Adil Maarouf1, Bertrand Audoin2, Fanelly Pariollaud2, Soraya Gherib2, Audrey Rico2, Elisabeth Soulier2, Sylviane Confort-Gouny2, Maxime Guye2, Lothar Schad2, Jean Pelletier2, Jean-Philippe Ranjeva2, Wafaa Zaaraoui2. 1. From CNRS (A.M., B.A., F.P., S.G., A.R., E.S., S.C.-G., M.G., J.P., J.-P.R., W.Z.), CRMBM UMR 7339, Aix-Marseille Université, Marseille; Service de Neurologie (A.M.), Centre Hospitalier Universitaire de Reims, Université de Reims Champagne Ardennes; Service de Neurologie (A.M., B.A., A.R., J.P.) and CEMEREM (M.G., A.M.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Marseille, France; and Computer Assisted Clinical Medicine (L.S.), Heidelberg University, Mannheim, Germany. adil.maarouf@ap-hm.fr. 2. From CNRS (A.M., B.A., F.P., S.G., A.R., E.S., S.C.-G., M.G., J.P., J.-P.R., W.Z.), CRMBM UMR 7339, Aix-Marseille Université, Marseille; Service de Neurologie (A.M.), Centre Hospitalier Universitaire de Reims, Université de Reims Champagne Ardennes; Service de Neurologie (A.M., B.A., A.R., J.P.) and CEMEREM (M.G., A.M.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Marseille, France; and Computer Assisted Clinical Medicine (L.S.), Heidelberg University, Mannheim, Germany.
Abstract
OBJECTIVE: To investigate whether brain total sodium accumulation assessed by 23Na MRI is associated with cognitive deficit in relapsing-remitting multiple sclerosis (RRMS). METHODS: Eighty-nine participants were enrolled in the study (58 patients with RRMS with a disease duration ≤10 years and 31 matched healthy controls). Patients were classified as cognitively impaired if they failed at least 2 tasks on the Brief Repeatable Battery. MRI was performed at 3T using 23Na MRI to obtain total sodium concentration (TSC) in the different brain compartments (lesions, normal-appearing white matter [NAWM], gray matter [GM]) and 1H- magnetization-prepared rapid gradient echo to assess GM atrophy (GM fraction). RESULTS: The mean disease duration was 3.1 years and the median Expanded Disability Status Scale score was 1 (range 0-4.5). Thirty-seven patients were classified as cognitively preserved and 21 as cognitively impaired. TSC was increased in GM and NAWM in cognitively impaired patients compared to cognitively preserved patients and healthy controls. Voxel-wise analysis demonstrated that sodium accumulation was mainly located in the neocortex in cognitively impaired patients. Regression analysis evidenced than the 2 best independent predictors of cognitive impairment were GM TSC and age. Receiver operating characteristic analyses demonstrated that sensitivity and specificity of the GM TSC to classify patients according to their cognitive status were 76% and 71%, respectively. CONCLUSIONS: This study provides 2 main findings. (1) In RRMS, total sodium accumulation in the GM is better associated with cognitive impairment than GM atrophy; and (2) total sodium accumulation in patients with cognitive impairment is mainly located in the neocortex.
OBJECTIVE: To investigate whether brain total sodium accumulation assessed by 23Na MRI is associated with cognitive deficit in relapsing-remitting multiple sclerosis (RRMS). METHODS: Eighty-nine participants were enrolled in the study (58 patients with RRMS with a disease duration ≤10 years and 31 matched healthy controls). Patients were classified as cognitively impaired if they failed at least 2 tasks on the Brief Repeatable Battery. MRI was performed at 3T using 23Na MRI to obtain total sodium concentration (TSC) in the different brain compartments (lesions, normal-appearing white matter [NAWM], gray matter [GM]) and 1H- magnetization-prepared rapid gradient echo to assess GM atrophy (GM fraction). RESULTS: The mean disease duration was 3.1 years and the median Expanded Disability Status Scale score was 1 (range 0-4.5). Thirty-seven patients were classified as cognitively preserved and 21 as cognitively impaired. TSC was increased in GM and NAWM in cognitively impairedpatients compared to cognitively preserved patients and healthy controls. Voxel-wise analysis demonstrated that sodium accumulation was mainly located in the neocortex in cognitively impairedpatients. Regression analysis evidenced than the 2 best independent predictors of cognitive impairment were GM TSC and age. Receiver operating characteristic analyses demonstrated that sensitivity and specificity of the GM TSC to classify patients according to their cognitive status were 76% and 71%, respectively. CONCLUSIONS: This study provides 2 main findings. (1) In RRMS, total sodium accumulation in the GM is better associated with cognitive impairment than GM atrophy; and (2) total sodium accumulation in patients with cognitive impairment is mainly located in the neocortex.
Authors: Aashim Bhatia; Vincent Kyu Lee; Yongxian Qian; Michael J Paldino; Rafael Ceschin; Jasmine Hect; James M Mountz; Dandan Sun; Gary Kohanbash; Ian F Pollack; Regina I Jakacki; Fernando Boada; Ashok Panigrahy Journal: Diagnostics (Basel) Date: 2022-05-13
Authors: Sara Collorone; Ferran Prados; Baris Kanber; Niamh M Cawley; Carmen Tur; Francesco Grussu; Bhavana S Solanky; Marios Yiannakas; Indran Davagnanam; Claudia A M Gandini Wheeler-Kingshott; Frederik Barkhof; Olga Ciccarelli; Ahmed T Toosy Journal: Brain Date: 2021-06-22 Impact factor: 13.501
Authors: Frank Riemer; Damien McHugh; Fulvio Zaccagna; Daniel Lewis; Mary A McLean; Martin J Graves; Fiona J Gilbert; Geoff J M Parker; Ferdia A Gallagher Journal: J Magn Reson Imaging Date: 2019-03-12 Impact factor: 4.813