Joint Annual Meeting ISMRM-ESMRMB 2014 10-16 May 2014 Milan, Italy

MS in Gray Matter

Friday 16 May 2014
Space 4  08:00 - 10:00 Moderators: Massimo Filippi, M.D., Feng Feng, M.D.

Stefano Tambalo1, Silvia Fiorini1, Roberta Rigolio2, Pietro Bontempi1, Andrea Sbarbati3, Guido Cavaletti2, Paola Marmiroli2, Stefano Pluchino4, and Pasquina Marzola5
1Dept. of Neuological and Movement Science, Università di Verona, Verona, Verona, Italy, 2Dept. of Surgery and Translational Medicine, Università Milano-Bicocca, Milano, Italy, 3Dept. of Neuological and Movement Science, INSTM Firenze, Verona, Italy, 4Dept of Clinical Neurosciences, John Van Geest Centre for Brain Repair, Stem Cell Institute and NIHR, University of Cambridge, Cambridge, United Kingdom, 5Dept. of Informatics, University of Verona, Verona, Italy

Experimental Autoimmune Encephalomyelitis (EAE) is a good model of Multiple Sclerosis in rodents. We have applied fMRI to invesigate the alteration in functional response in rats induced with EAE. Cortical activation is altered in EAE rat brain, compared to controls. fMRI showed an increase in the activated volume involving also the cortex ipsilateral and some extra-cortical areas at the observed time points. These results demonstrate brain cortex remodeling in EAE, a remakable feature of MS. The present model seems to be a relevant tool in preclinical MS studies.

08:12 0953.   
Hyperoxygenation in combination with susceptibility weighted imaging identifies vascular lesions in a model of multiple sclerosis
Nabeela Nathoo1, James A. Rogers2, V. Wee Yong2, and Jeff F. Dunn1,3
1Radiology, University of Calgary, Calgary, Alberta, Canada, 2Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada, 3Experimental Imaging Centre, University of Calgary, Calgary, Alberta, Canada

We showed previously that susceptibility weighted imaging (SWI) detects two types of lesions in the experimental autoimmune encephalomyelitis (EAE) model of multiple sclerosis: 1) vascular lesions, due to intravascular deoxyhemoglobin, and 2) parenchymal white matter lesions, due to iron deposition/demyelination. To identify vascular lesions in vivo, high oxygen was used during SWI MRI in EAE mice. High oxygen changed the appearance of vascular lesions, making them either disappear, become less dark, or become bright. As hyperoxygenation is well tolerated and safe, this method could be translated to MS patients to help differentiate between sources of lesions seen with SWI.

08:24 0954.   Enhanced detection of cortical lesions in multiple sclerosis using magnetization transfer and double inversion recovery
Refaat E Gabr1 and Ponnada A Narayana1
1Diagnostic and Interventional Radiology, University of Texas Health Science Center at Houston, Houston, TX, United States

Double inversion recovery (DIR) is a powerful imaging technique for detecting cortical lesions in multiple sclerosis. Yet, the number of lesions detected by DIR is significantly lower than number of lesions identified on histology. Here we propose using magnetization transfer to enhance the suppression of white matter to improve the depiction of cortical lesions. Experiments on 14 patients show that magnetization transfer DIR (MT-DIR) doubles the number of detected lesions and improves the lesion contrast by ~30%.

08:36 0955.   Cortical pathology is associated to proximal underlying white matte injury in multiple sclerosis: a multimodal 7T and 3T MRI study using surface based and tract based analysis.
Celine Louapre1, Sindhuja T Govindarajan2, Costanza Giannì2, Julien Cohen-Adad3, Revere Philip Kinkel4, and Caterina Mainero2
1AA Martinos Center for Biomedical Imaging, Charlestown, MA, United States, 2AA Martinos Center for Biomedical Imaging, MA, United States, 3Institute of Biomedical Engineering Ecole Polytechnique de Montreal, QC, Canada, 4Beth Israel Deaconess Medical Center, MA, United States

The relationship between diffuse cortical and underlying white matter (WM) injury in multiple sclerosis (MS) is not well understood. We used cortical thickness and intracortical laminar T2* relaxation decay to assess cortical injury, and to analyse its relationship with underlying WM pathology as assessed by diffusion tensor imaging. We found a spatial relationship between cortex and subcortical WM pathology at the overall brain level, and as a function of the depth from the white matter surface within WM tracts.

08:48 0956.   Connected WM lesions are associated with reduced cortical thickness in long-standing multiple sclerosis
Martijn D. Steenwijk1, Marita Daams1,2, Lisanne J. Balk3, Prejaas K. Tewarie3, Jeroen J.G. Geurts2, Frederik Barkhof1, Hugo Vrenken1,4, and Petra Pouwels4
1Department of Radiology and Nuclear Medicine, VU University medical center, Amsterdam, Noord-Holland, Netherlands, 2Department of Anatomy and Neurosciences, VU University medical center, Amsterdam, Noord-Holland, Netherlands, 3Department of Neurology, VU University medical center, Amsterdam, Noord-Holland, Netherlands, 4Department of Physics and Medical Technology, VU University medical center, Amsterdam, Noord-Holland, Netherlands

Gray matter (GM) atrophy is common in multiple sclerosis (MS), but the spatial relation with white matter (WM) pathology is largely unknown. Studies investigating this topic are often limited to early patients or specific tracts. We present a new method using an advanced tractography-based approach to obtain ‘lesion connectivity’ maps at the cortical surface. Group-level vertex-wise statistics in a large cohort (n=208) of long-standing MS patients revealed large areas with negative associations between lesion connectivity and cortical thickness, indicating that cortical atrophy in MS can –at least partly– be explained by axonal damage or disconnection due to WM lesions.

09:00 0957.   Multimodal imaging analysis in the assessment of gray and white matter damage in multiple sclerosis
Niels Bergsland1,2, Marcella Laganà1, Eleonora Tavazzi1, Matteo Caffini2, Paola Tortorella1, Marco Rovaris1, and Giuseppe Baselli2
1Istituto IRCCS Santa Maria Nascente, Fondazione Don Gnocchi, Milan, Italy, 2Dipartimento di Elettronica, Informatica e Bioingegneria, Politecnico di Milano, Milan, Italy

The study of the relationship between grey matter (GM) and white matter damage in multiple sclerosis (MS) is relevant. This was a cross-sectional MRI study of 30 MS patients. Probabilistic tractography data and lesion load of the cortico-spinal tract (CST) were obtained. Measures of motor cortex (MC) thickness and area were obtained with Freesurfer. MC thickness correlated with CST mean diffusivity and lesion volume, and EDSS. MC surface area correlated with EDSS. Our findings further characterize the GM damage and confirm its impact of on disability. CST damage correlated with cortical thickness supporting the link between GM and WM damage.

09:12 0958.   Improved SIENAX assessment of WM and GM volumes
Marco Battaglini1, Mark Jenkinson2, Antonio Giorgio1, Maria Assunta Rocca3, Maria Laura Stromillo1, Massimo Filippi3, jacqueline Palace4, and Nicola De Stefano1
1Medicine, Surgery and Neurosciences, University of Siena, Siena, Tuscany, Italy, 2Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, Oxford, United Kingdom, 3Neuroimaging Research Unit, Vita-Salute S.Raffaele University, Milano, Italy, 4Clinical Neurology, University of Oxford, Oxford, United Kingdom

This work provides a new SIENAX (SIENAX2.0) pipeline for the assessment of grey matter (GM) and white matter (WM) volume changes as measured on MR images of Multiple Sclerosis patients. Multisite datasets were analyzed and the results compared with those obtained by the SIENAX and the SPM8. New inhomogeneity correction and method for relabeling of potentially mislabeled GM clusters were introduced in SIENAX2.0 In isotropic high-quality dataset the new SIENAX2.0 allows robust GM and WM volume assessment halving the error when compared with SIENAX . In non-isotropic dataset, SIENAX2.0 significantly improves the robustness of GM and WM volume assessment.

09:24 0959.   
Statistical modeling to assess the impact of cortical parameters on cognition in Multiple Sclerosis.
Vanessa Lippolis1, Daniel Altmann2, Nils Muhlert3, Egidio Ugo D'Angelo4, Lucia Della Croce5, Matteo Pardini6,7, Declan Chard7, David H. Miller7, Maria Ron7, Fulvia Palesi8,9, and Claudia A.M. Wheeler-Kingshott7
1Mathematics, University of Pavia, Pavia, Pavia, Italy, 2Department of Medical Statistics, LSHTM, London, London, United Kingdom, 3School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom, 4Dept of Brain and Behavioral Sciences, University of Pavia, Pavia, Pavia, Italy,5Mathematics, University of Pavia, Pavia, Italy, 6Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Genoa, Italy, 7NMR Research Unit, Department of Neuroinflammation, Queen Square MS Centre, UCL Institute of Neurology, London, London, United Kingdom, 8Department of Physics, University of Pavia, Pavia, Pavia, Italy, 9Brain Connectivity Center, National Neurological Institute C. Mondino, Pavia, Pavia, Italy

We present a statistical model in the GLM framework to relate cognitive scores to MRI-based cortical parameters, using a cohort of patients with MS and healthy controls. The model determined that patients were significantly worse in the Stroop test and presented a significant loss of cortical thickness; indeed variables that best predict MS status are the Right Medial Thickness and Right and Left Lateral Area. Cortical parameters are associated with cognitive scores, but there is no evidence that pathology of MS has an effect on these associations. In further works models can be expanded designing therapeutic interventions.

Elisabetta Pagani1, Maria A. Rocca1, Paolo Preziosa1, Matteo Atzori2, Frederik Barkhof3, Nicola De Stefano4, Christian Enzinger5, Franz Fazekas6, Antonio Gallo7, Hanneke Hulst3, Laura Mancini2, Xavier Montalban8, Alex Rovira9, Maria Laura Stromillo4, Gioacchino Tedeschi7, Giancarlo Comi10, and Massimo Filippi1
1Neuroimaging Research Unit, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, MI, Italy,2Dept. Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, GB, United Kingdom, 3Department of Radiology, Free University Medical Centre, Amsterdam, NL, Netherlands, 4Department of Neurological and Behavioral Sciences, University of Siena, Siena, SI, Italy, 5Division of Neuroradiology, Medical University of Graz, Graz, AT, Austria, 6Department of Neurology, Medical University of Graz, Graz, AT, Austria, 7Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, NA, Italy, 8Department of Neurology-Neuroimmunology, Vall d’Hebron University Hospital, Barcelona, CT, Spain, 9Department of Radiology, Vall d’Hebron University Hospital, Barcelona, CT, Spain, 10Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, MI, Italy

Voxel-wise analysis to high-resolution 3DT1-weighted and diffusion tensor (DT)-MRI scans were applied to assess the structural correlates of cognitive dysfunction in multiple sclerosis (MS) patients and their validity in a multicenter setting. Twenty-three (37%) MS patients were classified as cognitively impaired (CI). Compared to cognitively preserved and controls, CI patients had atrophy of several deep gray matter nuclei, fronto-parietal regions and the corpus callosum (CC). Voxel-based approaches to define the regional distribution of brain damage in a multicenter setting in MS patients is feasible, contributing to better characterize disease clinical manifestations, including cognitive impairment.

09:48 0961.   Tract-Based Spatial Statistics of Diffusion MRI in Paediatric Multiple Sclerosis
Kiran K Seunarine1, Kshitij Mankad2, Michael Eyre2, Cheryl Hemingway2, and Christopher A Clark1
1Imaging and Biophysics, UCL Institute of Child Health, London, London, United Kingdom, 2Great Ormond Street Hospital, London, United Kingdom

Paediatric onset multiple sclerosis (POMS) is known to result in a slower accumulation of physical disability over time despite the higher relapse rate than adult-onset MS. However, the mechanisms associated with POMS remain unclear. In this study we investigate microstructural differences between POMS patients and healthy control children using tract-space spatial statistics (TBSS). Results show widespread differences throughout the TBSS skeleton in paediatric MS compared to controls for all tensor metrics. These differences are consistent with severe demyelination. In addition to this, we observe correlations between tensor metrics and several clinical scores in the POMS patient group.