus basalis of Meynert reveals associations with cognitive state in patients with multiple sclerosis (ID 1427)
Abstract
Background
Previous studies have shown that the nucleus basalis of Meynert (NBM), a group of neurons in the basal forebrain representing the major source of cholinergic innervations for the cerebral and subcortical cortex, is particularly vulnerable to neurodegeneration in Alzheimer’s disease (AD) and Parkinson’s disease (PD). Microstructural NBM damage, as reflected by increased diffusion tensor imaging (DTI)-derived measures of diffusivity, has been shown to be related to cognitive impairment in these diseases. As of now, the NBM has been scarcely investigated in multiple sclerosis (MS).
Objectives
To determine associations between microstructural properties of the NBM and cognitive outcomes in patients with MS (PwMS).
Methods
84 PwMS (54 relapsing-remitting MS, 30 secondary progressive MS) underwent 3T MRI with a protocol that included a diffusion-weighted imaging acquisition. All PwMS underwent cognitive assessment with the Brief International Cognitive Assessment for MS (BICAMS), which includes the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R) and California Verbal Learning Test-2nd edition (CVLT-2). Standard DTI measures, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were calculated. A probabilistic map of the NBM was utilized to calculate DTI-derived measures. Partial correlations were used to assess the relationship between BICAMS cognitive outcomes and DTI assessments of the NBM, controlling for age and education.
Results
Neuropsychological outcomes correlated with altered diffusivity within the NBM in PwMS. SDMT scores were associated with NBM measures of MD (r=-0.38, p<0.001), AD (r=-0.26, p=0.017), and RD (r=-0.40, p<0.001). BVMT-R was associated with MD (r=-0.33, p=0.002) and RD (r=-0.37, p=0.001), while CVLT-2 was associated with MD (r=-0.27, p=0.015), AD (r=-0.22, p=0.050) and RD (r=-0.27, p=0.016). After accounting for normalized NBM volume, NBM RD explained additional variance for SDMT (R2=0.24, p<0.001) and BVMT-R (R2=0.18, p=0.001), while NBM MD was retained for CVLT-2 (R2=0.17, p=0.015).
Conclusions
Our results show an association between cognitive impairment and microstructural NBM damage in PwMS, highlighting the potential role of NBM damage in determining the cognitive state in PwMS.
Presenter Of 1 Presentation
P0566 - Diffusion tensor imaging of the nucleus basalis of Meynert reveals associations with cognitive state in patients with multiple sclerosis (ID 1427)
Abstract
Background
Previous studies have shown that the nucleus basalis of Meynert (NBM), a group of neurons in the basal forebrain representing the major source of cholinergic innervations for the cerebral and subcortical cortex, is particularly vulnerable to neurodegeneration in Alzheimer’s disease (AD) and Parkinson’s disease (PD). Microstructural NBM damage, as reflected by increased diffusion tensor imaging (DTI)-derived measures of diffusivity, has been shown to be related to cognitive impairment in these diseases. As of now, the NBM has been scarcely investigated in multiple sclerosis (MS).
Objectives
To determine associations between microstructural properties of the NBM and cognitive outcomes in patients with MS (PwMS).
Methods
84 PwMS (54 relapsing-remitting MS, 30 secondary progressive MS) underwent 3T MRI with a protocol that included a diffusion-weighted imaging acquisition. All PwMS underwent cognitive assessment with the Brief International Cognitive Assessment for MS (BICAMS), which includes the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R) and California Verbal Learning Test-2nd edition (CVLT-2). Standard DTI measures, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were calculated. A probabilistic map of the NBM was utilized to calculate DTI-derived measures. Partial correlations were used to assess the relationship between BICAMS cognitive outcomes and DTI assessments of the NBM, controlling for age and education.
Results
Neuropsychological outcomes correlated with altered diffusivity within the NBM in PwMS. SDMT scores were associated with NBM measures of MD (r=-0.38, p<0.001), AD (r=-0.26, p=0.017), and RD (r=-0.40, p<0.001). BVMT-R was associated with MD (r=-0.33, p=0.002) and RD (r=-0.37, p=0.001), while CVLT-2 was associated with MD (r=-0.27, p=0.015), AD (r=-0.22, p=0.050) and RD (r=-0.27, p=0.016). After accounting for normalized NBM volume, NBM RD explained additional variance for SDMT (R2=0.24, p<0.001) and BVMT-R (R2=0.18, p=0.001), while NBM MD was retained for CVLT-2 (R2=0.17, p=0.015).
Conclusions
Our results show an association between cognitive impairment and microstructural NBM damage in PwMS, highlighting the potential role of NBM damage in determining the cognitive state in PwMS.