Correlation of clinical findings and brain volume data in multiple sclerosis

Fragoso, Yára Dadalti; Wille, Paulo Roberto; Abreu, Marcelo Rodrigues de; Brooks, Joseph Bruno Bidin; Dias, Ronaldo Maciel; Duarte, Juliana Ávila; Farage, Luciano; Finkelsztejn, Alessandro; Fröhlich, Alan Christmann; Gonçalves, Marcus Vinícius Magno; Guedes, Bruno Vasconcelos Sobreira; Medeiros, Leonardo Teixeira Lopes de; Oliveira, Rodrigo Mota de; Ribas, Flavio Diniz; Rocha, Fernanda Cipriano; Santos, Gutemberg Augusto Cruz dos; Scorcine, Claudio; Silveira, Guilherme Lopes da; Spedo, Carina Tellaroli; Tauil, Carlos Bernardo; Varela, Juliana Santos; Vieira, Vera Lúcia Ferreira

doi:10.1016/j.jocn.2017.06.006

Cited by 13 publications

(10 citation statements)

References 9 publications

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“…The extent of demyelination within both T2 and T1 lesions was not associated with cortical or white matter volume. Although several studies have pointed out that the lesion load measured through conventional MRI correlates with the grey matter volume in MS [41,42], our results suggested that demyelination specifically measured with [ 18 F]florbetapir PET imaging within MS lesions per-se is not the cause of brain atrophy. Supposedly, the balance between remyelination, preserved axonal integrity and the wallerian degeneration of axons traversing lesions might impact the total brain volume and the cortical thickness [43].…”

Section: Discussioncontrasting

confidence: 68%

[18F]Florbetapir PET/MR imaging to assess demyelination in multiple sclerosis

Carotenuto

Giordano

Dervenoulas

et al. 2019

Eur J Nucl Med Mol Imaging

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Purpose We evaluated myelin changes throughout the central nervous system in Multiple Sclerosis (MS) patients by using hybrid [ 18 F]florbetapir PET-MR imaging. Methods We included 18 relapsing-remitting MS patients and 12 healthy controls. Each subject performed a hybrid [ 18 F]florbetapir PET-MR and both a clinical and cognitive assessment. [ 18 F]florbetapir binding was measured as distribution volume ratio (DVR), through the Logan graphical reference method and the supervised cluster analysis to extract a reference region, and standard uptake value (SUV) in the 70-90 min interval after injection. The two quantification approaches were compared. We also evaluated changes in the measures derived from diffusion tensor imaging and arterial spin labeling. Results [ 18 F]florbetapir DVRs decreased from normal-appearing white matter to the centre of T2 lesion (P < 0.001), correlated with fractional anisotropy and with mean, axial and radial diffusivity within T2 lesions (coeff. = −0.15, P < 0.001, coeff. = −0.12, P < 0.001 and coeff. = −0.16, P < 0.001, respectively). Cerebral blood flow was reduced in white matter damaged areas compared to white matter in healthy controls (−10.9%, P = 0.005). SUV 70-90 and DVR are equally able to discriminate between intact and damaged myelin (area under the curve 0.76 and 0.66, respectively; P = 0.26). Conclusion Our findings demonstrate that [ 18 F]florbetapir PET imaging can measure in-vivo myelin damage in patients with MS. Demyelination in MS is not restricted to lesions detected through conventional MRI but also involves the normal appearing white matter. Although longitudinal studies are needed, [ 18 F]florbetapir PET imaging may have a role in clinical settings in the management of MS patients.

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Section: Discussioncontrasting

confidence: 68%

[18F]Florbetapir PET/MR imaging to assess demyelination in multiple sclerosis

Carotenuto

Giordano

Dervenoulas

et al. 2019

Eur J Nucl Med Mol Imaging

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“…Further studies may reveal the impact of regional atrophy and regional lesion burden on iTUG measurements, given their emerging association with clinical disability [21,22]. However, the aim of the present study was to describe the multi-dimensional aspects of disability using variables related to mobility and to explore their possible correlation with brain atrophy, with a focus on GM.…”

Section: Discussionmentioning

confidence: 98%

‘Timed up and go’ and brain atrophy: a preliminary MRI study to assess functional mobility performance in multiple sclerosis

et al. 2017

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Motor and cognitive disabilities are related to brain atrophy in multiple sclerosis (MS). 'Timed up and go' (TUG) has been recently tested in MS as functional mobility test, as it is able to evaluate ambulation/coordination-related tasks, as well as cognitive function related to mobility. The objective of this study is to evaluate the relationship between brain volumes and TUG performances. Inclusion criteria were a diagnosis of MS and the ability to walk at least 20 m. TUG was performed using a wearable inertial sensor. Times and velocities of TUG sub-phases were calculated by processing trunk acceleration data. Patients underwent to a brain MRI, and volumes of whole brain, white matter (WM), grey matter (GM), and cortical GM (C) were estimated with SIENAX. Sixty patients were enrolled. Mean age was 41.5 ± 11.6 years and mean EDSS 2.3 ± 1.2. Total TUG duration was correlated to lower WM (ρ = 0.358, p = 0.005) and GM (ρ = 0.309, p = 0.017) volumes. A stronger association with lower GM volume was observed for intermediate (ρ = 0.427, p = 0.001) and final turning (ρ = 0.390, p = 0.002). TUG is a useful tool in a clinical setting as it can not only evaluate patients' disability in terms of impaired functional mobility, but also estimate pathological features, such as grey atrophy.

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“…Furthermore, brain volume changes during the first year after disease onset, estimated by PBVC, were the best predictor of future neurologic impairment [90] regardless of the intermediate relapse rate [91]. Increased brain volume loss (BVL) has been correlated disability progression, independent from the number of previous relapses or the T2 lesion load in RRMS [92].…”

Section: Clinical Correlates Of Brain Atrophymentioning

confidence: 99%

Brain atrophy in multiple sclerosis: mechanisms, clinical relevance and treatment options

Andravizou

Dardiotis

Artemiadis

et al. 2019

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Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system characterized by focal or diffuse inflammation, demyelination, axonal loss and neurodegeneration. Brain atrophy can be seen in the earliest stages of MS, progresses faster compared to healthy adults, and is a reliable predictor of future physical and cognitive disability. In addition, it is widely accepted to be a valid, sensitive and reproducible measure of neurodegeneration in MS. Reducing the rate of brain atrophy has only recently been incorporated as a critical endpoint into the clinical trials of new or emerging disease modifying drugs (DMDs) in MS. With the advent of easily accessible neuroimaging softwares along with the accumulating evidence, clinicians may be able to use brain atrophy measures in their everyday clinical practice to monitor disease course and response to DMDs. In this review, we will describe the different mechanisms contributing to brain atrophy, their clinical relevance on disease presentation and course and the effect of current or emergent DMDs on brain atrophy and neuroprotection. which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Correlation of clinical findings and brain volume data in multiple sclerosis

Cited by 13 publications

References 9 publications

[18F]Florbetapir PET/MR imaging to assess demyelination in multiple sclerosis

[18F]Florbetapir PET/MR imaging to assess demyelination in multiple sclerosis

‘Timed up and go’ and brain atrophy: a preliminary MRI study to assess functional mobility performance in multiple sclerosis

Brain atrophy in multiple sclerosis: mechanisms, clinical relevance and treatment options

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