Characterization of multiple sclerosis grey and white matter pathology in the brain and spinal cord at 7 Tesla MRI
Author(s): ,
R. Ouellette
Affiliations:
Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden; Harvard Medical School
,
C.A. Treaba
Affiliations:
Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
,
T. Granberg
Affiliations:
Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden; Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
,
V. Barletta
Affiliations:
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
,
E. Herranz
Affiliations:
Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
,
G. Mangeat
Affiliations:
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
,
A. Mehndiratta
Affiliations:
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
,
S. Tauhid
Affiliations:
Harvard Medical School; Brigham and Women`s Hospital
,
F. Yousuf
Affiliations:
Harvard Medical School; Brigham and Women`s Hospital
,
B. De Leener
Affiliations:
NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
,
S. Dupont
Affiliations:
NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
,
J.A. Sloane
Affiliations:
Beth Israel Deaconess Medical Center, Boston, MA, United States
,
R. Bakshi
Affiliations:
Harvard Medical School; Brigham and Women`s Hospital
,
J. Cohen-Adad
Affiliations:
NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
C. Mainero
Affiliations:
Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
ECTRIMS Online Library. Ouellette R. Oct 12, 2018; 228961; P1121
Russell Ouellette
Russell Ouellette
Contributions
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Abstract

Abstract: P1121

Type: Poster Sessions

Abstract Category: Pathology and pathogenesis of MS - MRI and PET

Introduction: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disorder of the central nervous system, affecting both grey matter (GM) and white matter (WM) of the brain and the spinal cord. Recently, 7 Tesla (7T) magnetic resonance imaging (MRI) has been shown to improve the sensitivity to MS pathology in the brain, especially in the cortex, though studies of the spinal cord at 7T remain sparse.
Aims: To use 7T MRI to characterize GM and WM MS pathology in the brain and cervical spinal cord (SC) of relapsing-remitting and secondary progressive MS (RRMS, SPMS) subjects, and their relative contributions to neurological disability.
Methods: Thirty-one MS subjects (18 RRMS, 13 SPMS) and 11 age-matched healthy controls (HC) underwent 7T T2* imaging of the cervical SC (0.41x0.41x3.6 mm3) and brain (0.33x0.33x1 mm3) for segmentation. Cortical thickness was estimated using FreeSurfer on 3T T1-weighted scans. Cervical SC WM and GM were segmented using Spinal Cord Toolbox 3.0. Cross ­sectional areas (CSA) were calculated from C-C3. SC lesion fractions (LF) were quantified as the proportion of lesioned tissue in GM and WM to total tissue volume. MS subjects were clinically assessed using Expanded Disability Status Scale (EDSS), 9-Hole Peg Test (9-HPT), and Timed 25-Foot Walk (T25-FW). Comparisons were administered based on data distribution normality. Stepwise linear regression assessed the relation between MRI variables and disability metrics.
Results: Cervical SC lesions were found in 84% of MS subjects, with a LF in WM of 0.049 ± 0.091, in GM of 0.05 ± 0.16. Relative to HC, MS subjects had lower CSA in both WM (52.6±8.6 mm2 vs. 58.1±4.9 mm2, P=0.015) and GM (6.7±1.4 mm2 vs. 7.71±0.95 mm2, P=0.016) and also thinner cortex (2.34±0.13 mm vs. 2.41±0.07 mm, P=0.035). Stepwise linear regression identified cortical thickness as the most significant contributor of EDSS (r2=0.17, P=0.039) and T25-FW mobility disability (r2=0.44, P=0.001), while GM SC CSA was the most significant contributor of 9-HPT fine motor disability (r2=0.25, P=0.009). No significant associations were found between the brain and spinal cord MRI metrics.
Conclusions: 7T MRI can disclose GM and WM tissue pathology in the SC of RRMS and SPMS subjects, which significantly contributes to neurological disability together with brain pathology. The lack of an association between brain and spinal cord MRI metrics suggest that these pathological processes develop relatively independently.
Disclosure: This study was supported by a grant of the National Institute of Health (NIH R01NS078322­01­ A1) and by a grant from EMD Merck Serono.
C. Mainero has received research support from EMD Merck Serono and Sanofi-Genzyme, as well as speaker honoraria from Biogen.
T. Granberg was supported by Stockholm City Council and Karolinska Institutet (ALF grant 20150166) and the Swedish Society for Medical Research.
R. Bakshi has received consulting fees from EMD Merck Serono, Genentech, Sanofi-Genzyme, and Novartis and research support from Biogen, EMD Merck Serono and Novartis.
E. Herranz was supported by the NMSS fellowship FG­1507­05459.
R. Ouellette reports no disclosures.
J. Cohen-Adad reports no disclosures.
C.A. Treaba reports no disclosures.
J.A. Sloane reports no disclosures.
V Barletta reports no disclosures.
S. Tauhid reports no disclosures.
F. Yousuf reports no disclosures.
B. De Leener reports no disclosures.
S. Dupont reports no disclosures.

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