Lorenzo Conti1, Paolo Preziosa1,2, Alessandro Meani1, Elisabetta Pagani1, Paola Valsasina1, Olga Marchesi1, Carmen Vizzino1, Maria A Rocca1,2,3, Massimo Filippi1,2,4,5,3. 1. Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy. 2. Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. 3. Vita-Salute San Raffaele University, Milan, Italy. 4. Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. 5. Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Abstract
BACKGROUND: Cognitive impairment frequently affects multiple sclerosis (MS) patients. However, its neuroanatomical correlates still need to be fully explored. We investigated the contribution of structural and functional magnetic resonance imaging (MRI) abnormalities in explaining cognitive impairment in MS. METHODS: Brain dual-echo, diffusion tensor, 3D T1-weighted and resting-state (RS) MRI sequences were acquired from 276 MS patients and 102 healthy controls. Using random forest analysis, the contribution of regional white matter (WM) lesions, WM fractional anisotropy (FA) abnormalities, gray matter (GM) atrophy and RS functional connectivity (FC) alterations to cognitive impairment in MS patients was investigated. RESULTS: Eighty-four MS patients (30.4%) were cognitively impaired. The best MRI predictors of cognitive impairment (relative importance [%]) (out-of-bag area under the curve [AUC]=0.795) were (a) WM lesions in the right superior longitudinal fasciculus (100%), left anterior thalamic radiation (93.4%), left posterior corona radiata (78.5%), left medial lemniscus (74.2%), left inferior longitudinal fasciculus (70.4%), left optic radiation (68.7%), right middle cerebellar peduncle (60.6%) and right optic radiation (53.5%); (b) decreased FA in the splenium of the corpus callosum (64.3%), left optic radiation (61.0%), body of the corpus callosum (51.9%), and fornix (50.9%); (c) atrophy of the left precuneus (91.4%), right cerebellum crus I (84.4%), right caudate nucleus (78.6%), left thalamus (76.2%) and left supplementary motor area (59.8%). The relevance of these MRI measures in explaining cognitive impairment was confirmed in a cross-validation analysis (AUC=0.765). CONCLUSIONS: Structural damage in strategic WM and GM regions more than RS FC abnormalities explains cognitive impairment in MS patients. This article is protected by copyright. All rights reserved.
BACKGROUND:Cognitive impairment frequently affects multiple sclerosis (MS) patients. However, its neuroanatomical correlates still need to be fully explored. We investigated the contribution of structural and functional magnetic resonance imaging (MRI) abnormalities in explaining cognitive impairment in MS. METHODS: Brain dual-echo, diffusion tensor, 3D T1-weighted and resting-state (RS) MRI sequences were acquired from 276 MS patients and 102 healthy controls. Using random forest analysis, the contribution of regional white matter (WM) lesions, WM fractional anisotropy (FA) abnormalities, gray matter (GM) atrophy and RS functional connectivity (FC) alterations to cognitive impairment in MS patients was investigated. RESULTS: Eighty-four MS patients (30.4%) were cognitively impaired. The best MRI predictors of cognitive impairment (relative importance [%]) (out-of-bag area under the curve [AUC]=0.795) were (a) WM lesions in the right superior longitudinal fasciculus (100%), left anterior thalamic radiation (93.4%), left posterior corona radiata (78.5%), left medial lemniscus (74.2%), left inferior longitudinal fasciculus (70.4%), left optic radiation (68.7%), right middle cerebellar peduncle (60.6%) and right optic radiation (53.5%); (b) decreased FA in the splenium of the corpus callosum (64.3%), left optic radiation (61.0%), body of the corpus callosum (51.9%), and fornix (50.9%); (c) atrophy of the left precuneus (91.4%), right cerebellum crus I (84.4%), right caudate nucleus (78.6%), left thalamus (76.2%) and left supplementary motor area (59.8%). The relevance of these MRI measures in explaining cognitive impairment was confirmed in a cross-validation analysis (AUC=0.765). CONCLUSIONS:Structural damage in strategic WM and GM regions more than RS FC abnormalities explains cognitive impairment in MS patients. This article is protected by copyright. All rights reserved.
Authors: Paolo Preziosa; Elisabetta Pagani; Alessandro Meani; Olga Marchesi; Lorenzo Conti; Andrea Falini; Maria A Rocca; Massimo Filippi Journal: J Neurol Date: 2022-10-06 Impact factor: 6.682
Authors: Jan Hamann; Barbara Ettrich; Karl Titus Hoffman; Florian Then Bergh; Donald Lobsien Journal: Front Neurol Date: 2022-08-29 Impact factor: 4.086