Maria Petracca1, Wafaa Zaaraoui2, Sirio Cocozza3, Roxana Vancea4, Jonathan Howard5, Monika M Heinig4, Lazar Fleysher6, Niels Oesingmann7, Jean-Philippe Ranjeva8, Matilde Inglese9. 1. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Neurosciences, Reproductive and Odonto-stomatological Sciences, University "Federico II", Naples, Italy. 2. Aix-Marseille Univ, CNRS, CRMBM UMR, 7339, Marseille, France. 3. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy. 4. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA. 5. Department of Neurology, New York University School of Medicine, New York, NY, USA. 6. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, USA. 7. APHM, Hôpitaux de la Timone, CEMEREM, Marseille, France. 8. Aix-Marseille Univ, CNRS, CRMBM UMR, 7339, Marseille, France; UK Biobank, Stockport, Cheshire, SK3 0SA, UK. 9. Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, (DINOGMI) University of Genova and IRCCS AOU San Martino-IST, Genoa, Italy. Electronic address: matilde.inglese@mssm.edu.
Abstract
OBJECTIVE: Multiple sclerosis (MS) is less prevalent in African Americans (AAs) than Caucasians (CAs) but in the former the disease course tends to be more severe. In order to clarify the MRI correlates of disease severity in AAs, we performed a multimodal brain MRI study to comprehensively assess the extent of grey matter (GM) damage and the degree of functional adaptation to structural damage in AAs with MS. METHODS: In this cross-sectional study, we characterized GM damage in terms of focal lesions and volume loss and functional adaptation during the execution of a simple motor task on a sample of 20 AAs and 20 CAs with MS and 20 healthy controls (CTRLs). RESULTS: In AAs, we observed a wider range of EDSS scores than CAs, with multisystem involvement being more likely in AAs (p < 0.01). While no significant differences were detected in lesion loads and global brain volumes, AAs showed regional atrophy in the posterior lobules of cerebellum, temporo-occipital and frontal regions in comparison with CAs (p < 0.01), with cerebellar atrophy being the best metric in differentiating AAs from CAs (p = 0.007, AUC = 0.96 and p = 0.005, AUC = 0.96, respectively for right and left cerebellar clusters). In AAs, the functional analysis of cortical activations showed an increase in task-related activation of areas involved in high level processing and a decreased activation in the medial prefrontal cortex compared to CAs. INTERPRETATION: In our study, the direct comparison of AAs and CAs points to cerebellar atrophy as the main difference between subgroups.
OBJECTIVE:Multiple sclerosis (MS) is less prevalent in African Americans (AAs) than Caucasians (CAs) but in the former the disease course tends to be more severe. In order to clarify the MRI correlates of disease severity in AAs, we performed a multimodal brain MRI study to comprehensively assess the extent of grey matter (GM) damage and the degree of functional adaptation to structural damage in AAs with MS. METHODS: In this cross-sectional study, we characterized GM damage in terms of focal lesions and volume loss and functional adaptation during the execution of a simple motor task on a sample of 20 AAs and 20 CAs with MS and 20 healthy controls (CTRLs). RESULTS: In AAs, we observed a wider range of EDSS scores than CAs, with multisystem involvement being more likely in AAs (p < 0.01). While no significant differences were detected in lesion loads and global brain volumes, AAs showed regional atrophy in the posterior lobules of cerebellum, temporo-occipital and frontal regions in comparison with CAs (p < 0.01), with cerebellar atrophy being the best metric in differentiating AAs from CAs (p = 0.007, AUC = 0.96 and p = 0.005, AUC = 0.96, respectively for right and left cerebellar clusters). In AAs, the functional analysis of cortical activations showed an increase in task-related activation of areas involved in high level processing and a decreased activation in the medial prefrontal cortex compared to CAs. INTERPRETATION: In our study, the direct comparison of AAs and CAs points to cerebellar atrophy as the main difference between subgroups.
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Authors: Annette F Okai; Lilyana Amezcua; Regina R Berkovich; Angel R Chinea; Keith R Edwards; Brian Steingo; Aljoeson Walker; Alan K Jacobs; Nadia Daizadeh; Mitzi J Williams Journal: Neurol Ther Date: 2019-10-25