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

Abstract

(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...

Structural MRI correlates of cognitive impairment in patients with multiple sclerosis

“…In agreement with the results from previous studies [Dineen et al, 2009;Hulst et al, 2013;Mesaros et al, 2012;Roosendaal et al, 2009] and with that of a recent metaanalysis [Welton et al, 2015] which after including data from 12 MS studies (495 MS patients and 253 HC) has suggested that brain WM damage is more functionally relevant for cognitive dysfunction than for physical disability, we found that, compared with HC and CP patients, CI MS patients had increased MD of the majority of WM tracts as well as reduced FA of the L IFOF, R ILF, L SLF, and R anterior cingulum. Moreover, diffusivity abnormalities of several clusters in cognitive-relevant WM tracts significantly correlated with performance at different cognitive domains, except for verbal memory and fluency.…”

Brain connectivity and cognitive processing speed in multiple sclerosis: A systematic review

“…Papers selected to be included in this review were assessed according to a customised set of criteria, adapted from those used by Welton and colleagues [26], that give an indication of their scientific quality and to ascertain possible sources of bias. A checklist of twelve questions was created and organised in five areas: methodology, clinical characteristics, MRI parameters, statistical analysis and results.…”

“…A meta-analysis of seven diffusion tensor imaging (DTI) studies found that cognitive decline in general was associated with lower fractional anisotropy, i.e. a measure of integrity of structural connectivity, in various tracts involved in different cognitive functions [26]. Another meta-analysis of thirty-nine studies [27] showed a strong correlation between measures of cognitive PS, namely the Paced Auditory Serial Addition Test (PASAT) and the Symbol-Digit Modalities Test (SDMT), and indices of white matter (WM) lesion volume and atrophy.…”

Brain imaging in myotonic dystrophy type 1

“…4,5 A single author (KO) scored all studies for quality and risk of bias on a scale of 0, 1 or 2 (0 representing the worst and 2 representing the best score).…”