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Marastoni D, Turano E, Tamanti A, Colato E, Pisani AI, Scartezzini A, Carotenuto S, Mazziotti V, Camera V, Anni D, Ziccardi S, Guandalini M, Pizzini FB, Virla F, Mariotti R, Magliozzi R, Bonetti B, Steinman L, Calabrese M. Association of Levels of CSF Osteopontin With Cortical Atrophy and Disability in Early Multiple Sclerosis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200265. [PMID: 38917380 PMCID: PMC11203401 DOI: 10.1212/nxi.0000000000200265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/29/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND AND OBJECTIVES To evaluate CSF inflammatory markers with accumulation of cortical damage as well as disease activity in patients with early relapsing-remitting MS (RRMS). METHODS CSF levels of osteopontin (OPN) and 66 inflammatory markers were assessed using an immune-assay multiplex technique in 107 patients with RRMS (82 F/25 M, mean age 35.7 ± 11.8 years). All patients underwent regular clinical assessment and yearly 3T MRI scans for 2 years while 39 patients had a 4-year follow-up. White matter lesion number and volume, cortical lesions (CLs) and volume, and global cortical thickness (CTh) were evaluated together with the 'no evidence of disease activity' (NEDA-3) status, defined by no relapses, no disability worsening, and no MRI activity, including CLs. RESULTS The random forest algorithm selected OPN, CXCL13, TWEAK, TNF, IL19, sCD30, sTNFR1, IL35, IL16, and sCD163 as significantly associated with changes in global CTh. OPN and CXCL13 were most related to accumulation of atrophy after 2 and 4 years. In a multivariate linear regression model on CSF markers, OPN (p < 0.001), CXCL13 (p = 0.001), and sTNFR1 (p = 0.024) were increased in those patients with accumulating atrophy (adjusted R-squared 0.615). The 10 markers were added in a model that included all clinical, demographic, and MRI variables: OPN (p = 0.002) and IL19 (p = 0.022) levels were confirmed to be significantly increased in patients developing more CTh change over the follow-up (adjusted R-squared 0.619). CXCL13 and OPN also revealed the best association with NEDA-3 after 2 years, with OPN significantly linked to disability accumulation (OR 2.468 [1.46-5.034], p = 0.004) at the multivariate logistic regression model. DISCUSSION These data confirm and expand our knowledge on the prognostic role of the CSF inflammatory profile in predicting changes in cortical pathology and disease activity in early MS. The data emphasize a crucial role of OPN.
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Affiliation(s)
- Damiano Marastoni
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Ermanna Turano
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Agnese Tamanti
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Elisa Colato
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Anna Isabella Pisani
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Arianna Scartezzini
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Silvia Carotenuto
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Valentina Mazziotti
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Valentina Camera
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Daniela Anni
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Stefano Ziccardi
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Maddalena Guandalini
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Francesca B Pizzini
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Federica Virla
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Raffaella Mariotti
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Roberta Magliozzi
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Bruno Bonetti
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Lawrence Steinman
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
| | - Massimiliano Calabrese
- From the Neurology B (D.M., E.T., A.T., E.C., A.I.P., A.S., S.C., V.M., V.C., D.A., S.Z., M.G., F.V., R. Magliozzi, M.C.); Anatomy and Histology section (E.T., F.V., R. Mariotti), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Anatomy and Neurosciences (E.C.), MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands; Neuroradiology and Radiology Units (F.B.P.), Department of Engineering for Innovation Medicine, University of Verona, Italy; Department of Brain Sciences (R. Magliozzi), Faculty of Medicine, Imperial College London, United Kingdom; Neurology A (B.B.), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; and Department of Neurology and Neurological Sciences Stanford University (L.S.), CA
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5
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Beck ES, Mullins WA, Dos Santos Silva J, Filippini S, Parvathaneni P, Maranzano J, Morrison M, Suto DJ, Donnay C, Dieckhaus H, Luciano NJ, Sharma K, Gaitán MI, Liu J, de Zwart JA, van Gelderen P, Cortese I, Narayanan S, Duyn JH, Nair G, Sati P, Reich DS. Cortical lesions uniquely predict motor disability accrual and form rarely in the absence of new white matter lesions in multiple sclerosis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.22.23295974. [PMID: 37886541 PMCID: PMC10602044 DOI: 10.1101/2023.09.22.23295974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Background and objectives Cortical lesions (CL) are common in multiple sclerosis (MS) and associate with disability and progressive disease. We asked whether CL continue to form in people with stable white matter lesions (WML) and whether the association of CL with worsening disability relates to pre-existing or new CL. Methods A cohort of adults with MS were evaluated annually with 7 tesla (T) brain magnetic resonance imaging (MRI) and 3T brain and spine MRI for 2 years, and clinical assessments for 3 years. CL were identified on 7T images at each timepoint. WML and brain tissue segmentation were performed using 3T images at baseline and year 2. Results 59 adults with MS had ≥1 7T follow-up visit (mean follow-up time 2±0.5 years). 9 had "active" relapsing-remitting MS (RRMS), defined as new WML in the year prior to enrollment. Of the remaining 50, 33 had "stable" RRMS, 14 secondary progressive MS (SPMS), and 3 primary progressive MS. 16 total new CL formed in the active RRMS group (median 1, range 0-10), 7 in the stable RRMS group (median 0, range 0-5), and 4 in the progressive MS group (median 0, range 0-1) (p=0.006, stable RR vs PMS p=0.88). New CL were not associated with greater change in any individual disability measure or in a composite measure of disability worsening (worsening Expanded Disability Status Scale or 9-hole peg test or 25-foot timed walk). Baseline CL volume was higher in people with worsening disability (median 1010μl, range 13-9888 vs median 267μl, range 0-3539, p=0.001, adjusted for age and sex) and in individuals with RRMS who subsequently transitioned to SPMS (median 2183μl, range 270-9888 vs median 321μl, range 0-6392 in those who remained RRMS, p=0.01, adjusted for age and sex). Baseline WML volume was not associated with worsening disability or transition from RRMS to SPMS. Discussion CL formation is rare in people with stable WML, even in those with worsening disability. CL but not WML burden predicts future worsening of disability, suggesting that the relationship between CL and disability progression is related to long-term effects of lesions that form in the earlier stages of disease, rather than to ongoing lesion formation.
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Affiliation(s)
- Erin S Beck
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - W Andrew Mullins
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | | | - Stefano Filippini
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Department of Neurosciences, Drug, and Child Health, University of Florence, Florence, Italy
| | - Prasanna Parvathaneni
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Josefina Maranzano
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
- Department of Anatomy, University of Quebec, Trois-Rivieres, QC, Canada
| | - Mark Morrison
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Daniel J Suto
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Corinne Donnay
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Henry Dieckhaus
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Nicholas J Luciano
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Kanika Sharma
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - María Ines Gaitán
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jiaen Liu
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Advanced Imaging Research Center and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jacco A de Zwart
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Peter van Gelderen
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Irene Cortese
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Sridar Narayanan
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jeff H Duyn
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Govind Nair
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pascal Sati
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Reich
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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10
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Beck ES, Maranzano J, Luciano NJ, Parvathaneni P, Filippini S, Morrison M, Suto DJ, Wu T, van Gelderen P, de Zwart JA, Antel S, Fetco D, Ohayon J, Andrada F, Mina Y, Thomas C, Jacobson S, Duyn J, Cortese I, Narayanan S, Nair G, Sati P, Reich DS. Cortical lesion hotspots and association of subpial lesions with disability in multiple sclerosis. Mult Scler 2022; 28:1351-1363. [PMID: 35142571 DOI: 10.1177/13524585211069167] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dramatic improvements in visualization of cortical (especially subpial) multiple sclerosis (MS) lesions allow assessment of impact on clinical course. OBJECTIVE Characterize cortical lesions by 7 tesla (T) T2*-/T1-weighted magnetic resonance imaging (MRI); determine relationship with other MS pathology and contribution to disability. METHODS Sixty-four adults with MS (45 relapsing-remitting/19 progressive) underwent 3 T brain/spine MRI, 7 T brain MRI, and clinical testing. RESULTS Cortical lesions were found in 94% (progressive: median 56/range 2-203; relapsing-remitting: 15/0-168; p = 0.004). Lesion distribution across 50 cortical regions was nonuniform (p = 0.006), with highest lesion burden in supplementary motor cortex and highest prevalence in superior frontal gyrus. Leukocortical and white matter lesion volumes were strongly correlated (r = 0.58, p < 0.0001), while subpial and white matter lesion volumes were moderately correlated (r = 0.30, p = 0.002). Leukocortical (p = 0.02) but not subpial lesions (p = 0.40) were correlated with paramagnetic rim lesions; both were correlated with spinal cord lesions (p = 0.01). Cortical lesion volumes (total and subtypes) were correlated with expanded disability status scale, 25-foot timed walk, nine-hole peg test, and symbol digit modality test scores. CONCLUSION Cortical lesions are highly prevalent and are associated with disability and progressive disease. Subpial lesion burden is not strongly correlated with white matter lesions, suggesting differences in inflammation and repair mechanisms.
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Affiliation(s)
- Erin S Beck
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Josefina Maranzano
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada; Department of Anatomy, University of Quebec in Trois-Rivières, Trois-Rivières, QC, Canada
| | - Nicholas J Luciano
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Prasanna Parvathaneni
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Stefano Filippini
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.,Department of Neurosciences, Drug and Child Health, University of Florence, Florence, Italy
| | - Mark Morrison
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Daniel J Suto
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Tianxia Wu
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Peter van Gelderen
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jacco A de Zwart
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Samson Antel
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Dumitru Fetco
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Joan Ohayon
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Frances Andrada
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Yair Mina
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chevaz Thomas
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Steve Jacobson
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jeff Duyn
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Irene Cortese
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Sridar Narayanan
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Govind Nair
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Pascal Sati
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.,Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Reich
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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