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Demyelination of the CNS sensory afferent system correlates to wide-spread demyelination of the brain in multiple sclerosis (MS): a TBSS study of brain DTI and median nerve SEP latency
Author(s): ,
B. Ettrich
Affiliations:
Psychiatry and Psychotherapy, University Hospital of Leipzig; Neurology
,
D. Lobsien
Affiliations:
Neuroradiology, University Hospital Leipzig, Leipzig, Germany
,
J. Hamann
Affiliations:
Neuroradiology, University Hospital Leipzig, Leipzig, Germany
,
K.T. Hoffmann
Affiliations:
Neuroradiology, University Hospital Leipzig, Leipzig, Germany
F. Then Bergh
Affiliations:
Psychiatry and Psychotherapy, University Hospital of Leipzig; Neurology
ECTRIMS Online Library. Ettrich B. Oct 12, 2018; 228981
Barbara Ettrich
Barbara Ettrich
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Abstract: P1141

Type: Poster Sessions

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

Objective: To examine, in vivo, the relation of demyelination of the CNS sensory afferent system and brain white matter in MS.
Background: Prolonged somatosensory evoked potential of the median nerve (MSEP) latency is common in MS and primarily reflects demyelination. MSEP may serve as surrogate in remyelination trials, but it is unknown if MSEP changes more generally reflect demyelination in the MS brain, as previously shown for VEP latencies (Lobsien, Ettrich et al., 2014). Diffusion tensor imaging (DTI) yields information on tissue integrity (fractional anisotropy, FA), axonal integrity (axial diffusivity, AD) and demyelination (radial diffusivity, RD).
Design/Methods: 48 patients (39 MS, 9 CIS; 28 women; EDSS 2.1 +/- 1.6) underwent standard MSEP, and brain MRI including DTI at 3T (Siemens Magnetom Trio; single-shot EPI - technique with 80 diffusion directions). Mean N20 latencies (N20) and mean central conducting time (CCT) were calculated from MSEP. MRI were analyzed using FSL (FMRIB, Oxford, Great Britain) and TBSS. The images were processed and maps of FA, RD and AD were produced. These maps were projected to a common space, creating a skeleton of white matter tracts common to all subjects. Tract-based spatial statistics with GLM design was used to test the correlation of MSEP N20 and CCT with FA, RD and AD in these tracts, controlling for age and gender.
Results: Mean MSEP N20 and CCT correlated negatively to FA and significantly positively to RD in white matter tracts, especially in the optic tracts, the genu and splenium of the corpus callosum and the deep frontal white matter of both hemispheres. N20 and CCT did not correlate to AD.
Conclusions: In accordance to our previous study of VEP latencies, the degree of CNS sensory afferent system demyelination as assessed by MSEP latencies correlates to DTI-MRI measures of tissue destruction and demyelination well beyond the primary sensory tracts. This strengthens the value of both electrophysiological and advanced MRI measures as surrogate markers for CNS myelin content in patients with multiple sclerosis.
Literature:
Whole-brain diffusion tensor imaging in correlation to visual-evoked potentials in multiple sclerosis: a tract-based spatial statistics analysis. Lobsien D*, Ettrich B*, Sotiriou K, Classen J, Then Bergh F#,
Hoffmann KT#. AJNR Am J Neuroradiol. 2014, doi 10.3174/ajnr.A4034
Disclosure: Florian Then Bergh: FTB has received personal compensation for speaking and attending advisory boards from Actelion, Bayer, Biogen, Genzyme, Merck, Novartis, Teva and Roche; financial support, through his institution, to attend scientific meetings or for investigator initiated studies from Actelion, Bayer, Biogen, Genzyme, Merck, Novartis and Teva.
Barbara Ettrich: BE has received financial support, through her institution, to attend scientific meetings or for investigator initiated studies from Bayer, Biogen, Genzyme, Merck, Novartis and Teva.
Donald Lobsien: DL has nothing to disclose
Jan Hamann: JH has nothing to disclose
Karl Titus Hoffmann: KTH has nothing to disclose

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