Spatial patterns of brain lesions assessed through covariance estimations of lesional voxels in multiple Sclerosis: The SPACE-MS technique

Tur, Carmen; Grussu, Francesco; Angelis, Floriana De; Prados, Ferrán; Kanber, Baris; Calvi, Alberto; Eshaghi, Arman; Charalambous, Thalis; Cortese, Rosa; Chard, Declan; Chataway, Jeremy; Thompson, Alan J.; Ciccarelli, Olga; Wheeler-Kingshott, C

doi:10.1016/j.nicl.2021.102904

Cited by 6 publications

(4 citation statements)

References 54 publications

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“…25,26 In addition, newer techniques offer visualization of tracts and nuclei according to myelin density 27 and the importance of the spatial distribution of white matter lesions. 28 Reductions in pontine brain parenchymal fraction in pwMS with sexual dysfunction has also been reported. 29 Recently, spinal cord atrophy in a cranio-caudal pattern was shown to represent subclinical progressive disease before the onset of clinical evidence, 30 and disproportionate neurodegenerative features within the medulla and UCSC were previously described in B/AA pwMS with no clinical disability when compared to EA pwMS early in the disease course.…”

Section: Discussionmentioning

confidence: 93%

Selective vulnerability of brainstem and cervical spinal cord regions in people with non-progressive multiple sclerosis of Black or African American and European ancestry

et al. 2022

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Background: We evaluated imaging features suggestive of neurodegeneration within the brainstem and upper cervical spinal cord (UCSC) in non-progressive multiple sclerosis (MS). Methods: Standardized 3-Tesla three-dimensional brain magnetic resonance imaging (MRI) studies were prospectively acquired. Rates of change in volume, surface texture, curvature were quantified at the pons and medulla-UCSC. Whole and regional brain volumes and T2-weighted lesion volumes were also quantified. Independent regression models were constructed to evaluate differences between those of Black or African ancestry (B/AA) and European ancestry (EA) with non-progressive MS. Results: 209 people with MS (pwMS) having at least two MRI studies, 29% possessing 3–6 timepoints, resulted in 487 scans for analysis. Median follow-up time between MRI timepoints was 1.33 (25th–75th percentile: 0.51–1.98) years. Of 183 non-progressive pwMS, 88 and 95 self-reported being B/AA and EA, respectively. Non-progressive pwMS demonstrated greater rates of decline in pontine volume ( p < 0.0001) in B/AA and in medulla-UCSC volume ( p < 0.0001) for EA pwMS. Longitudinal surface texture and curvature changes suggesting reduced tissue integrity were observed at the ventral medulla-UCSC ( p < 0.001), dorsal pons ( p < 0.0001) and dorsal medulla ( p < 0.0001) but not the ventral pons ( p = 0.92) between groups. Conclusions: Selectively vulnerable regions within the brainstem-UCSC may allow for more personalized approaches to disease surveillance and management.

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Section: Discussionmentioning

confidence: 93%

Selective vulnerability of brainstem and cervical spinal cord regions in people with non-progressive multiple sclerosis of Black or African American and European ancestry

et al. 2022

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“…Regarding the voxel-wise regression analysis, the most striking finding was that the attention within a voxel, which indicates the importance of a given voxel to decide the disability class of a given patient, was not (only) explained by the mere presence of lesions or native-to-MNI deformation (used as proxy for volume change or atrophy) in that particular voxel. This may suggest that DL-based methods pay attention to more general aspects of the image, possibly focusing on complex spatial relationships between voxel-wise information, considering that distributional features of brain lesions might impact on disability progression ( Tur et al, 2022 ), or image texture-related information, maybe denoting microscopic processes such as underlying demyelination ( Gilmore et al, 2009 ). Of note, these more general aspects of the image deserve further research and, anyway cannot be summarised as presence/absence of lesions and/or atrophy in a given point.…”

Section: Discussionmentioning

confidence: 99%

Deciphering multiple sclerosis disability with deep learning attention maps on clinical MRI

Coll

Pareto

Carbonell‐Mirabent

et al. 2023

NeuroImage: Clinical

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“…Clinical variables (and their units ) were EDSS score ( points ); inverse of 9HPT, that is, mean of the reciprocal value of the mean time of the two right-hand attempts and the reciprocal value of the mean time of the two left-hand attempts ( 1/s ); 27,28 inverse of the TWT, that is, inverse of the mean of two attempts ( 1/s ) 27,28 and SDMT score ( number of correct answers in 90 seconds ). All clinical variables were considered as continuous.…”

Section: Methodsmentioning

confidence: 99%

What contributes to disability in progressive MS? A brain and cervical cord–matched quantitative MRI study

Tur,

Battiston,

Yiannakas

et al. 2024

Mult Scler

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Background: We assessed the ability of a brain-and-cord-matched quantitative magnetic resonance imaging (qMRI) protocol to differentiate patients with progressive multiple sclerosis (PMS) from controls, in terms of normal-appearing (NA) tissue abnormalities, and explain disability. Methods: A total of 27 patients and 16 controls were assessed on the Expanded Disability Status Scale (EDSS), 25-foot timed walk (TWT), 9-hole peg (9HPT) and symbol digit modalities (SDMT) tests. All underwent 3T brain and (C2-C3) cord structural imaging and qMRI (relaxometry, quantitative magnetisation transfer, multi-shell diffusion-weighted imaging), using a fast brain-and-cord–matched protocol with brain-and-cord–unified imaging readouts. Lesion and NA-tissue volumes and qMRI metrics reflecting demyelination and axonal loss were obtained. Random forest analyses identified the most relevant volumetric/qMRI measures to clinical outcomes. Confounder-adjusted linear regression estimated the actual MRI-clinical associations. Results: Several qMRI/volumetric differences between patients and controls were observed ( p < 0.01). Higher NA-deep grey matter quantitative-T1 (EDSS: beta = 7.96, p = 0.006; 9HPT: beta = −0.09, p = 0.004), higher NA-white matter orientation dispersion index (TWT: beta = −3.21, p = 0.005; SDMT: beta = −847.10, p < 0.001), lower whole-cord bound pool fraction (9HPT: beta = 0.79, p = 0.001) and higher NA-cortical grey matter quantitative-T1 (SDMT = −94.31, p < 0.001) emerged as particularly relevant predictors of greater disability. Conclusion: Fast brain-and-cord–matched qMRI protocols are feasible and identify demyelination – combined with other mechanisms – as key for disability accumulation in PMS.

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Spatial patterns of brain lesions assessed through covariance estimations of lesional voxels in multiple Sclerosis: The SPACE-MS technique

Abstract: Graphical abstract

Cited by 6 publications

References 54 publications

Selective vulnerability of brainstem and cervical spinal cord regions in people with non-progressive multiple sclerosis of Black or African American and European ancestry

Selective vulnerability of brainstem and cervical spinal cord regions in people with non-progressive multiple sclerosis of Black or African American and European ancestry

Deciphering multiple sclerosis disability with deep learning attention maps on clinical MRI

What contributes to disability in progressive MS? A brain and cervical cord–matched quantitative MRI study

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