Increased cortical and deep grey matter sodium concentration is associated with physical and cognitive disability in relapse-onset multiple sclerosis.

Publication: Research - peer-reviewConference abstract for conference

  • WJ Brownlee
    WJ BrownleeQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology
  • Patricia Alves Da Mota
  • Ferran Prados
    Ferran PradosQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology
  • Bhavana S Solanky
    Bhavana S SolankyQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology
  • Frank Riemer
    Frank Riemer
  • Manuel Jorge Cardoso
    Manuel Jorge Cardoso
  • Sébastien Ourselin
    Sébastien Ourselin
  • Xavier Golay
    Xavier Golay
  • CAM Gandini Wheeler-Kingshott
    CAM Gandini Wheeler-KingshottQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology
  • DH Miller
    DH MillerQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology
  • O Ciccarelli
    O CiccarelliQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology
Background: 23Na-MRI is a novel approach to investigating neuroaxonal metabolic dysfunction and neuroaxonal loss in vivo in people with multiple sclerosis (MS). Objective: To investigate the relationship of tissue-specific total sodium concentration (TSC) with disease course and disability in relapse-onset MS. Methods: 70 MS patients (57 relapsing-remitting MS [RRMS] and 13 secondary progressive MS [SPMS], mean disease duration 14.7 years, all followed from disease onset) and 32 healthy controls (HC) had 23Na and 1H-MRI. The TSC in cortical grey matter (CGM), deep grey matter (DGM), normal-appearing white matter (NAWM), T1-isointense and T1-hypointense lesions was calculated. Physical disability was assessed using the Expanded Disability Status Scale (EDSS), timed 25-foot walk test (TWT) and 9-hole peg test (9HPT). Cognition was assessed using the paced auditory serial addition test (PASAT), symbol digit modalities test (SDMT) and tests of verbal and visual memory. Linear regression was used to compare differences in tissue TSC between groups. Multivariable linear regression was used to identify independent associations between TSC and disability with adjustment for age, sex, disease duration, grey/white matter tissue volumes. Results: In MS patients the median EDSS was 2 (range 0-7) and 27 (40%) were cognitively impaired. The brain parenchymal, grey matter and white matter fractions were lower in MS patients compared with HC (p< 0.05). TSC in CGM, DGM and NAWM was higher in MS patients compared with HC (p< 0.01) and higher in T1-hypointense than T1-isointense lesions (p< 0.01). TSC was higher in all tissues and both lesion types in SPMS compared with RRMS patients (p< 0.01). In the multivariable linear regression models, higher CGM sodium concentration was associated with physical disability as measured by the EDSS (β= 0.26, 95%CI 0.16,0.36, R2=0.36) and TWT (β= -0.01, 95%CI -0.013,-0.006, R2=0.42) and higher DGM sodium concentration was associated with cognitive dysfunction as measured by PASAT (β=-0.13, 95%CI -0.19, -0.07, R2=0.35), SDMT (β= -0.18, 95%CI -0.26, -0.11, R2=0.40) and visual memory (β=-0.06, 95%CI -0.11, -.0.02, R2=0.19). Conclusion: Sodium accumulation in cortical and deep grey matter may reflect underlying neurodegeneration that is relevant to the development of long-term disability and cognitive impairment in relapse-onset MS. 23Na-MRI may become a secondary outcome measure in clinical trials of neuroprotective agents.
Original languageEnglish
Publication year2016
StatePublished - 2016
Event - London, United Kingdom

Conference

Conference32nd ECTRIMS Congress
CountryUnited Kingdom
CityLondon
Period14/09/201617/09/2016

    Keywords

  • Multiple Sclerosis, Sodium MRI

See relations at Aarhus University Citationformats

ID: 108685578