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01-02-2019 | Original Communication

Brain tissue volumes and relaxation rates in multiple sclerosis: implications for cognitive impairment

Authors: Rosario Megna, Bruno Alfano, Roberta Lanzillo, Teresa Costabile, Marco Comerci, Giovanni Vacca, Antonio Carotenuto, Marcello Moccia, Giuseppe Servillo, Anna Prinster, Vincenzo Brescia Morra, Mario Quarantelli

Published in: Journal of Neurology | Issue 2/2019

Abstract

Objective

Both normal gray matter atrophy and brain tissue relaxation rates, in addition to total lesion volume, have shown significant correlations with cognitive test scores in multiple sclerosis (MS). Aim of the study was to assess the relative contributions of macro- and microstructural changes of both normal and abnormal brain tissues, probed, respectively, by their volumes and relaxation rates, to the cognitive status and physical disability of MS patients.

Methods

MRI studies from 241 patients with relapsing–remitting MS were retrospectively analyzed by fully automated multiparametric relaxometric segmentation. Ordinal backward regression analysis was applied to the resulting volumes and relaxation rates of both normal (gray matter, normal-appearing white matter and CSF) and abnormal (T2-weighted lesions) brain tissues, controlling for age, sex and disease duration, to identify the main independent contributors to the cognitive status, as measured by the percentage of failed tests at a cognitive test battery (Rao’s Brief Repeatable Battery and Stroop test, available in 186 patients), and to the physical disability, as assessed by the Expanded Disability Status Scale (EDSS).

Results

The R1 relaxation rate (a putative marker of tissue disruption) of the MS lesions appeared the single most significant contributor to cognitive impairment (p < 0.001). On the contrary, the EDSS appeared mainly affected by the decrease in R2 of the gray matter (p < 0.0001), (possibly influenced by cortical plaques, edema and inflammation).

Conclusions

In RR-MS the tissue damage in white matter lesions appears the single main determinant of the cognitive status of patients, likely through disconnection phenomena, while the physical disability appears related to the involvement of gray matter.

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Title: Brain tissue volumes and relaxation rates in multiple sclerosis: implications for cognitive impairment
Authors: Rosario Megna
Bruno Alfano
Roberta Lanzillo
Teresa Costabile
Marco Comerci
Giovanni Vacca
Antonio Carotenuto
Marcello Moccia
Giuseppe Servillo
Anna Prinster
Vincenzo Brescia Morra
Mario Quarantelli
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 2/2019
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-9139-6

At a glance: The STEP trials

Springer Medicine

Brain tissue volumes and relaxation rates in multiple sclerosis: implications for cognitive impairment

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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