Cortical diffusion kurtosis imaging and thalamic volume are associated with cognitive and walking performance in relapsing-remitting multiple sclerosis

TY - CHAP

T1 - Cortical diffusion kurtosis imaging and thalamic volume are associated with cognitive and walking performance in relapsing-remitting multiple sclerosis

AU - Nygaard, Mikkel K E

AU - Langeskov-Christensen, Martin

AU - Dalgas, Ulrik

AU - Eskildsen, Simon F

PY - 2021/10

Y1 - 2021/10

N2 - BACKGROUND: In multiple sclerosis (MS), pronounced neurodegeneration manifests itself as cerebral gray matter (GM) atrophy, which is associated with cognitive and physical impairments. Microstructural changes in GM estimated by diffusion kurtosis imaging (DKI) may reveal neurodegeneration that is undetectable by conventional structural MRI and thus serve as a more sensitive marker of disease progression.OBJECTIVE: The primary objective was to investigate the relationships between morphological and diffusional properties in cerebral GM and physical and cognitive performance in relapsing-remitting MS (RRMS) patients. A secondary objective was to investigate the relationship between GM microstructure and white matter (WM) injury, estimated by the volume of WM lesions.METHODS: Sixty-seven RRMS patients performed the brief repeatable battery of neuropsychological tests (BRB-N), the 6-minute walk test (6MWT), the six spot step test (SSST), and underwent MRI scans using structural and DKI protocols. GM volumetrics and DKI measurements were analyzed in the cortex and deep GM structures using a general linear model with demographics, physical- and cognitive performance as covariates.RESULTS: Mean diffusivity (MD) in the cortex was associated with the SSST, 6MWT, information processing, global cognitive performance, and volume of WM lesions. In addition, thalamic volume was associated with SSST (r2 = 0.21, 6MWT (r2 = 0.18), information processing (r2 = 0.21), and WM lesion volume (r2 = 0.60).CONCLUSION: Cortical diffusion and thalamic volume are associated with walking and cognitive performance in RRMS patients and are highly affected by the presence of WM lesions.

AB - BACKGROUND: In multiple sclerosis (MS), pronounced neurodegeneration manifests itself as cerebral gray matter (GM) atrophy, which is associated with cognitive and physical impairments. Microstructural changes in GM estimated by diffusion kurtosis imaging (DKI) may reveal neurodegeneration that is undetectable by conventional structural MRI and thus serve as a more sensitive marker of disease progression.OBJECTIVE: The primary objective was to investigate the relationships between morphological and diffusional properties in cerebral GM and physical and cognitive performance in relapsing-remitting MS (RRMS) patients. A secondary objective was to investigate the relationship between GM microstructure and white matter (WM) injury, estimated by the volume of WM lesions.METHODS: Sixty-seven RRMS patients performed the brief repeatable battery of neuropsychological tests (BRB-N), the 6-minute walk test (6MWT), the six spot step test (SSST), and underwent MRI scans using structural and DKI protocols. GM volumetrics and DKI measurements were analyzed in the cortex and deep GM structures using a general linear model with demographics, physical- and cognitive performance as covariates.RESULTS: Mean diffusivity (MD) in the cortex was associated with the SSST, 6MWT, information processing, global cognitive performance, and volume of WM lesions. In addition, thalamic volume was associated with SSST (r2 = 0.21, 6MWT (r2 = 0.18), information processing (r2 = 0.21), and WM lesion volume (r2 = 0.60).CONCLUSION: Cortical diffusion and thalamic volume are associated with walking and cognitive performance in RRMS patients and are highly affected by the presence of WM lesions.

KW - Cognition

KW - Diffusion kurtosis imaging

KW - Gray matter

KW - Magnetic resonance imaging

KW - Multiple sclerosis

KW - Walk test

U2 - 10.1007/s00415-021-10543-4

DO - 10.1007/s00415-021-10543-4

M3 - Book chapter

C2 - 33829319

VL - 268

T3 - Journal of Neurology

SP - 3861

EP - 3870

BT - Cortical diffusion kurtosis imaging and thalamic volume are associated with cognitive and walking performance in relapsing-remitting multiple sclerosis

ER -