Early White Matter Changes in Childhood Multiple Sclerosis: A Diffusion Tensor Imaging Study

Blaschek, Astrid; Keeser, Daniel; Müller, Stefanie; Koerte, Inga K.; Schröder, Axel; Müller‐Felber, Wolfgang; Heinen, Florian; Ertl‐Wagner, Birgit

doi:10.3174/ajnr.a3581

Cited by 20 publications

(28 citation statements)

References 38 publications

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“…63,64 A correlation between reduced FA and impaired performance in mathematics 56 and with impaired processing speed 65 has been reported in 34 young patients with paediatric-onset multiple sclerosis. Findings from two studies of tract-based analyses have showed reduced FA in normal-appearing white matter in 14 paediatric patients 66 and ten paediatric patients 67 compared with age-matched and sex-matched healthy controls. Taken together, findings from these studies suggest that myelin architecture might be disrupted early in multiple sclerosis, but large serial studies and tract-based analyses are needed to further assess the effect of multiple sclerosis on myelinated pathways over time.…”

Section: Mri In Paediatric Multiple Sclerosismentioning

confidence: 99%

Multiple sclerosis in children: an update on clinical diagnosis, therapeutic strategies, and research

Waldman¹,

Ghezzi²,

Bar‐Or³

et al. 2014

The Lancet Neurology

136

119

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The clinical features, diagnostic challenges, neuroimaging appearance, therapeutic options, and pathobiological research progress in childhood—and adolescent—onset multiple sclerosis have been informed by many new insights in the past 7 years. National programmes in several countries, collaborative research efforts, and an established international paediatric multiple sclerosis study group have contributed to revised clinical diagnostic definitions, identified clinical features of multiple sclerosis that differ by age of onset, and made recommendations regarding the treatment of paediatric multiple sclerosis. The relative risks conveyed by genetic and environmental factors to paediatric multiple sclerosis have been the subject of several large cohort studies. MRI features have been characterised in terms of qualitative descriptions of lesion distribution and applicability of MRI aspects to multiple sclerosis diagnostic criteria, and quantitative studies have assessed total lesion burden and the effect of the disease on global and regional brain volume. Humoral-based and cell-based assays have identified antibodies against myelin, potassium-channel proteins, and T-cell profiles that support an adult-like T-cell repertoire and cellular reactivity against myelin in paediatric patients with multiple sclerosis. Finally, the safety and efficacy of standard first-line therapies in paediatric multiple sclerosis populations are now appreciated in more detail, and consensus views on the future conduct and feasibility of phase 3 trials for new drugs have been proposed.

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Section: Mri In Paediatric Multiple Sclerosismentioning

confidence: 99%

Multiple sclerosis in children: an update on clinical diagnosis, therapeutic strategies, and research

Waldman¹,

Ghezzi²,

Bar‐Or³

et al. 2014

The Lancet Neurology

136

119

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“…Since its description in 2006, tract-based spatial statistics (TBSS) 15 , has been applied to multisubject spatial analysis of DTI data examining neurological and cognitive correlates of WM degradation in MS [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] . These studies broadly support the suggestion that disconnection of cortical or subcortical grey matter by diffuse and focal damage of interconnecting white matter may be an important factor contributing to physical disability and cognitive dysfunction in MS 18 .…”

Section: Introductionmentioning

confidence: 99%

Functionally Relevant White Matter Degradation in Multiple Sclerosis: A Tract-based Spatial Meta-Analysis

Welton¹,

Kent²,

Constantinescu³

et al. 2015

Radiology

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(2015) Functionally relevant white matter degradation in multiple sclerosis: a tract-based spatial meta-analysis. Radiology, 275 (1). pp. 89-96. ISSN 152789-96. ISSN -1315 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/38908/1/14-0925-clean.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the University of Nottingham End User licence and may be reused according to the conditions of the licence. For more details see: http://eprints.nottingham.ac.uk/end_user_agreement.pdf A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk Advances in Knowledge:1. There are differential and only minimally-overlapping distributions of lower fractional anisotropy relating to clinical disability and cognitive impairment.Low anterior callosal and thalamic fractional anisotropy has specific importance to cognitive status, whereas low posterior callosal and deep parietal fractional anisotropy has specific importance to physical disability (uncorrected p<0.005, z>1, cluster extent≥10 voxels).2. Cerebral white matter degradation may be more relevant to cognitive than physical disability: 2.3 times as many voxels had a significantly lower fractional anisotropy in relation to cognition (753 voxels) than to physical disability (323 voxels) and the z-scores for those clusters were higher for cognition than for physical disability (2.532 and 1.701, respectively). Implications for Patient Care:1. Widespread white matter damage measured by diffusion tensor imaging occurs in multiple sclerosis; our meta-analysis reveals differential and only minimally-overlapping distributions of white matter damage relating to both cognitive and physical disability.Summary Statement: Our voxelwise meta-analysis of studies relating tract fractional anisotropy to cognitive and physical disability in multiple sclerosis reveals minimally-overlapping distributions and a possible greater relevance to cognition than to physical disability. Abstract PurposeTo identify statistical consensus between published studies for distribution and functional relevance of tract white matter degradation in multiple sclerosis (MS). Materials and MethodsBy systematically searching online databases, we identified tract-based spatial statistics (TBSS) studies which (1) compare fractional anisotropy (FA; a marker for white matter integrity) in MS patients to healthy controls, (2) correlate FA in MS patients with physical disability, or (3) correlate FA in MS patients with cognitive performance. We performed voxelwise meta-analyses using the Signed Differentia...

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“…Finally, FA was computed for the a priori regions of interest (ROIs) by averaging the FA of each voxel within the ROI mask (combining the Freesurfer labels contained in Table generated the ROI masks). The a priori ROIs for the region‐wise FA analyses, selected based on previous literature, were frontal, parietal, occipital, and temporal lobe WM, as well as the thalamus and corpus callosum …”

Section: Methodsmentioning

confidence: 99%

“…The a priori ROIs for the region-wise FA analyses, selected based on previous literature, were frontal, parietal, occipital, and temporal lobe WM, as well as the thalamus and corpus callosum. 11,15,[30][31][32] Tractography analysis was then performed with FMRIB's Diffusion Toolbox (FDT) to compute the probability of streamlines or connections between Freesurfer-defined seeds and targets (exclusion masks). 33 The following parameters within FDT were used: curvature threshold = .2 mm, maximum steps per sample = 2,000, step length = .5 mm, and total samples = 5,000.…”

Section: Image Processingmentioning

confidence: 99%

Brief Computer‐Based Information Processing Measures are Linked to White Matter Integrity in Pediatric‐Onset Multiple Sclerosis

Bartlett

Shaw

Schwarz

et al. 2018

Journal of Neuroimaging

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BACKGROUND AND PURPOSE Pediatric‐onset multiple sclerosis (POMS) is a demyelinating disorder with unique clinical challenges. A brief computer‐administered cognitive screening battery measuring processing speed (Cogstate) and the Brief International Cognitive Assessment in MS (BICAMS) detect cognitive impairment in POMS. The neuroanatomic correlates of these deficits are incompletely understood. The purpose of this study is to define the neuroanatomic underpinnings of deficits identified with cognitive screening batteries in POMS. METHODS Participants with POMS and age‐matched healthy controls (HCs) were screened with Cogstate and BICAMS. Diffusion tensor imaging assessed region‐wise and tractography‐based fractional anisotropy (FA). RESULTS The POMS (n = 15) and HC (n = 21) groups were matched on age (mean ages 17.9 ± 3.2 vs. 17.8 ± 3.3 years, respectively) and on an estimate of general intellectual functioning. The Cogstate composite revealed significant slowing in POMS relative to HCs (P = .004), but the BICAMS composite did not significantly distinguish the groups (P = .10). The Cogstate composite showed moderate‐to‐strong correlations with regional FA (r = –.67 to –.82) and significantly associated with uncinate fasciculus FA following multiple comparisons correction (P = .002) in POMS. However, the BICAMS composite measure showed only weak‐to‐moderate correlations with FA in POMS (r = –.19 to –.57), with none surviving multiple comparisons correction. CONCLUSIONS Computer‐administered measures of cognitive processing are particularly sensitive in POMS and are closely linked to white matter FA.

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Early White Matter Changes in Childhood Multiple Sclerosis: A Diffusion Tensor Imaging Study

Cited by 20 publications

References 38 publications

Multiple sclerosis in children: an update on clinical diagnosis, therapeutic strategies, and research

Multiple sclerosis in children: an update on clinical diagnosis, therapeutic strategies, and research

Functionally Relevant White Matter Degradation in Multiple Sclerosis: A Tract-based Spatial Meta-Analysis

Brief Computer‐Based Information Processing Measures are Linked to White Matter Integrity in Pediatric‐Onset Multiple Sclerosis

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