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Jellinger KA. Cognitive impairment in multiple sclerosis: from phenomenology to neurobiological mechanisms. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02786-y. [PMID: 38761183 DOI: 10.1007/s00702-024-02786-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
Multiple sclerosis (MS) is an autoimmune-mediated disease of the central nervous system characterized by inflammation, demyelination and chronic progressive neurodegeneration. Among its broad and unpredictable range of clinical symptoms, cognitive impairment (CI) is a common and disabling feature greatly affecting the patients' quality of life. Its prevalence is 20% up to 88% with a wide variety depending on the phenotype of MS, with highest frequency and severity in primary progressive MS. Involving different cognitive domains, CI is often associated with depression and other neuropsychiatric symptoms, but usually not correlated with motor and other deficits, suggesting different pathophysiological mechanisms. While no specific neuropathological data for CI in MS are available, modern research has provided evidence that it arises from the disease-specific brain alterations. Multimodal neuroimaging, besides structural changes of cortical and deep subcortical gray and white matter, exhibited dysfunction of fronto-parietal, thalamo-hippocampal, default mode and cognition-related networks, disruption of inter-network connections and involvement of the γ-aminobutyric acid (GABA) system. This provided a conceptual framework to explain how aberrant pathophysiological processes, including oxidative stress, mitochondrial dysfunction, autoimmune reactions and disruption of essential signaling pathways predict/cause specific disorders of cognition. CI in MS is related to multi-regional patterns of cerebral disturbances, although its complex pathogenic mechanisms await further elucidation. This article, based on systematic analysis of PubMed, Google Scholar and Cochrane Library, reviews current epidemiological, clinical, neuroimaging and pathogenetic evidence that could aid early identification of CI in MS and inform about new therapeutic targets and strategies.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, Vienna, A-1150, Austria.
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2
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Ding B, Lou J, Qin T, Xie W, Li D, Li P, Wang X, Lin Z, Guo X, Zhu J. L-ascorbyl-2-phosphate alleviates white matter injury caused by chronic hypoxia through the PRMT5/P53/NF-κB pathway. J Neurochem 2024; 168:142-160. [PMID: 38169121 DOI: 10.1111/jnc.16038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/21/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024]
Abstract
White matter injury (WMI) is one of the most serious complications associated with preterm births. Damage to oligodendrocytes, which are the key cells involved in WMI pathogenesis, can directly lead to myelin abnormalities. L-ascorbyl-2-phosphate (AS-2P) is a stable form of vitamin C. This study aimed to explore the protective effects of AS-2P against chronic hypoxia-induced WMI, and elucidate the underlying mechanisms. An in vivo chronic hypoxia model and in vitro oxygen-glucose deprivation (OGD) model were established to explore the effects of AS-2P on WMI using immunofluorescence, immunohistochemistry, western blotting, real-time quantitative polymerase chain reaction, Morris water maze test, novel object recognition test, beaming-walking test, electron microscopy, and flow cytometry. The results showed that AS-2P resulted in the increased expression of MBP, Olig2, PDGFRα and CC1, improved thickness and density of the myelin sheath, and reduced TNF-α expression and microglial cell infiltration to alleviate inflammation in the brain after chronic hypoxia. Moreover, AS-2P improved the memory, learning and motor abilities of the mice with WMI. These protective effects of AS-2P may involve the upregulation of protein arginine methyltransferase 5 (PRMT5) and downregulation of P53 and NF-κB. In conclusion, our study demonstrated that AS-2P attenuated chronic hypoxia-induced WMI in vivo and OGD-induced oligodendrocyte injury in vitro possibly by regulating the PRMT5/P53/NF-κB pathway, suggesting that AS-2P may be a potential therapeutic option for WMI.
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Affiliation(s)
- Bingqing Ding
- Department of Pediatrics, the Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jia Lou
- Department of Pediatrics, the Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tianqi Qin
- Department of Pediatrics, the Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weiwei Xie
- Department of Pediatrics, the Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Di Li
- Department of Pediatrics, the Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Peijun Li
- Department of Pediatrics, the Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Structural Malformations in Children of Zhejiang Province, Wenzhou, Zhejiang, China
- Key Laboratory of Perinatal Medicine of Wenzhou, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Pediatric Disease, Wenzhou, Zhejiang, China
| | - Xingyun Wang
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenlang Lin
- Department of Pediatrics, the Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Structural Malformations in Children of Zhejiang Province, Wenzhou, Zhejiang, China
- Key Laboratory of Perinatal Medicine of Wenzhou, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Pediatric Disease, Wenzhou, Zhejiang, China
| | - Xiaoling Guo
- Key Laboratory of Structural Malformations in Children of Zhejiang Province, Wenzhou, Zhejiang, China
- Basic Medical Research Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Children Genitourinary Diseases of Wenzhou, Wenzhou, Zhejiang, China
| | - Jianghu Zhu
- Department of Pediatrics, the Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Structural Malformations in Children of Zhejiang Province, Wenzhou, Zhejiang, China
- Key Laboratory of Perinatal Medicine of Wenzhou, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Pediatric Disease, Wenzhou, Zhejiang, China
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3
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Theodorsdottir A, Nielsen HH, Ravnborg MH, Illes Z. Patient reported outcomes in a secondary progressive MS cohort related to cognition, MRI and physical outcomes. Mult Scler Relat Disord 2023; 71:104550. [PMID: 36842312 DOI: 10.1016/j.msard.2023.104550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/03/2023] [Accepted: 02/02/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patient-reported outcomes (PROs) are increasingly being used as outcomes in secondary progressive multiple sclerosis (SPMS) trials. We examined how PROs reflect disease burden in SPMS. METHODS In this observational prospective study, 65 SPMS patients were examined by five different PROs (Fatigue Scale Motor Cognition (FSMC), Multiple Sclerosis Impact Scale version 2 (MSIS-29v2), 36-Item Short Form Health Survey version 2 (SF-36v2), EQ-5D-5L and Work Productivity and Activity Impairment Questionnaire: Multiple Sclerosis version 2.0 (WPAI:MS)); two different rating scales, Multiple Sclerosis Impairment Scale (MSIS) and Expanded Disability Status Scale (EDSS); functional tests of mobility (Timed-25-Foot Walk (T-25FW), 6-Spot Step Test (6-SST) and (9-Hole Peg Test (9-HPT)); cognitive tests (Symbol Digital Modalities Test (SDMT) and Brief Visuospatial Memory Test-Revised (BVMT-R)); and multimodal Magnetic Resonance Imaging (MRI). RESULTS When the PROs were divided into physical and psychological subscores, the PRO physical subscores of FSMC, MSIS-29v2 and SF-36v2 correlated with physical rating scales (EDSS, MSIS) and physical measures of upper (9-HPT) and lower extremity function (T-25FW and 6-SST)) (p = 0.04-0.0001). 9-HPT correlated the least with physical subscores of PROs but showed the strongest correlation with activity impairment (subscore of WPAI:MS). In contrast, psychological PRO subscores of FSMC, MSIS-29v2 and SF-36v2 did not reflect the cognitive outcomes (SDMT and BVMT-R), although the cognitive scores correlated with disease burden indicated by MRI lesion volumes. The psychological PRO subscores did not correlate with fatigue, physical and MRI outcomes either. CONCLUSION Correlation between PRO physical subscores and physical outcomes supports PROs as potentially useful clinical endpoints in SPMS. The results of this study indicate that patients with SPMS highly perceive their mobility on function of their lower extremities, while they perceive their daily activities highly dependent on function of the upper extremities. Psychological subscores of MS specific PROs may be less suitable as surrogate markers for the cognitive status and should be considered as a mental quality of life measurement independent of disease burden.
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Affiliation(s)
- A Theodorsdottir
- Department of Neurology, Odense University Hospital, J.B. Winsloewsvej 4, 5000 Odense C, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, J.B. Winsloewsvej 4, 5000 Odense C, Denmark.
| | - H H Nielsen
- Department of Neurology, Odense University Hospital, J.B. Winsloewsvej 4, 5000 Odense C, Denmark; Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21, st., 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, J.B. Winsloewsvej 19, 3., 5000 Odense C, Denmark
| | - M H Ravnborg
- Filadelfia Epilepsy Hospital, Kolonivej 1, 4293 Dianalund, Denmark
| | - Z Illes
- Department of Neurology, Odense University Hospital, J.B. Winsloewsvej 4, 5000 Odense C, Denmark; Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21, st., 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, J.B. Winsloewsvej 19, 3., 5000 Odense C, Denmark
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Wagner B, Härig CL, Walter B, Sommer J, Sammer G, Berghoff M. Is There Reduced Hemodynamic Brain Activation in Multiple Sclerosis Even with Undisturbed Cognition? Int J Mol Sci 2022; 24:ijms24010112. [PMID: 36613551 PMCID: PMC9820283 DOI: 10.3390/ijms24010112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Cognitive impairments related to changes in deep gray matter and other brain regions occur in up to 70% of people with multiple sclerosis. But do such brain changes also occur in patients without significant cognitive impairment? Eighteen participants with relapsing-remitting multiple sclerosis (RRMS) and fifteen healthy controls participated in this study. Cognitive status, depression, and fatigue were assessed using the Multiple Sclerosis Inventory of Cognition (MUSIC), Beck's Depression Inventory (BDI-II), and the Fatigue Severity Scale (FSS). fMRI was recorded while a participant performed the modified attention network test (ANT). The effects of ANT executive attention network on hemodynamic activation of a priori defined regions of interest, including the hippocampus, anterior cingulate cortex (ACC), thalamus, caudate nucleus, pallidum, and putamen were studied. The individual lesion load was estimated. For fMRI data analysis a general linear model with randomization statistics including threshold-free cluster enhancement as implemented in the FSL software was used. Participants with RRMS showed reduced activation of the executive attention network in the hippocampus, pallidum, and ACC. The thalamus was involved in both group activations but did not differ between groups. In summary, functional changes in the brain can also be demonstrated in RRMS patients without cognitive deficits. The affected brain regions can best be assigned to the attention network for executive control. This association could likely serve as a biological indicator of susceptibility to imminent cognitive impairment in MS.
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Affiliation(s)
- Bianca Wagner
- Department of Neurology, Justus-Liebig-University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Clara L. Härig
- Department of Neurology, Justus-Liebig-University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Bertram Walter
- Bender Institute of Neuroimaging, Justus-Liebig-University of Giessen, Otto-Behaghel-Strasse 10H, 35394 Giessen, Germany
| | - Jens Sommer
- Department of Psychiatry, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany
| | - Gebhard Sammer
- Cognitive Neuro Science at the Centre of Psychiatry, Justus-Liebig-University of Giessen, Klinikstrasse 36, 35392 Giessen, Germany
- Department of Psychology, Justus-Liebig-University of Giessen, Otto-Behaghel-Strasse 10F, 35394 Giessen, Germany
- Correspondence: (G.S.); (M.B.); Tel.: +49-641-45835 (G.S.); +49-641-98544306 (M.B.); Fax: +49-641-99-45789 (G.S.); +49-641-98545329 (M.B.)
| | - Martin Berghoff
- Department of Neurology, Justus-Liebig-University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
- Correspondence: (G.S.); (M.B.); Tel.: +49-641-45835 (G.S.); +49-641-98544306 (M.B.); Fax: +49-641-99-45789 (G.S.); +49-641-98545329 (M.B.)
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Bakhtiari A, Vestergaard MB, Benedek K, Fagerlund B, Mortensen EL, Osler M, Lauritzen M, Larsson HBW, Lindberg U. Changes in hippocampal volume during a preceding 10-year period do not correlate with cognitive performance and hippocampal blood‒brain barrier permeability in cognitively normal late-middle-aged men. GeroScience 2022; 45:1161-1175. [PMID: 36534276 PMCID: PMC9886720 DOI: 10.1007/s11357-022-00712-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Hippocampal blood-brain barrier (BBB) permeability may increase in normal healthy ageing and contribute to neurodegenerative disease. To examine this hypothesis, we investigated the correlation between blood-brain barrier (BBB) permeability, regional brain volume, memory functions and health and lifestyle factors in The Metropolit 1953 Danish Male Birth Cohort. We used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with a gadolinium-based contrast agent to assess BBB permeability in 77 participants in the cohort. BBB permeability was measured as Ki values in the hippocampus, thalamus and white matter. Over a 10-year period, we observed progressive atrophy of both the left and right hippocampus (p = 0.001). There was no significant correlation between current BBB permeability and hippocampal volume, prior atrophy or cognition. The hippocampus volume ratio was associated with better visual and verbal memory scores (p < 0.01). Regional BBB differences revealed higher Ki values in the hippocampus and white matter than in the thalamus (p < 0.001). Participants diagnosed with type II diabetes had significantly higher BBB permeability in the white matter (p = 0.015) and thalamus (p = 0.016), which was associated with a higher Fazekas score (p = 0.024). We do not find evidence that BBB integrity is correlated with age-related hippocampal atrophy or cognitive functions. The association between diabetes, white matter hyperintensities and increased BBB permeability is consistent with the idea that cerebrovascular disease compromises BBB integrity. Our findings suggest that the hippocampus is particularly prone to age-related atrophy, which may explain some of the cognitive changes that accompany older age, but this prior atrophy is not correlated with current BBB permeability.
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Affiliation(s)
- Aftab Bakhtiari
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. .,Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. .,Faculty of Health and Medical Sciences, Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark. .,Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Mark B. Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Krisztina Benedek
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark ,Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | | | - Merete Osler
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark ,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Martin Lauritzen
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark ,Faculty of Health and Medical Sciences, Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark ,Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik B. W. Larsson
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark ,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ulrich Lindberg
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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York EN, Thrippleton MJ, Meijboom R, Hunt DPJ, Waldman AD. Quantitative magnetization transfer imaging in relapsing-remitting multiple sclerosis: a systematic review and meta-analysis. Brain Commun 2022; 4:fcac088. [PMID: 35652121 PMCID: PMC9149789 DOI: 10.1093/braincomms/fcac088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/17/2021] [Accepted: 03/31/2022] [Indexed: 11/28/2022] Open
Abstract
Myelin-sensitive MRI such as magnetization transfer imaging has been widely used in multiple sclerosis. The influence of methodology and differences in disease subtype on imaging findings is, however, not well established. Here, we systematically review magnetization transfer brain imaging findings in relapsing-remitting multiple sclerosis. We examine how methodological differences, disease effects and their interaction influence magnetization transfer imaging measures. Articles published before 06/01/2021 were retrieved from online databases (PubMed, EMBASE and Web of Science) with search terms including 'magnetization transfer' and 'brain' for systematic review, according to a pre-defined protocol. Only studies that used human in vivo quantitative magnetization transfer imaging in adults with relapsing-remitting multiple sclerosis (with or without healthy controls) were included. Additional data from relapsing-remitting multiple sclerosis subjects acquired in other studies comprising mixed disease subtypes were included in meta-analyses. Data including sample size, MRI acquisition protocol parameters, treatments and clinical findings were extracted and qualitatively synthesized. Where possible, effect sizes were calculated for meta-analyses to determine magnetization transfer (i) differences between patients and healthy controls; (ii) longitudinal change and (iii) relationships with clinical disability in relapsing-remitting multiple sclerosis. Eighty-six studies met inclusion criteria. MRI acquisition parameters varied widely, and were also underreported. The majority of studies examined the magnetization transfer ratio in white matter, but magnetization transfer metrics, brain regions examined and results were heterogeneous. The analysis demonstrated a risk of bias due to selective reporting and small sample sizes. The pooled random-effects meta-analysis across all brain compartments revealed magnetization transfer ratio was 1.17 per cent units (95% CI -1.42 to -0.91) lower in relapsing-remitting multiple sclerosis than healthy controls (z-value: -8.99, P < 0.001, 46 studies). Linear mixed-model analysis did not show a significant longitudinal change in magnetization transfer ratio across all brain regions [β = 0.12 (-0.56 to 0.80), t-value = 0.35, P = 0.724, 14 studies] or normal-appearing white matter alone [β = 0.037 (-0.14 to 0.22), t-value = 0.41, P = 0.68, eight studies]. There was a significant negative association between the magnetization transfer ratio and clinical disability, as assessed by the Expanded Disability Status Scale [r = -0.32 (95% CI -0.46 to -0.17); z-value = -4.33, P < 0.001, 13 studies]. Evidence suggests that magnetization transfer imaging metrics are sensitive to pathological brain changes in relapsing-remitting multiple sclerosis, although effect sizes were small in comparison to inter-study variability. Recommendations include: better harmonized magnetization transfer acquisition protocols with detailed methodological reporting standards; larger, well-phenotyped cohorts, including healthy controls; and, further exploration of techniques such as magnetization transfer saturation or inhomogeneous magnetization transfer ratio.
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Affiliation(s)
- Elizabeth N. York
- Centre for Clinical Brain Sciences, University of
Edinburgh, Edinburgh, UK
| | | | - Rozanna Meijboom
- Centre for Clinical Brain Sciences, University of
Edinburgh, Edinburgh, UK
| | - David P. J. Hunt
- Centre for Clinical Brain Sciences, University of
Edinburgh, Edinburgh, UK
- UK Dementia Research Institute, University of
Edinburgh, Edinburgh, UK
- Anne Rowling Regenerative Neurology Clinic,
University of Edinburgh, Edinburgh, UK
| | - Adam D. Waldman
- Centre for Clinical Brain Sciences, University of
Edinburgh, Edinburgh, UK
- UK Dementia Research Institute, University of
Edinburgh, Edinburgh, UK
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Govindarajan ST, Liu Y, Parra Corral MA, Bangiyev L, Krupp L, Charvet L, Duong TQ. White matter correlates of slowed information processing speed in unimpaired multiple sclerosis patients with young age onset. Brain Imaging Behav 2021; 15:1460-1468. [PMID: 32748319 DOI: 10.1007/s11682-020-00345-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Slowed information processing speed is among the earliest markers of cognitive impairment in multiple sclerosis (MS) and has been associated with white matter (WM) structural integrity. Localization of WM tracts associated with slowing, but not significant impairment, on specific cognitive tasks in pediatric and young age onset MS can facilitate early and effective therapeutic intervention. Diffusion tensor imaging data were collected on 25 MS patients and 24 controls who also underwent the Symbol Digit Modalities Test (SDMT) and the computer-based Cogstate simple and choice reaction time tests. Fractional anisotropy (FA), mean (MD), radial (RD) and axial (AD) diffusivities were correlated voxel-wise with processing speed measures. All DTI metrics of several white matter tracts were significantly different between groups (p < 0.05). Notably, higher MD, RD, and AD, but not FA, in the corpus callosum correlated with lower scores on both SDMT and simple reaction time. Additionally, all diffusivity metrics in the left corticospinal tract correlated negatively with SDMT scores, whereas only MD in the right superior fronto-occipital fasciculus correlated with simple reaction time. In conclusion, subtle slowing of processing speed is correlated with WM damage in the visual-motor processing pathways in patients with young age of MS onset.
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Affiliation(s)
| | - Yilin Liu
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | | | - Lev Bangiyev
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Lauren Krupp
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Leigh Charvet
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Tim Q Duong
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY, USA.
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8
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Kocovski P, Tabassum-Sheikh N, Marinis S, Dang PT, Hale MW, Orian JM. Immunomodulation Eliminates Inflammation in the Hippocampus in Experimental Autoimmune Encephalomyelitis, but Does Not Ameliorate Anxiety-Like Behavior. Front Immunol 2021; 12:639650. [PMID: 34177891 PMCID: PMC8222726 DOI: 10.3389/fimmu.2021.639650] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/17/2021] [Indexed: 01/21/2023] Open
Abstract
Multiple sclerosis (MS) is an autoimmune disease targeting the central nervous system, characterized by an unpredictable disease course and a wide range of symptoms. Emotional and cognitive deficits are now recognized as primary disease manifestations and not simply the consequence of living with a chronic condition, raising questions regarding the efficacy of current therapeutics for these specific symptoms. Mechanisms underlying psychiatric sequelae in MS are believed to be similar to those underlying pathogenesis, that is mediated by cytokines and other inflammatory mediators. To gain insight into the pathogenesis of MS depression, we performed behavioral assays in the murine experimental autoimmune encephalomyelitis (EAE) MS model, in the presence or absence of immunomodulation using the drug FTY720, an analogue of the lipid signaling molecule sphingosine-1-phosphate (S1P). Specifically, mice were challenged with the elevated plus maze (EPM) test, a validated experimental paradigm for rodent-specific anxiety-like behavior. FTY720 treatment failed to ameliorate anxiety-like symptoms, irrespective of dosage. On the other hand, it was effective in reducing inflammatory infiltration, microglial reactivity and levels of pro-inflammatory molecules in the hippocampus, confirming the anti-inflammatory capacity of treatment. To explore the absence of FTY720 effect on behavior, we confirmed expression of S1P receptors (S1PR) S1PR1, S1PR3 and S1PR5 in the hippocampus and mapped the dynamics of these receptors in response to drug treatment alone, or in combination with EAE induction. We identified a complex pattern of responses, differing between (1) receptors, (2) dosage and (3) hippocampal sub-field. FTY720 treatment in the absence of EAE resulted in overall downregulation of S1PR1 and S1PR3, while S1PR5 exhibited a dose-dependent upregulation. EAE induction alone resulted in overall downregulation of all three receptors. On the other hand, combined FTY720 and EAE showed generally no effect on S1PR1 and S1PR3 expression except for the fimbrium region, but strong upregulation of S1PR5 over the range of doses examined. These data illustrate a hitherto undescribed complexity of S1PR response to FTY720 in the hippocampus, independent of drug effect on effector immune cells, but simultaneously emphasize the need to explore novel treatment strategies to specifically address mood disorders in MS.
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Affiliation(s)
- Pece Kocovski
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Nuzhat Tabassum-Sheikh
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Melbourne, VIC, Australia
| | - Stephanie Marinis
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Melbourne, VIC, Australia
| | - Phuc T. Dang
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Melbourne, VIC, Australia
| | - Matthew W. Hale
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Jacqueline M. Orian
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Melbourne, VIC, Australia
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Costers L, Van Schependom J, Laton J, Baijot J, Sjøgård M, Wens V, De Tiège X, Goldman S, D'Haeseleer M, D'hooghe MB, Woolrich M, Nagels G. The role of hippocampal theta oscillations in working memory impairment in multiple sclerosis. Hum Brain Mapp 2021; 42:1376-1390. [PMID: 33247542 PMCID: PMC7927306 DOI: 10.1002/hbm.25299] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 01/04/2023] Open
Abstract
Working memory (WM) problems are frequently present in people with multiple sclerosis (MS). Even though hippocampal damage has been repeatedly shown to play an important role, the underlying neurophysiological mechanisms remain unclear. This study aimed to investigate the neurophysiological underpinnings of WM impairment in MS using magnetoencephalography (MEG) data from a visual-verbal 2-back task. We analysed MEG recordings of 79 MS patients and 38 healthy subjects through event-related fields and theta (4-8 Hz) and alpha (8-13 Hz) oscillatory processes. Data was source reconstructed and parcellated based on previous findings in the healthy subject sample. MS patients showed a smaller maximum theta power increase in the right hippocampus between 0 and 400 ms than healthy subjects (p = .014). This theta power increase value correlated negatively with reaction time on the task in MS (r = -.32, p = .029). Evidence was provided that this relationship could not be explained by a 'common cause' confounding relationship with MS-related neuronal damage. This study provides the first neurophysiological evidence of the influence of hippocampal dysfunction on WM performance in MS.
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Affiliation(s)
- Lars Costers
- AIMS Lab, Center For NeurosciencesUZ Brussel, Vrije Universiteit BrusselBrusselBelgium
| | - Jeroen Van Schependom
- AIMS Lab, Center For NeurosciencesUZ Brussel, Vrije Universiteit BrusselBrusselBelgium
- Departement of Electronics and Informatics (ETRO)Vrije Universiteit BrusselBrusselBelgium
- Departement of RadiologyUZ BrusselBrusselBelgium
| | - Jorne Laton
- AIMS Lab, Center For NeurosciencesUZ Brussel, Vrije Universiteit BrusselBrusselBelgium
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Johan Baijot
- AIMS Lab, Center For NeurosciencesUZ Brussel, Vrije Universiteit BrusselBrusselBelgium
| | - Martin Sjøgård
- Laboratoire de Cartographie Fonctionnelle du Cerveau (LCFC)UNI—ULB Neuroscience Institute, Université libre de Bruxelles (ULB)BruxellesBelgium
| | - Vincent Wens
- Laboratoire de Cartographie Fonctionnelle du Cerveau (LCFC)UNI—ULB Neuroscience Institute, Université libre de Bruxelles (ULB)BruxellesBelgium
- Magnetoencephalography Unit, Department of Functional Neuroimaging, Service of Nuclear MedicineCUB‐Hôpital ErasmeBruxellesBelgium
| | - Xavier De Tiège
- Laboratoire de Cartographie Fonctionnelle du Cerveau (LCFC)UNI—ULB Neuroscience Institute, Université libre de Bruxelles (ULB)BruxellesBelgium
- Magnetoencephalography Unit, Department of Functional Neuroimaging, Service of Nuclear MedicineCUB‐Hôpital ErasmeBruxellesBelgium
| | - Serge Goldman
- Laboratoire de Cartographie Fonctionnelle du Cerveau (LCFC)UNI—ULB Neuroscience Institute, Université libre de Bruxelles (ULB)BruxellesBelgium
- Magnetoencephalography Unit, Department of Functional Neuroimaging, Service of Nuclear MedicineCUB‐Hôpital ErasmeBruxellesBelgium
| | - Miguel D'Haeseleer
- Department of NeurologyNational MS Center MelsbroekMelsbroekBelgium
- Department of NeurologyUZ BrusselsBruxellesBelgium
| | - Marie Beatrice D'hooghe
- Department of NeurologyNational MS Center MelsbroekMelsbroekBelgium
- Department of NeurologyUZ BrusselsBruxellesBelgium
| | - Mark Woolrich
- Oxford Centre for Human Brain Activity (OHBA)University of OxfordOxfordUK
- Oxford University Centre for Functional MRI of the Brain (FMRIB)University of OxfordOxfordUK
| | - Guy Nagels
- AIMS Lab, Center For NeurosciencesUZ Brussel, Vrije Universiteit BrusselBrusselBelgium
- Department of NeurologyUZ BrusselsBruxellesBelgium
- St Edmund HallUniversity of OxfordOxfordUK
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10
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Beyond Alzheimer's disease: Can bilingualism be a more generalized protective factor in neurodegeneration? Neuropsychologia 2020; 147:107593. [PMID: 32882240 DOI: 10.1016/j.neuropsychologia.2020.107593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/10/2020] [Accepted: 08/26/2020] [Indexed: 01/18/2023]
Abstract
Bilingualism has been argued to have an impact on cognition and brain structure. Effects have been reported across the lifespan: from healthy children to ageing adults, including clinical (ageing) populations. It has been argued that active bilingualism may significantly contribute to the delaying of the expression of Alzheimer's disease symptoms. If bilingualism plays an ameliorative role against the expression of neurodegeneration in dementia, it is possible that it could have similar effects for other neurodegenerative disorders, including Multiple Sclerosis, Parkinson's and Huntington's Diseases. To date, however, direct relevant evidence remains limited, not least because the necessary scientific motivations for investigating this with greater depth have not yet been fully articulated. Herein, we provide a roadmap that reviews the relevant literatures, highlighting potential links across neurodegenerative disorders and bilingualism more generally.
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11
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Voskuhl RR, Patel K, Paul F, Gold SM, Scheel M, Kuchling J, Cooper G, Asseyer S, Chien C, Brandt AU, Meyer CE, MacKenzie-Graham A. Sex differences in brain atrophy in multiple sclerosis. Biol Sex Differ 2020; 11:49. [PMID: 32859258 PMCID: PMC7456053 DOI: 10.1186/s13293-020-00326-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Women are more susceptible to multiple sclerosis (MS) than men by a ratio of approximately 3:1. However, being male is a risk factor for worse disability progression. Inflammatory genes have been linked to susceptibility, while neurodegeneration underlies disability progression. Thus, there appears to be a differential effect of sex on inflammation versus neurodegeneration. Further, gray matter (GM) atrophy is not uniform across the brain in MS, but instead shows regional variation. Here, we study sex differences in neurodegeneration by comparing regional GM atrophy in a cohort of men and women with MS versus their respective age- and sex-matched healthy controls. METHODS Voxel-based morphometry (VBM), deep GM substructure volumetry, and cortical thinning were used to examine regional GM atrophy. RESULTS VBM analysis showed deep GM atrophy in the thalamic area in both men and women with MS, whereas men had additional atrophy in the putamen as well as in localized cortical regions. Volumetry confirmed deep GM loss, while localized cortical thinning confirmed GM loss in the cerebral cortex. Further, MS males exhibited worse performance on the 9-hole peg test (9HPT) than MS females. We observed a strong correlation between thalamic volume and 9HPT performance in MS males, but not in MS females. CONCLUSION More regional GM atrophy was observed in men with MS than women with MS, consistent with previous observations that male sex is a risk factor for worse disease progression.
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Affiliation(s)
- Rhonda R Voskuhl
- Department of Neurology, University of California, Los Angeles, 635 Charles E. Young Drive South, Gordon Neuroscience Research Building, Los Angeles, CA, 90095, USA.
| | - Kevin Patel
- Department of Neurology, University of California, Los Angeles, 635 Charles E. Young Drive South, Gordon Neuroscience Research Building, Los Angeles, CA, 90095, USA
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Stefan M Gold
- Institute for Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry and Medical Department, Division of Psychosomatic Medicine, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael Scheel
- Institute of Neuroradiology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Joseph Kuchling
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Departments of Neurology and Neuropsychiatry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Graham Cooper
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Departments of Neurology and Neuropsychiatry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Einstein Center for Neurosciences, Berlin, Germany
| | - Susanna Asseyer
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Chien
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department for Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alexander U Brandt
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Departments of Neurology and Neuropsychiatry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Cassandra Eve Meyer
- Department of Neurology, University of California, Los Angeles, 635 Charles E. Young Drive South, Gordon Neuroscience Research Building, Los Angeles, CA, 90095, USA
| | - Allan MacKenzie-Graham
- Department of Neurology, University of California, Los Angeles, 635 Charles E. Young Drive South, Gordon Neuroscience Research Building, Los Angeles, CA, 90095, USA
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12
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Sobel RA, Eaton MJ, Jaju PD, Lowry E, Hinojoza JR. Anti-Myelin Proteolipid Protein Peptide Monoclonal Antibodies Recognize Cell Surface Proteins on Developing Neurons and Inhibit Their Differentiation. J Neuropathol Exp Neurol 2020; 78:819-843. [PMID: 31400116 PMCID: PMC6703999 DOI: 10.1093/jnen/nlz058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/30/2019] [Accepted: 06/18/2019] [Indexed: 12/15/2022] Open
Abstract
Using a panel of monoclonal antibodies (mAbs) to myelin proteolipid protein (PLP) peptides, we found that in addition to CNS myelin, mAbs to external face but not cytoplasmic face epitopes immunostained neurons in immature human CNS tissues and in adult hippocampal dentate gyrus and olfactory bulbs, that is neural stem cell niches (NSCN). To explore the pathobiological significance of these observations, we assessed the mAb effects on neurodifferentiation in vitro. The mAbs to PLP 50-69 (IgG1κ and IgG2aκ), and 178-191 and 200-219 (both IgG1κ) immunostained live cell surfaces and inhibited neurite outgrowth of E18 rat hippocampal precursor cells and of PC12 cells, which do not express PLP. Proteins immunoprecipitated from PC12 cell extracts and captured by mAb-coated magnetic beads were identified by GeLC-MS/MS. Each neurite outgrowth-inhibiting mAb captured a distinct set of neurodifferentiation molecules including sequence-similar M6 proteins and other unrelated membrane and extracellular matrix proteins, for example integrins, Eph receptors, NCAM-1, and protocadherins. These molecules are expressed in adult human NSCN and are implicated in the pathogenesis of many chronic CNS disease processes. Thus, diverse anti-PLP epitope autoantibodies may inhibit neuronal precursor cell differentiation via multispecific recognition of cell surface molecules thereby potentially impeding endogenous neuroregeneration in NSCN and in vivo differentiation of exogenous neural stem cells.
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Affiliation(s)
- Raymond A Sobel
- Laboratory Service, Veterans Affairs Health Care System, Palo Alto, California.,Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Mary Jane Eaton
- Laboratory Service, Veterans Affairs Health Care System, Palo Alto, California.,Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Prajakta Dilip Jaju
- Laboratory Service, Veterans Affairs Health Care System, Palo Alto, California.,Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Eugene Lowry
- Laboratory Service, Veterans Affairs Health Care System, Palo Alto, California.,Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Julian R Hinojoza
- Laboratory Service, Veterans Affairs Health Care System, Palo Alto, California.,Department of Pathology, Stanford University School of Medicine, Stanford, California
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13
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Abel S, Vavasour I, Lee LE, Johnson P, Ackermans N, Chan J, Dvorak A, Schabas A, Wiggermann V, Tam R, Kuan AJ, Morrow SA, Wilken J, Laule C, Rauscher A, Bhan V, Sayao AL, Devonshire V, Li DK, Carruthers R, Traboulsee A, Kolind SH. Myelin Damage in Normal Appearing White Matter Contributes to Impaired Cognitive Processing Speed in Multiple Sclerosis. J Neuroimaging 2019; 30:205-211. [PMID: 31762132 DOI: 10.1111/jon.12679] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Cognitive impairment is a core symptom in multiple sclerosis (MS). Damage to normal appearing white matter (NAWM) is likely involved. We sought to determine if greater myelin heterogeneity in NAWM is associated with decreased cognitive performance in MS. METHODS A total of 27 participants with MS and 13 controls matched for age, sex, and education underwent myelin water imaging (MWI) from which the myelin water fraction (MWF) was calculated. Corpus callosum, superior longitudinal fasciculus, and cingulum were chosen as regions of interest (ROIs) a priori based on their involvement in MS-related cognitive impairment. Cognitive performance was assessed using the Symbol Digit Modalities Test (SDMT). Pearson ́s product moment correlations were performed to assess relationships between cognitive performance and myelin heterogeneity (variance of MWF within an ROI). RESULTS In MS, myelin heterogeneity in all three ROIs was significantly associated with performance on the SDMT. These correlations ranged from moderate (r = -.561) to moderately strong (r = -.654) and were highly significant (P values ranged from .001 to .0002). Conversely, myelin heterogeneity was not associated with SDMT performance in controls in any ROI (P > .108). CONCLUSION Increased myelin heterogeneity in NAWM is associated with decreased cognitive processing speed performance in MS.
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Affiliation(s)
- Shawna Abel
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Irene Vavasour
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lisa Eunyoung Lee
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Poljanka Johnson
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathalie Ackermans
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Jillian Chan
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam Dvorak
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alice Schabas
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Vanessa Wiggermann
- Department of Physics and Astronomy and Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roger Tam
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Annie J Kuan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah A Morrow
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | - Jeffrey Wilken
- Department of Neurology and Washington Neuropsychology Research Group, Georgetown University Hospital, LLC, Fairfax, VA
| | - Cornelia Laule
- Department of Radiology Pathology & Laboratory Medicine, Physics & Astronomy and International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexander Rauscher
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Virender Bhan
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Ana-Luiza Sayao
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Virginia Devonshire
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - David Kb Li
- Department of Radiology and Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Carruthers
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Anthony Traboulsee
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon H Kolind
- Department of Medicine (Neurology), Radiology, Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
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14
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Chrysin suppress immune responses and protects from experimental autoimmune encephalomyelitis in mice. J Neuroimmunol 2019; 335:577007. [DOI: 10.1016/j.jneuroim.2019.577007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 01/24/2023]
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15
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Abstract
Cognitive impairment is increasingly recognized to be a core feature of multiple sclerosis (MS), with important implications for the everyday life of individuals with MS and for disease management. Unfortunately, the exact mechanisms that underlie this cognitive impairment are poorly understood and there are no effective therapeutic options for this aspect of the disease. During MS, focal brain inflammatory lesions, together with pathological changes of both CNS grey matter and normal-appearing white matter, can interfere with cognitive functions. Moreover, inflammation may alter the crosstalk between the immune and the nervous systems, modulating the induction of synaptic plasticity and neurotransmission. In this Review, we examine the CNS structures and cognitive domains that are affected by the disease, with a specific focus on hippocampal involvement in MS and experimental autoimmune encephalomyelitis, an experimental model of MS. We also discuss the hypothesis that, during MS, immune-mediated alterations of synapses' ability to express long-term plastic changes may contribute to the pathogenesis of cognitive impairment by interfering with the dynamics of neuronal networks.
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16
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Nobis L, Manohar SG, Smith SM, Alfaro-Almagro F, Jenkinson M, Mackay CE, Husain M. Hippocampal volume across age: Nomograms derived from over 19,700 people in UK Biobank. Neuroimage Clin 2019; 23:101904. [PMID: 31254939 PMCID: PMC6603440 DOI: 10.1016/j.nicl.2019.101904] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/13/2019] [Accepted: 06/16/2019] [Indexed: 12/18/2022]
Abstract
Measurement of hippocampal volume has proven useful to diagnose and track progression in several brain disorders, most notably in Alzheimer's disease (AD). For example, an objective evaluation of a patient's hippocampal volume status may provide important information that can assist diagnosis or risk stratification of AD. However, clinicians and researchers require access to age-related normative percentiles to reliably categorise a patient's hippocampal volume as being pathologically small. Here we analysed effects of age, sex, and hemisphere on the hippocampus and neighbouring temporal lobe volumes, in 19,793 generally healthy participants in the UK Biobank. A key finding of the current study is a significant acceleration in the rate of hippocampal volume loss in middle age, more pronounced in females than in males. In this report, we provide normative values for hippocampal and total grey matter volume as a function of age for reference in clinical and research settings. These normative values may be used in combination with our online, automated percentile estimation tool to provide a rapid, objective evaluation of an individual's hippocampal volume status. The data provide a large-scale normative database to facilitate easy age-adjusted determination of where an individual hippocampal and temporal lobe volume lies within the normal distribution.
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Affiliation(s)
- Lisa Nobis
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Sanjay G Manohar
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Stephen M Smith
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Fidel Alfaro-Almagro
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Mark Jenkinson
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Clare E Mackay
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Department of Experimental Psychology, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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17
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Rocca MA, Barkhof F, De Luca J, Frisén J, Geurts JJG, Hulst HE, Sastre-Garriga J, Filippi M. The hippocampus in multiple sclerosis. Lancet Neurol 2018; 17:918-926. [PMID: 30264730 DOI: 10.1016/s1474-4422(18)30309-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/18/2018] [Accepted: 08/06/2018] [Indexed: 12/16/2022]
Abstract
Some of the clinical manifestations of multiple sclerosis, such as memory impairment and depression, are, at least partly, related to involvement of the hippocampus. Pathological studies have shown extensive demyelination, neuronal damage, and synaptic abnormalities in the hippocampus of patients with multiple sclerosis, and improvements in MRI technology have provided novel ways to assess hippocampal involvement in vivo. It is now accepted that clinical manifestations related to the hippocampus are due not only to focal hippocampal damage, but also to disconnection of the hippocampus from several brain networks. Evidence suggests anatomical and functional subspecialisation of the different hippocampal subfields, resulting in variability between regions in the extent to which damage and repair occur. The hippocampus also has important roles in plasticity and neurogenesis, both of which potentially contribute to functional preservation and restoration. These findings underline the importance of evaluation of the hippocampus not only to improve understanding of the clinical manifestations of multiple sclerosis, but also as a potential future target for treatment.
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Affiliation(s)
- Maria A Rocca
- Neuroimaging Research Unit and Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, Netherlands; Institute of Neurology and Institute of Healthcare Engineering, UCL Institute of Neurology, London, UK
| | - John De Luca
- Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Jonas Frisén
- Department of Cell and Molecular Biology, Karolinska Institute, Sweden
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, Netherlands
| | - Hanneke E Hulst
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, Netherlands
| | - Jaume Sastre-Garriga
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Massimo Filippi
- Neuroimaging Research Unit and Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
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18
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Spirou A, Liu PP, Natsheh JY, Neuteboom E, Dobryakova E. Neural Correlates of Outcome Anticipation in Multiple Sclerosis. Front Neurol 2018; 9:572. [PMID: 30140247 PMCID: PMC6094992 DOI: 10.3389/fneur.2018.00572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/25/2018] [Indexed: 11/13/2022] Open
Abstract
Outcome anticipation is not only a mental preparation for upcoming consequences, but also an essential component of learning and decision-making. Thus, anticipation of consequences is a key process in everyday functioning. The striatum and the ventromedial prefrontal cortex are among the key regions that have been shown to be involved in outcome anticipation. However, while structural abnormalities of these regions as well as altered decision-making have been noted in individuals with multiple sclerosis (MS), neural correlates of outcome anticipation have not been explored in this population. Thus, we examined the neural correlates of outcome anticipation in MS by analyzing brain activation in individuals with MS while they performed a modified version of a card-guessing task. Seventeen MS and 13 healthy controls performed the task while functional magnetic resonance imaging (fMRI) was obtained. To achieve maximal anticipatory response and prevent the possibility of differential performance on the task, participants were presented with monetary rewards only on 50% of the trials. While replicating previous evidence of structural abnormalities of the striatum in MS, our results further showed that individuals with MS exhibited greater activation in the putamen, right hippocampus, and posterior cingulate cortex during outcome anticipation compared to healthy controls. Furthermore, even though there was no strategy that participants could learn in order to predict outcomes, 76% of participants with MS indicated that they used strategies while performing the task. We thus propose that the increased neural activation observed in MS during outcome anticipation might be explained by a failure in recognizing the lack of regularity in the task structure that could result in using strategies to perform the task.
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Affiliation(s)
- Angela Spirou
- Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, United States
| | - Pei-Pei Liu
- Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, United States.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Joman Y Natsheh
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States.,Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
| | - Eliane Neuteboom
- Department of Anatomy & Neurosciences, University of Amsterdam, Amsterdam, Netherlands
| | - Ekaterina Dobryakova
- Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, United States.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
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19
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Sinnecker T, Granziera C, Wuerfel J, Schlaeger R. Future Brain and Spinal Cord Volumetric Imaging in the Clinic for Monitoring Treatment Response in MS. Curr Treat Options Neurol 2018; 20:17. [PMID: 29679165 DOI: 10.1007/s11940-018-0504-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Volumetric analysis of brain imaging has emerged as a standard approach used in clinical research, e.g., in the field of multiple sclerosis (MS), but its application in individual disease course monitoring is still hampered by biological and technical limitations. This review summarizes novel developments in volumetric imaging on the road towards clinical application to eventually monitor treatment response in patients with MS. RECENT FINDINGS In addition to the assessment of whole-brain volume changes, recent work was focused on the volumetry of specific compartments and substructures of the central nervous system (CNS) in MS. This included volumetric imaging of the deep brain structures and of the spinal cord white and gray matter. Volume changes of the latter indeed independently correlate with clinical outcome measures especially in progressive MS. Ultrahigh field MRI and quantitative MRI added to this trend by providing a better visualization of small compartments on highly resolving MR images as well as microstructural information. New developments in volumetric imaging have the potential to improve sensitivity as well as specificity in detecting and hence monitoring disease-related CNS volume changes in MS.
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Affiliation(s)
- Tim Sinnecker
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Medical Image Analysis Center Basel AG, Basel, Switzerland
- NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Cristina Granziera
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Jens Wuerfel
- Medical Image Analysis Center Basel AG, Basel, Switzerland
- NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Ultrahigh Field Facility, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Regina Schlaeger
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.
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20
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Keser Z, Hasan KM, Mwangi B, Younes K, Khayat-Khoei M, Kamali A, Lincoln JA, Nelson FM. Quantitative Limbic System Mapping of Main Cognitive Domains in Multiple Sclerosis. Front Neurol 2018; 9:132. [PMID: 29593633 PMCID: PMC5857595 DOI: 10.3389/fneur.2018.00132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/22/2018] [Indexed: 12/03/2022] Open
Abstract
Background and objective Cognitive impairment (CI) is common in multiple sclerosis (MS), but underlying mechanisms and their imaging correlates are not completely understood. The gray and white matter structures of the limbic system (LS) play crucial roles in different aspects of cognition. To investigate their role in MS related CI, and since a detailed evaluations are lacking in the literature, we used a comprehensive neuroimaging approach to evaluate CI’s correlations with the main components of the LS. Methods Ten non-cognitively impaired MS patients and 30 MS patients with diagnosed CI, who underwent a comprehensive neuropsychological evaluation were included in the analysis. Microstructural integrity, volumetry of main limbic gray and white matter structures and cortical thickness were assessed for associations with CI. Results Fornix and cingulum/cingulate cortices were found to be the strongest correlates of CI in MS. As expected, LS’ gray and white matter structures were involved in various cognitive functions. Uncinate fasciculi showed significant correlation with verbal and visuospatial learning and memory, phonemic and semantic fluency; hippocampi with visuospatial skills, phonemic and semantic fluency, executive functions, and processing speed; thalami with verbal learning, visuospatial skills, semantic fluency; and amygdala with verbal recognition discrimination. Conclusion This comprehensive neuroimaging approach elucidated the role of the main limbic structures in cognitive functions associated with MS-related CI.
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Affiliation(s)
- Zafer Keser
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Khader M Hasan
- Department of Diagnostic and Interventional Radiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Benson Mwangi
- Department of Psychiatry, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Kyan Younes
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Mahsa Khayat-Khoei
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Arash Kamali
- Department of Diagnostic and Interventional Radiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - John A Lincoln
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Flavia M Nelson
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
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21
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Koenig KA, Rao SM, Lowe MJ, Lin J, Sakaie KE, Stone L, Bermel RA, Trapp BD, Phillips MD. The role of the thalamus and hippocampus in episodic memory performance in patients with multiple sclerosis. Mult Scler 2018; 25:574-584. [PMID: 29512427 DOI: 10.1177/1352458518760716] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Episodic memory loss is one of the most common cognitive symptoms in patients with multiple sclerosis (MS), but the pathophysiology of this symptom remains unclear. Both the hippocampus and thalamus have been implicated in episodic memory and show regional atrophy in patients with MS. OBJECTIVE In this work, we used functional magnetic resonance imaging (fMRI) during a verbal episodic memory task, lesion load, and volumetric measures of the hippocampus and thalamus to assess the relative contributions to verbal and visual-spatial episodic memory. METHODS Functional activation, lesion load, and volumetric measures from 32 patients with MS and 16 healthy controls were used in a predictive analysis of episodic memory function. RESULTS After adjusting for disease duration, immediate recall performance on a visual-spatial episodic memory task was significantly predicted by hippocampal volume ( p < 0.003). Delayed recall on the same task was significantly predicted by volume of the left thalamus ( p < 0.003). For both memory measures, functional activation of the thalamus during encoding was more predictive than that of volume measures ( p < 0.002). CONCLUSION Our results suggest that functional activation may be useful as a predictive measure of episodic memory loss in patients with MS.
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Affiliation(s)
| | - Stephen M Rao
- Schey Center for Cognitive Neuroimaging, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mark J Lowe
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jian Lin
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ken E Sakaie
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lael Stone
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Robert A Bermel
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Bruce D Trapp
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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22
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Manca R, Sharrack B, Paling D, Wilkinson ID, Venneri A. Brain connectivity and cognitive processing speed in multiple sclerosis: A systematic review. J Neurol Sci 2018; 388:115-127. [PMID: 29627004 DOI: 10.1016/j.jns.2018.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/06/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Processing speed (PS) decline is the most commonly observed cognitive deficit in people with multiple sclerosis (MS) resulting in a significant impact on quality of life. Despite its importance, knowledge of the underlying neural substrates is lacking. OBJECTIVE As MS is increasingly recognised as a disconnection syndrome, our aim was to carry out a systematic literature review to clarify the relationship between PS performance and MRI measures of structural and functional brain connectivity in people with MS. SEARCH METHODS A literature search was carried out on PubMed and Web of Science that included publications predating September 2017. Additional articles were added after inspection of the reference lists of all selected papers. DATA EXTRACTION All selected papers were categorised in three sections according to the MRI measures investigated, independently or both. Quality assessment was carried out using a customised set of criteria. RESULTS Thirty-two articles met the inclusion criteria and were included in the review. Microstructural integrity of the anterior corpus callosum and functional connectivity of frontal areas were more consistently found to correlate with PS performance, though high variability of findings was observed across studies. Several methodological flaws emerged from the reviewed literature. CONCLUSIONS Despite the observed trends, no definite conclusions can be drawn on the relationship between brain connectivity and PS decline in MS given the limitations of the current literature. Future investigations may benefit from theoretical and methodological advances to clarify how MS-related brain damage affects patients' cognition.
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Affiliation(s)
- Riccardo Manca
- Department of Neurosciences, University of Sheffield, Sheffield, UK
| | - Basil Sharrack
- Department of Neurosciences, University of Sheffield, Sheffield, UK; Department of Neurology, Sheffield Teaching Hospital NHS Trust, Sheffield, UK
| | - David Paling
- Department of Neurosciences, University of Sheffield, Sheffield, UK; Department of Neurology, Sheffield Teaching Hospital NHS Trust, Sheffield, UK
| | - Iain D Wilkinson
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Annalena Venneri
- Department of Neurosciences, University of Sheffield, Sheffield, UK.
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23
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Cell-specific and region-specific transcriptomics in the multiple sclerosis model: Focus on astrocytes. Proc Natl Acad Sci U S A 2018; 115:E302-E309. [PMID: 29279367 PMCID: PMC5777065 DOI: 10.1073/pnas.1716032115] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Changes in gene expression that occur across the central nervous system (CNS) during neurological diseases do not address the heterogeneity of cell types from one CNS region to another and are complicated by alterations in cellular composition during disease. Multiple sclerosis (MS) is multifocal by definition. Here, a cell-specific and region-specific transcriptomics approach was used to determine gene expression changes in astrocytes in the most widely used MS model, experimental autoimmune encephalomyelitis (EAE). Astrocyte-specific RNAs from various neuroanatomic regions were attained using RiboTag technology. Sequencing and bioinformatics analyses showed that EAE-induced gene expression changes differed between neuroanatomic regions when comparing astrocytes from spinal cord, cerebellum, cerebral cortex, and hippocampus. The top gene pathways that were changed in astrocytes from spinal cord during chronic EAE involved decreases in expression of cholesterol synthesis genes while immune pathway gene expression in astrocytes was increased. Optic nerve from EAE and optic chiasm from MS also showed decreased cholesterol synthesis gene expression. The potential role of cholesterol synthesized by astrocytes during EAE and MS is discussed. Together, this provides proof-of-concept that a cell-specific and region-specific gene expression approach can provide potential treatment targets in distinct neuroanatomic regions during multifocal neurological diseases.
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Sun J, Zhou H, Bai F, Ren Q, Zhang Z. Myelin injury induces axonal transport impairment but not AD-like pathology in the hippocampus of cuprizone-fed mice. Oncotarget 2017; 7:30003-17. [PMID: 27129150 PMCID: PMC5058659 DOI: 10.18632/oncotarget.8981] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/16/2016] [Indexed: 12/02/2022] Open
Abstract
Both multiple sclerosis (MS) and Alzheimer's disease (AD) are progressive neurological disorders with myelin injury and memory impairment. However, whether myelin impairment could cause AD-like neurological pathology remains unclear. To explore neurological pathology following myelin injury, we assessed cognitive function, the expression of myelin proteins, axonal transport-associated proteins, axonal structural proteins, synapse-associated proteins, tau and beta amyloid and the status of neurons, using the cuprizone mouse model of demyelination. We found the mild impairment of learning ability in cuprizone-fed mice and the decreased expression of myelin basic protein (MBP) in the hippocampus. And anti-LINGO-1 improved learning ability and partly restored MBP level. Furthermore, we also found kinesin light chain (KLC), neurofilament light chain (NFL) and neurofilament heavy chain (NF200) were declined in demyelinated hippocampus, which could be partly improved by treatment with anti-LINGO-1. However, we did not observe the increased expression of beta amyloid, hyperphosphorylation of tau and loss of neurons in demyelinated hippocampus. Our results suggest that demyelination might lead to the impairment of neuronal transport, but not cause increased level of hyperphosphorylated tau and beta amyloid. Our research demonstrates remyelination might be an effective pathway to recover the function of neuronal axons and cognition in MS.
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Affiliation(s)
- Junjun Sun
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hong Zhou
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Feng Bai
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Qingguo Ren
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhijun Zhang
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
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Yousuf F, Dupuy SL, Tauhid S, Chu R, Kim G, Tummala S, Khalid F, Weiner HL, Chitnis T, Healy BC, Bakshi R. A two-year study using cerebral gray matter volume to assess the response to fingolimod therapy in multiple sclerosis. J Neurol Sci 2017; 383:221-229. [DOI: 10.1016/j.jns.2017.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/14/2017] [Accepted: 10/09/2017] [Indexed: 02/04/2023]
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Cao G, Edden RAE, Gao F, Li H, Gong T, Chen W, Liu X, Wang G, Zhao B. Reduced GABA levels correlate with cognitive impairment in patients with relapsing-remitting multiple sclerosis. Eur Radiol 2017; 28:1140-1148. [PMID: 28986640 DOI: 10.1007/s00330-017-5064-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/18/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To investigate if brain gamma-aminobutyric acid (GABA) levels in patients with relapsing-remitting multiple sclerosis (RRMS) are abnormal compared with healthy controls, and their relationship to cognitive function in RRMS. METHODS Twenty-eight RRMS patients and twenty-six healthy controls underwent magnetic resonance spectroscopy (MRS) at 3-T to detect GABA signals from posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC) and left hippocampus using the 'MEGAPoint Resolved Spectroscopy Sequence' (MEGA-PRESS) technique. All subjects also underwent a cognitive assessment. RESULTS In RRMS patients, GABA+ were lower in the PCC (p = 0.036) and left hippocampus (p = 0.039) compared with controls, decreased GABA+ in the PCC and left hippocampus were associated with specific cognitive functions (r = -0.452, p = 0.016 and r = 0.451, p = 0.016 respectively); GABA+ in the mPFC were not significantly decreased or related to any cognitive scores (p > 0.05). CONCLUSIONS This study demonstrates that abnormalities of the GABAergic system may be present in the pathogenesis of RRMS and suggests a potential link between regional GABA levels and cognitive impairment in patients with RRMS. KEY POINTS • GABA levels may decrease in patients with RRMS. • Lower GABA levels correlated with worse cognitive performance in patients with RRMS. • Dysfunctional GABAergic neurotransmission may have a role in cognitive impairment in RRMS.
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Affiliation(s)
- Guanmei Cao
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, 250021, Shandong, China
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- FM Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, 21287, USA
| | - Fei Gao
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, 250021, Shandong, China
| | - Hao Li
- Air Force General Hospital PLA, Beijing, 100142, China
| | - Tao Gong
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, 250021, Shandong, China
| | | | - Xiaohui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, Shandong, China
| | - Guangbin Wang
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, 250021, Shandong, China.
| | - Bin Zhao
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, 250021, Shandong, China
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Information processing deficits as a driving force for memory impairment in MS: A cross--sectional study of memory functions and MRI in early and late stage MS. Mult Scler Relat Disord 2017; 18:119-127. [PMID: 29141793 DOI: 10.1016/j.msard.2017.09.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/08/2017] [Accepted: 09/23/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Memory impairment (MI) is a common symptom of MS. Previous studies were conflicting in respect to the possible existence of early MI and the role of hippocampal atrophy. The objective of this study was to investigate MI and structural MRI correlates in homogenous groups of early and late MS, controlling for a potential information-processing speed (IPS) deficit, and utilizing multiple memory test paradigms. METHODS 152 individually matched subjects were recruited: early MS (EMS, N = 25, disease duration 1.0 ± 0.8 years), late MS (LMS, N = 52, 16.5 ± 5.2 years), and corresponding controls. Five memory tests were utilized to account for differences in learning material (verbal, visual), encoding (incidental, intentional), and retrieval (free recall, recognition, recurring recognition). Performance was related to IPS, memory-specific (hippocampal volumes), and unspecific MRI measures (T1/T2LL, brain volume, cortical thickness). RESULTS Memory was impaired across all tests in LMS, but not in EMS. LMS-patients were also significantly impaired in IPS which was correlated with several memory scores. Regression analyses revealed IPS and cortical thickness as predictors for visual MI, and IPS, sex, and left hippocampal volume as predictors for verbal MI. CONCLUSION Additionally to direct destructions in memory specific tracts such as the hippocampus, memory decline in MS may also be related to a general factor comprising slowed information-processing and global tissue loss.
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Sandi D, Biernacki T, Szekeres D, Füvesi J, Kincses ZT, Rózsa C, Mátyás K, Kása K, Matolcsi J, Zboznovits D, Burány Z, Langane É, Vécsei L, Bencsik K. Prevalence of cognitive impairment among Hungarian patients with relapsing-remitting multiple sclerosis and clinically isolated syndrome. Mult Scler Relat Disord 2017; 17:57-62. [PMID: 29055476 DOI: 10.1016/j.msard.2017.06.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/12/2017] [Accepted: 06/30/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Cognitive impairment (CI) is a frequent symptom of multiple sclerosis (MS); its prevalence is reported to be 43-70%. It is one of the most important determinants of MS patients' quality of life, as it is one of the main factors for MS patients becoming unemployed. AIM We aimed to determine the prevalence of CI among the relapsing-remitting MS (RRMS) and clinically isolated syndrome (CIS) patients in Hungary, to evaluate the predicting factors of CI and to assess the differences between sexes and patients with different educational levels. PATIENTS AND METHODS Five-hundred and fifty-three CIS and RRMS patients were enrolled to our study from three Hungarian MS centers. Age at screening, age at disease onset, disease duration, EDSS score, sex and educational levels were analyzed as socio-demographic factors. The BICAMS battery was used to assess their cognitive state, the BDI-II battery to assess depression. For statistical analysis, we utilized logistical regression, and used Fisher exact tests, chi-square tests and one-way ANOVA. RESULTS The mean age of our patients was 44.93 ± 11.69 years, mean age at disease onset was 31.95 ± 10.01 years, the mean disease duration was 13.05 ± 8.05 years and the median EDSS score 2.0 (Range: 6.5, IQR:2.0) points. Three-hundred and sixteen (57.1%) patients had CI. Sex, educational level and EDSS score proved to be significant predictors of CI (OR: 2.71, p < 0.001; OR: 1.94, p = 0.023; OR: 0.47, p = 0.003 respectively). CI was significantly (p < 0.001) more frequent among men (70.1%) than women (52.0%). We found, that educational level and EDSS score were only a significant predicting factor among women. Thus, the prevalence of CI among women with college or university degree was significantly (p < 0.001) less common (39.4%) than women with 12-15 years of education (57.4%) and women without a high school degree (66.7%). Also, we found that among women with higher EDSS score than 2 points, the prevalence of CI is 69.9% as compared to women with EDSS score between 0 and 2 points, where the prevalence is 42.8% (p < 0.001). No such differences were observed among man. DISCUSSION Our prevalence data is similar to those reported in the literature (43-70%), and almost identical to the one assessment using the BICAMS battery. We found that men are more vulnerable to CI than women in MS, as was reported recently. We are the first to report however, that higher educational level and lower EDSS scores are only associated with better cognitive performance in women.
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Affiliation(s)
- Dániel Sandi
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, Semmelweis u 6., H-6725 Szeged, Hungary
| | - Tamás Biernacki
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, Semmelweis u 6., H-6725 Szeged, Hungary
| | - Dóra Szekeres
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, Semmelweis u 6., H-6725 Szeged, Hungary
| | - Judit Füvesi
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, Semmelweis u 6., H-6725 Szeged, Hungary
| | - Zsigmond Tamás Kincses
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, Semmelweis u 6., H-6725 Szeged, Hungary
| | - Csilla Rózsa
- Jahn Ferenc Dél-Pest Hospital, Köves út, H-1204 Budapest, Hungary
| | - Klotild Mátyás
- Markhot Ferenc Teaching Hospital, Széchenyi u 27-29, H-3300 Eger, Hungary
| | - Krisztián Kása
- Jahn Ferenc Dél-Pest Hospital, Köves út, H-1204 Budapest, Hungary
| | - Judit Matolcsi
- Jahn Ferenc Dél-Pest Hospital, Köves út, H-1204 Budapest, Hungary
| | - Dóra Zboznovits
- Jahn Ferenc Dél-Pest Hospital, Köves út, H-1204 Budapest, Hungary
| | - Zita Burány
- Jahn Ferenc Dél-Pest Hospital, Köves út, H-1204 Budapest, Hungary
| | - Éva Langane
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, Semmelweis u 6., H-6725 Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, Semmelweis u 6., H-6725 Szeged, Hungary; MTA - SZTE Neuroscience Research Group, Semmelweis u 6., H-6725 Szeged, Hungary
| | - Krisztina Bencsik
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, Semmelweis u 6., H-6725 Szeged, Hungary.
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Mansour ZM, Lepping RJ, Honea RA, Brooks WM, Yeh HW, Burns JM, Sharma NK. Structural Brain Imaging in People With Low Back Pain. Spine (Phila Pa 1976) 2017; 42:726-732. [PMID: 27879564 PMCID: PMC5425308 DOI: 10.1097/brs.0000000000001915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE The aim of this study was to determine whether low back pain (subacute and chronic) is related to differences in brain volume. SUMMARY OF BACKGROUND DATA Inconsistent findings have been reported about the effect of chronic low back pain on brain volume, and the effect of subacute low back pain on brain volume has not been sufficiently investigated. METHODS A total of 130 participants were included (23 subacute and 68 chronic low back pain; 39 healthy controls). The main outcome measure was whole and regional brain volume. Clinical outcome measures included pain duration, pain intensity, fear avoidance belief questionnaire, Oswestry Disability Index, and Beck's Depression Inventory. RESULTS Decrease in brain volume in several regions was observed in chronic low back pain when compared with health subjects; however, after correcting for multiple comparisons, no significant differences were detected between any of the three groups in whole-brain volume. Regionally, we detected less gray matter volume in two voxels in the middle frontal gyrus in chronic low back pain participants compared with healthy controls. None of the clinical outcome measures were correlated with brain volume measurements. CONCLUSION Low back pain (subacute or chronic) is not related to significant differences in brain volume after correction for multiple comparisons. The effect size was too small to detect possible subtle changes unless much larger sample sizes are examined, or it is possible that low back pain does not affect brain volume. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Zaid M. Mansour
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, Kansas, 66160
| | - Rebcca J. Lepping
- Hoglund Brian Imaging Center, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, Kansas, 66160
| | - Robyn A. Honea
- Alzheimer’s Research Disease Center, University of Kansas School of Medicine, Kansas City, Kansas, 66160
| | - William M. Brooks
- Hoglund Brian Imaging Center, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, Kansas, 66160
| | - Hung-Wen Yeh
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas, 66160
| | - Jeffrey M. Burns
- Alzheimer’s Research Disease Center, University of Kansas School of Medicine, Kansas City, Kansas, 66160
- Department of Neurology, University of Kansas School of Medicine, Kansas City, Kansas, 66160
| | - Neena K. Sharma
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, Kansas, 66160
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Selective dentate gyrus disruption causes memory impairment at the early stage of experimental multiple sclerosis. Brain Behav Immun 2017; 60:240-254. [PMID: 27847283 DOI: 10.1016/j.bbi.2016.11.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/07/2016] [Accepted: 11/12/2016] [Indexed: 11/21/2022] Open
Abstract
Memory impairment is an early and disabling manifestation of multiple sclerosis whose anatomical and biological substrates are still poorly understood. We thus investigated whether memory impairment encountered at the early stage of the disease could be explained by a differential vulnerability of particular hippocampal subfields. By using experimental autoimmune encephalomyelitis (EAE), a mouse model of multiple sclerosis, we identified that early memory impairment was associated with selective alteration of the dentate gyrus as pinpointed in vivo with diffusion-tensor-imaging (DTI). Neuromorphometric analyses and electrophysiological recordings confirmed dendritic degeneration, alteration in glutamatergic synaptic transmission and impaired long-term synaptic potentiation selectively in the dentate gyrus, but not in CA1, together with a more severe pattern of microglial activation in this subfield. Systemic injections of the microglial inhibitor minocycline prevented DTI, morphological, electrophysiological and behavioral impairments in EAE-mice. Furthermore, daily infusions of minocycline specifically within the dentate gyrus were sufficient to prevent memory impairment in EAE-mice while infusions of minocycline within CA1 were inefficient. We conclude that early memory impairment in EAE is due to a selective disruption of the dentate gyrus associated with microglia activation. These results open new pathophysiological, imaging, and therapeutic perspectives for memory impairment in multiple sclerosis.
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Mancini A, Gaetani L, Di Gregorio M, Tozzi A, Ghiglieri V, Calabresi P, Di Filippo M. Hippocampal neuroplasticity and inflammation: relevance for multiple sclerosis. ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s40893-017-0019-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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32
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Contribution of Gray and White Matter Abnormalities to Cognitive Impairment in Multiple Sclerosis. Int J Mol Sci 2016; 18:ijms18010046. [PMID: 28035997 PMCID: PMC5297681 DOI: 10.3390/ijms18010046] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/10/2016] [Accepted: 12/16/2016] [Indexed: 02/05/2023] Open
Abstract
Patients with multiple sclerosis (MS) commonly exhibit cognitive impairments (CI). However, the neural mechanisms underlying CI remain unclear. The current study applied diffusion tensor imaging (DTI) and voxel-based morphometric (VBM) magnetic resonance imaging (MRI) techniques to evaluate differences in white matter (WM) integrity and gray matter (GM) volume between MS patients with CI and MS patients with cognitive preservation (CP). Neuropsychological assessment and MRI were obtained from 39 relapsing-remitting MS (RRMS) patients and 29 healthy controls (HCs). Patients were classified as CI or CP according to cognitive ability, and demographic characteristics and MRI images were compared. Compared with HCs, MS patients exhibited widespread damage in WM integrity, and GM loss in several regions. Compared with CP patients, CI patients exhibited more extensive WM impairments, particularly in the corpus callosum, cerebellar peduncle, corona radiata, optic radiation, superior longitudinal fasciculus, anterior limb of the internal capsule, and cingulate, as well as decreased GM volume in the bilateral caudate, left insula and right temporal lobe. MS patients with CI exhibited more significant structural abnormalities than those with CP. Widespread impairments of WM integrity and selective GM atrophy both appear to be associated with impaired cognition in RRMS.
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Planche V, Ruet A, Coupé P, Lamargue-Hamel D, Deloire M, Pereira B, Manjon JV, Munsch F, Moscufo N, Meier DS, Guttmann CR, Dousset V, Brochet B, Tourdias T. Hippocampal microstructural damage correlates with memory impairment in clinically isolated syndrome suggestive of multiple sclerosis. Mult Scler 2016; 23:1214-1224. [PMID: 27780913 DOI: 10.1177/1352458516675750] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We investigated whether diffusion tensor imaging (DTI) could reveal early hippocampal damage and clinically relevant correlates of memory impairment in persons with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS). METHODS A total of 37 persons with CIS, 32 with MS and 36 controls prospectively included from 2011 to 2014 were tested for cognitive performances and scanned with 3T-magnetic resonance imaging (MRI) to assess volumetric and DTI changes within the hippocampus, whole brain volume and T2-lesion load. RESULTS While there was no hippocampal atrophy in the CIS group, hippocampal fractional anisotropy (FA) was significantly decreased compared to controls. Decrease in hippocampal FA together with increased mean diffusivity (MD) was even more prominent in MS patients. In CIS, hippocampal MD was correlated with episodic verbal memory performance ( r = -0.57, p = 0.0002 and odds ratio (OR) = 0.058, 95% confidence interval (CI) = 0.0057-0.59, p = 0.016 adjusted for age, gender, depression and T2-lesion load), but not with cognitive tasks unrelated to hippocampal functions. Hippocampal MD was the only variable discriminating memory-impaired from memory-preserved persons with CIS (area under the curve (AUC) = 0.77, sensitivity = 90.0%, specificity = 70.3%, positive predictive value (PPV) = 52.9%, negative predictive value (NPV) = 95.0%). CONCLUSION DTI alterations within the hippocampus might reflect early neurodegenerative processes that are correlated with episodic memory performance, discriminating persons with CIS according to their memory status.
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Affiliation(s)
- Vincent Planche
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Aurélie Ruet
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Pierrick Coupé
- Laboratoire Bordelais de Recherche en Informatique (LaBRI), Talence, France
| | - Delphine Lamargue-Hamel
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France
| | - Mathilde Deloire
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Bruno Pereira
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - José V Manjon
- Universitat Politècnica de València, Valencia, Spain
| | - Fanny Munsch
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France
| | - Nicola Moscufo
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dominik S Meier
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Charles Rg Guttmann
- Universite de Bordeaux, Bordeaux, France/Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Vincent Dousset
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Bruno Brochet
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Thomas Tourdias
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
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Paul F. Pathology and MRI: exploring cognitive impairment in MS. Acta Neurol Scand 2016; 134 Suppl 200:24-33. [PMID: 27580903 DOI: 10.1111/ane.12649] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2016] [Indexed: 01/24/2023]
Abstract
Cognitive impairment is a frequent symptom in people with multiple sclerosis, affecting up to 70% of patients. This article reviews the published association of cognitive dysfunction with neuroimaging findings. Cognitive impairment has been related to focal T2 hyperintense lesions, diffuse white matter damage and corical and deep gray matter atrophy. Focal lesions cannot sufficiently explain cognitive dysfunction in MS; microstructural tissue damage detectable by diffusion tensor imaging and gray matter atrophy are probably at least as relevant. Resting state functional magnetic resonance imaging is increasingly used to investigate the contribution of functional connectivity changes to cognitive function in MS. The fact that at least one third of MS patients are not overtly cognitively impaired despite significant radiographic tissue damage argues for protective factors (brain reserve, cognitive reserve) that require further clarification. It is concluded that the reported correlations between imaging findings and cognitive function do not imply causality. Well conceived and sufficiently powered longitudinal studies are lacking. Such studies would help unravel protective mechanisms against cogniitve decline and identify suitable imaging techniques to monitor cognitive function in individual patients with MS.
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Affiliation(s)
- F. Paul
- NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center; Department of Neurology; Charité - Universitaetsmedizin Berlin; Berlin Germany
- Experimental and Clinical Research Center; Max Delbrueck Center for Molecular Medicine and Charité - Universitaetsmedizin Berlin; Berlin Germany
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Keser Z, Hasan KM, Mwangi B, Gabr RE, Steinberg JL, Wilken J, Wolinsky JS, Nelson FM. Limbic Pathway Correlates of Cognitive Impairment in Multiple Sclerosis. J Neuroimaging 2016; 27:37-42. [PMID: 27541485 DOI: 10.1111/jon.12381] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 07/05/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Distinct injuries to various limbic white matter pathways have been reported to be associated with different aspects of cognitive dysfunction in multiple sclerosis (MS). Diffusion tensor imaging (DTI) offers a noninvasive method to map tissue microstructural organization. We utilized quantitative magnetic resonance imaging methods to analyze the main limbic system-white matter structures in MS patients with cognitive impairment (CI). METHODS Ten cognitively nonimpaired MS (MSNI) patients and 36 patients with diagnosed CI (MSCI) underwent the minimal assessment of Cognitive Function in MS (MACFIMS) battery. DTI measures of fornix, cingulum, uncinate fasciculus (UF) included tract volume and corresponding fractional anisotropy (FA), mean (MD), axial (AD), and radial (AD) diffusivities. These were statistically analyzed for associations with CI after adjusting for the confounders. RESULTS Fornix FA and RD, left cingulum FA, MD, and RD, right cingulum FA, MD, and RD, and left UF FA showed significant differences between MSNI and MSCI (P < .001). Fornix FA (r = -.6) and RD (r = .52), and right cingulum FA (r = -.54) and RD (r = .5) correlated significantly with CI in regression analyses. CONCLUSIONS The extent of disruption of microstructural disorganization in the main limbic pathways using DTI impacts the extent of CI seen in subjects with MS.
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Affiliation(s)
- Zafer Keser
- Department of Neurology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Khader M Hasan
- Department of Interventional and Diagnostic Radiology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Benson Mwangi
- UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Refaat E Gabr
- Department of Interventional and Diagnostic Radiology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Joel L Steinberg
- Collaborative Advanced Research Imaging Center for Clinical and Translational Research, Houston, TX, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
| | - Jeffrey Wilken
- Department of Neurology, Georgetown University Medical Center, Washington, DC
| | - Jerry S Wolinsky
- Department of Neurology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Flavia M Nelson
- Department of Neurology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
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Filley CM, Fields RD. White matter and cognition: making the connection. J Neurophysiol 2016; 116:2093-2104. [PMID: 27512019 DOI: 10.1152/jn.00221.2016] [Citation(s) in RCA: 242] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 08/04/2016] [Indexed: 12/14/2022] Open
Abstract
Whereas the cerebral cortex has long been regarded by neuroscientists as the major locus of cognitive function, the white matter of the brain is increasingly recognized as equally critical for cognition. White matter comprises half of the brain, has expanded more than gray matter in evolution, and forms an indispensable component of distributed neural networks that subserve neurobehavioral operations. White matter tracts mediate the essential connectivity by which human behavior is organized, working in concert with gray matter to enable the extraordinary repertoire of human cognitive capacities. In this review, we present evidence from behavioral neurology that white matter lesions regularly disturb cognition, consider the role of white matter in the physiology of distributed neural networks, develop the hypothesis that white matter dysfunction is relevant to neurodegenerative disorders, including Alzheimer's disease and the newly described entity chronic traumatic encephalopathy, and discuss emerging concepts regarding the prevention and treatment of cognitive dysfunction associated with white matter disorders. Investigation of the role of white matter in cognition has yielded many valuable insights and promises to expand understanding of normal brain structure and function, improve the treatment of many neurobehavioral disorders, and disclose new opportunities for research on many challenging problems facing medicine and society.
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Affiliation(s)
- Christopher M Filley
- Behavioral Neurology Section, Departments of Neurology and Psychiatry, University of Colorado School of Medicine, Aurora, Colorado; .,Denver Department of Veterans Affairs Medical Center, Denver, Colorado; and
| | - R Douglas Fields
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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Baumann PS, Griffa A, Fournier M, Golay P, Ferrari C, Alameda L, Cuenod M, Thiran JP, Hagmann P, Do KQ, Conus P. Impaired fornix-hippocampus integrity is linked to peripheral glutathione peroxidase in early psychosis. Transl Psychiatry 2016; 6:e859. [PMID: 27459724 PMCID: PMC5545707 DOI: 10.1038/tp.2016.117] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 03/17/2016] [Accepted: 04/15/2016] [Indexed: 12/19/2022] Open
Abstract
Several lines of evidence implicate the fornix-hippocampus circuit in schizophrenia. In early-phase psychosis, this circuit has not been extensively investigated and the underlying mechanisms affecting the circuit are unknown. The hippocampus and fornix are vulnerable to oxidative stress at peripuberty in a glutathione (GSH)-deficient animal model. The purposes of the current study were to assess the integrity of the fornix-hippocampus circuit in early-psychosis patients (EP), and to study its relationship with peripheral redox markers. Diffusion spectrum imaging and T1-weighted magnetic resonance imaging (MRI) were used to assess the fornix and hippocampus in 42 EP patients compared with 42 gender- and age-matched healthy controls. Generalized fractional anisotropy (gFA) and volumetric properties were used to measure fornix and hippocampal integrity, respectively. Correlation analysis was used to quantify the relationship of gFA in the fornix and hippocampal volume, with blood GSH levels and glutathione peroxidase (GPx) activity. Patients compared with controls exhibited lower gFA in the fornix as well as smaller volume in the hippocampus. In EP, but not in controls, smaller hippocampal volume was associated with high GPx activity. Disruption of the fornix-hippocampus circuit is already present in the early stages of psychosis. Higher blood GPx activity is associated with smaller hippocampal volume, which may support a role of oxidative stress in disease mechanisms.
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Affiliation(s)
- P S Baumann
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - A Griffa
- Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - M Fournier
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - P Golay
- Department of Psychiatry, Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Service of Community Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - C Ferrari
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - L Alameda
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - M Cuenod
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - J-P Thiran
- Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - P Hagmann
- Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - K Q Do
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - P Conus
- Department of Psychiatry, Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Yousuf F, Kim G, Tauhid S, Glanz BI, Chu R, Tummala S, Healy BC, Bakshi R. The Contribution of Cortical Lesions to a Composite MRI Scale of Disease Severity in Multiple Sclerosis. Front Neurol 2016; 7:99. [PMID: 27445966 PMCID: PMC4925661 DOI: 10.3389/fneur.2016.00099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/13/2016] [Indexed: 12/28/2022] Open
Abstract
Objective To test a new version of the Magnetic Resonance Disease Severity Scale (v.3 = MRDSS3) for multiple sclerosis (MS), incorporating cortical gray matter lesions (CLs) from 3T magnetic resonance imaging (MRI). Background MRDSS1 was a cerebral MRI-defined composite scale of MS disease severity combining T2 lesion volume (T2LV), the ratio of T1 to T2LV (T1/T2), and whole brain atrophy [brain parenchymal fraction (BPF)]. MRDSS2 expanded the scale to include cerebral gray matter fraction (GMF) and upper cervical spinal cord area (UCCA). We tested the contribution of CLs to the scale (MRDSS3) in modeling the MRI relationship to clinical status. Methods We studied 51 patients [3 clinically isolated syndrome, 43 relapsing-remitting, 5 progressive forms, age (mean ± SD) 40.7 ± 9.1 years, Expanded Disability Status Scale (EDSS) score 1.6 ± 1.7] and 20 normal controls by high-resolution cerebrospinal MRI. CLs required visibility on both fluid-attenuated inversion-recovery (FLAIR) and modified driven equilibrium Fourier transform sequences. The MACFIMS battery defined cognitively impaired (n = 18) vs. preserved (n = 33) MS subgroups. Results EDSS significantly correlated with only BPF, UCCA, MRDSS2, and MRDSS3 (all p < 0.05). After adjusting for depressive symptoms, the cognitively impaired group had higher severity of MRI metrics than the cognitively preserved group in regard to only BPF, GMF, T1/T2, MRDSS1, and MRDSS2 (all p < 0.05). CL number was not significantly related to EDSS score or cognition status. Conclusion CLs from 3T MRI did not appear to improve the validity of the MRDSS. Further studies employing advanced sequences or higher field strengths may show more utility for the incorporation of CLs into composite scales.
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Affiliation(s)
- Fawad Yousuf
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Laboratory for Neuroimaging Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gloria Kim
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Laboratory for Neuroimaging Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Shahamat Tauhid
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Laboratory for Neuroimaging Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bonnie I Glanz
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Renxin Chu
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Laboratory for Neuroimaging Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Subhash Tummala
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Laboratory for Neuroimaging Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brian C Healy
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rohit Bakshi
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Laboratory for Neuroimaging Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Ernst A, Noblet V, Gounot D, Blanc F, de Seze J, Manning L. Neural correlates of episodic future thinking impairment in multiple sclerosis patients. J Clin Exp Neuropsychol 2016; 37:1107-23. [PMID: 26378725 DOI: 10.1080/13803395.2015.1080228] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Recent clinical investigations showed impaired episodic future thinking (EFT) abilities in multiple sclerosis (MS) patients. On these bases, the aim of the current study was to explore the structural and functional correlates of EFT impairment in nondepressed MS patients. METHOD Twenty-one nondepressed MS patients and 20 matched healthy controls were assessed with the adapted Autobiographical Interview (AI), and patients were selected on the bases of an EFT impaired score criterion. The 41 participants underwent a functional magnetic resonance imaging (fMRI) session, distinguishing the construction and elaboration phases of the experimental EFT, and the categorical control tests. Structural images were also acquired. RESULTS During the EFT fMRI task, increased cerebral activations were observed in patients (relative to healthy controls) within the EFT core network. These neural changes were particularly important during the construction phase of future events and involved mostly the prefrontal region. This was accompanied by an increased neural response mostly in anterior, and also posterior, cerebral regions, in association with the amount of detail produced by patients. In parallel, structural measures corroborated a main positive association between the prefrontal regions' volume and EFT performance. However, no association between the hippocampus and EFT performance was observed in patients, at both structural and functional levels. CONCLUSION We have documented significant overlaps between the structural and functional underpinnings of EFT impairment, with a main role of the prefrontal region in its clinical expression in MS patients.
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Affiliation(s)
- Alexandra Ernst
- a Cognitive Neuropsychology and Physiopathology of Schizophrenia (INSERM UMR 1114) , Strasbourg University , Strasbourg , France
| | - Vincent Noblet
- c ICube (CNRS UMR 7357) , Strasbourg University , Strasbourg , France.,d Fédération de Médecine translationnelle de Strasbourg (FMTS) , Strasbourg , France
| | - Daniel Gounot
- c ICube (CNRS UMR 7357) , Strasbourg University , Strasbourg , France
| | - Frédéric Blanc
- b Department of Neurology and Centre Mémoire de Ressources et de Recherche (CMRR) , University Hospital of Strasbourg , Strasbourg , France.,c ICube (CNRS UMR 7357) , Strasbourg University , Strasbourg , France.,d Fédération de Médecine translationnelle de Strasbourg (FMTS) , Strasbourg , France
| | - Jérôme de Seze
- b Department of Neurology and Centre Mémoire de Ressources et de Recherche (CMRR) , University Hospital of Strasbourg , Strasbourg , France.,e Clinical Investigation Centre (CIC, INSERM 1434), University Hospital of Strasbourg , Strasbourg , France
| | - Liliann Manning
- a Cognitive Neuropsychology and Physiopathology of Schizophrenia (INSERM UMR 1114) , Strasbourg University , Strasbourg , France
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Popescu V, Schoonheim MM, Versteeg A, Chaturvedi N, Jonker M, Xavier de Menezes R, Gallindo Garre F, Uitdehaag BMJ, Barkhof F, Vrenken H. Grey Matter Atrophy in Multiple Sclerosis: Clinical Interpretation Depends on Choice of Analysis Method. PLoS One 2016; 11:e0143942. [PMID: 26745873 PMCID: PMC4706325 DOI: 10.1371/journal.pone.0143942] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/11/2015] [Indexed: 11/27/2022] Open
Abstract
Background Studies disagree on the location of grey matter (GM) atrophy in the multiple sclerosis (MS) brain. Aim To examine the consistency between FSL, FreeSurfer, SPM for GM atrophy measurement (for volumes, patient/control discrimination, and correlations with cognition). Materials and Methods 127 MS patients and 50 controls were included and cortical and deep grey matter (DGM) volumetrics were performed. Consistency of volumes was assessed with Intraclass Correlation Coefficient/ICC. Consistency of patients/controls discrimination was assessed with Cohen’s d, t-tests, MANOVA and a penalized double-loop logistic classifier. Consistency of association with cognition was assessed with Pearson correlation coefficient and ANOVA. Voxel-based morphometry (SPM-VBM and FSL-VBM) and vertex-wise FreeSurfer were used for group-level comparisons. Results The highest volumetry ICC were between SPM and FreeSurfer for cortical regions, and the lowest between SPM and FreeSurfer for DGM. The caudate nucleus and temporal lobes had high consistency between all software, while amygdala had lowest volumetric consistency. Consistency of patients/controls discrimination was largest in the DGM for all software, especially for thalamus and pallidum. The penalized double-loop logistic classifier most often selected the thalamus, pallidum and amygdala for all software. FSL yielded the largest number of significant correlations. DGM yielded stronger correlations with cognition than cortical volumes. Bilateral putamen and left insula volumes correlated with cognition using all methods. Conclusion GM volumes from FreeSurfer, FSL and SPM are different, especially for cortical regions. While group-level separation between MS and controls is comparable, correlations between regional GM volumes and clinical/cognitive variables in MS should be cautiously interpreted.
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Affiliation(s)
- Veronica Popescu
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Menno M. Schoonheim
- Department of Anatomy and Neurosciences, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan Versteeg
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Nimisha Chaturvedi
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Marianne Jonker
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Renee Xavier de Menezes
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Francisca Gallindo Garre
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Bernard M. J. Uitdehaag
- Department of Neurology, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
- Department of Physics and Medical Technology, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
- * E-mail:
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Tariq H. Effect of balance exercises for person with multiple sclerosis using Wii ®game: A systematic review of randomized and non-randomized control trials. ACTA MEDICA INTERNATIONAL 2016. [DOI: 10.5530/ami.2016.1.39] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Detection and quantification of regional cortical gray matter damage in multiple sclerosis utilizing gradient echo MRI. NEUROIMAGE-CLINICAL 2015; 9:164-75. [PMID: 27330979 PMCID: PMC4907986 DOI: 10.1016/j.nicl.2015.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 12/29/2022]
Abstract
Cortical gray matter (GM) damage is now widely recognized in multiple sclerosis (MS). The standard MRI does not reliably detect cortical GM lesions, although cortical volume loss can be measured. In this study, we demonstrate that the gradient echo MRI can reliably and quantitatively assess cortical GM damage in MS patients using standard clinical scanners. High resolution multi-gradient echo MRI was used for regional mapping of tissue-specific MRI signal transverse relaxation rate values (R2(*)) in 10 each relapsing-remitting, primary-progressive and secondary-progressive MS subjects. A voxel spread function method was used to correct artifacts induced by background field gradients. R2(*) values from healthy controls (HCs) of varying ages were obtained to establish baseline data and calculate ΔR2(*) values - age-adjusted differences between MS patients and HC. Thickness of cortical regions was also measured in all subjects. In cortical regions, ΔR2(*) values of MS patients were also adjusted for changes in cortical thickness. Symbol digit modalities (SDMT) and paced auditory serial addition (PASAT) neurocognitive tests, as well as Expanded Disability Status Score, 25-foot timed walk and nine-hole peg test results were also obtained on all MS subjects. We found that ΔR2(*) values were lower in multiple cortical GM and normal appearing white matter (NAWM) regions in MS compared with HC. ΔR2(*) values of global cortical GM and several specific cortical regions showed significant (p < 0.05) correlations with SDMT and PASAT scores, and showed better correlations than volumetric measures of the same regions. Neurological tests not focused on cognition (Expanded Disability Status Score, 25-foot timed walk and nine-hole peg tests) showed no correlation with cortical GM ΔR2(*) values. The technique presented here is robust and reproducible. It requires less than 10 min and can be implemented on any MRI scanner. Our results show that quantitative tissue-specific R2(*) values can serve as biomarkers of tissue injury due to MS in the brain, including the cerebral cortex, an area that has been difficult to evaluate using standard MRI.
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Key Words
- 25FTW, 25-foot timed walk
- 9HPT, Nine-hole peg test
- Cognitive disability
- Cortical gray matter
- EDSS, expanded disability status scale
- GEPCI, gradient echo plural contrast imaging
- GM, gray matter
- HC, healthy control
- MPRAGE, magnetization prepared rapid gradient echo
- MS, multiple sclerosis
- Multiple sclerosis
- NAWM, normal appearing white matter
- NCGMV, normalized cortical gray matter volume
- PASAT, paced auditory serial addition test
- PPMS, primary-progressive multiple sclerosis
- Quantitative
- R2*
- ROI, region of interest
- RRMS, relapsing–remitting multiple sclerosis
- SDMT, symbol digit modalities test
- SPMS, secondary-progressive multiple sclerosis
- WM, white matter
- WMLL, white matter lesion load
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Koenig KA, Sakaie KE, Lowe MJ, Lin J, Stone L, Bermel RA, Beall EB, Rao SM, Trapp BD, Phillips MD. The relationship between cognitive function and high-resolution diffusion tensor MRI of the cingulum bundle in multiple sclerosis. Mult Scler 2015; 21:1794-801. [PMID: 26106010 DOI: 10.1177/1352458515576983] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Imaging can provide noninvasive neural markers of disease progression in multiple sclerosis (MS) that are related to behavioral and cognitive symptoms. Past work suggests that diffusion tensor imaging (DTI) provides a measure of white matter pathology, including demyelination and axonal counts. OBJECTIVES In the current study, the authors investigate the relationship of DTI measures in the cingulum bundle to common deficits in MS, including episodic memory, working memory, and information processing speed. METHODS Fifty-seven patients with MS and 17 age- and education-matched controls underwent high-spatial resolution diffusion scans and cognitive testing. Probabilistic tracking was used to generate tracks from the posterior cingulate cortex to the entorhinal cortex. RESULTS Radial and axial diffusivity values were significantly different between patients and controls (p < 0.031), and in patients bilateral diffusion measures were significantly related to measures of episodic memory and speed of processing (p < 0.033). CONCLUSIONS The tractography-based measures of posterior cingulum integrity reported here support further development of DTI as a viable measure of axonal integrity and cognitive function in patients with MS.
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Affiliation(s)
| | - Ken E Sakaie
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mark J Lowe
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jian Lin
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lael Stone
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Robert A Bermel
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Erik B Beall
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Stephen M Rao
- Schey Center for Cognitive Neuroimaging, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Bruce D Trapp
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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Douet V, Chang L. Fornix as an imaging marker for episodic memory deficits in healthy aging and in various neurological disorders. Front Aging Neurosci 2015; 6:343. [PMID: 25642186 PMCID: PMC4294158 DOI: 10.3389/fnagi.2014.00343] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 12/14/2014] [Indexed: 01/12/2023] Open
Abstract
The fornix is a part of the limbic system and constitutes the major efferent and afferent white matter tracts from the hippocampi. The underdevelopment of or injuries to the fornix are strongly associated with memory deficits. Its role in memory impairments was suggested long ago with cases of surgical forniceal transections. However, recent advances in brain imaging techniques, such as diffusion tensor imaging, have revealed that macrostructural and microstructural abnormalities of the fornix correlated highly with declarative and episodic memory performance. This structure appears to provide a robust and early imaging predictor for memory deficits not only in neurodegenerative and neuroinflammatory diseases, such as Alzheimer's disease and multiple sclerosis, but also in schizophrenia and psychiatric disorders, and during neurodevelopment and “typical” aging. The objective of the manuscript is to present a systematic review regarding published brain imaging research on the fornix, including the development of its tracts, its role in various neurological diseases, and its relationship to neurocognitive performance in human studies.
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Affiliation(s)
- Vanessa Douet
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii Honolulu, HI, USA
| | - Linda Chang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii Honolulu, HI, USA
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DeLuca GC, Yates RL, Beale H, Morrow SA. Cognitive impairment in multiple sclerosis: clinical, radiologic and pathologic insights. Brain Pathol 2015; 25:79-98. [PMID: 25521179 PMCID: PMC8029470 DOI: 10.1111/bpa.12220] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 10/15/2014] [Indexed: 01/18/2023] Open
Abstract
Cognitive impairment is a common and debilitating feature of multiple sclerosis (MS) that has only recent gained considerable attention. Clinical neuropsychological studies have made apparent the multifaceted nature of cognitive troubles often encountered in MS and continue to broaden our understanding of its complexity. Radiographic studies have started to decipher the neuroanatomic substrate of MS-related cognitive impairment and have shed light onto its pathogenesis. Where radiographic studies have been limited by inadequate resolution or non-specificity, pathological studies have come to the fore. This review aims to provide an overview of the nature of cognitive impairment typically seen in MS and to explore the literature on imaging and pathological studies relevant to its evolution. In particular, the relative contributions of gray (i.e., cerebral cortex, hippocampus, thalamus and basal ganglia) and white matter to MS-related cognitive impairment will be discussed and the importance of interconnectivity between structures highlighted. The pressing need for longitudinal studies combining standardized neuropsychometric, paraclinical and radiographic outcomes obtained during life with post-mortem tissue analysis after death is presented.
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Affiliation(s)
- Gabriele C. DeLuca
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Richard L. Yates
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Harry Beale
- Oxford Medical SchoolUniversity of OxfordOxfordUK
| | - Sarah A. Morrow
- Department of Clinical Neurological SciencesThe University of Western OntarioLondonCanada
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Kern KC, Gold SM, Lee B, Montag M, Horsfall J, O'Connor MF, Sicotte NL. Thalamic-hippocampal-prefrontal disruption in relapsing-remitting multiple sclerosis. NEUROIMAGE-CLINICAL 2014; 8:440-7. [PMID: 26106524 PMCID: PMC4473119 DOI: 10.1016/j.nicl.2014.12.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 07/06/2014] [Accepted: 12/21/2014] [Indexed: 01/22/2023]
Abstract
Background Cortical, thalamic and hippocampal gray matter atrophy in relapsing–remitting MS (RRMS) is associated cognitive deficits. However, the role of interconnecting white matter pathways including the fornix, cingulum, and uncinate fasciculus (UF) is less well studied. Objective To assess MS damage to a hippocampal–thalamic–prefrontal network and the relative contributions of its components to specific cognitive domains. Methods We calculated diffusion tensor fractional anisotropy (FA) in the fornix, cingulum and UF as well as thalamic and hippocampal volumes in 27 RRMS patients and 20 healthy controls. A neuropsychological battery was administered and 4 core tests known to be sensitive to MS changes were used to assess cognitive impairment. To determine the relationships between structure and cognition, all tests were grouped into 4 domains: attention/executive function, processing speed, verbal memory, and spatial memory. Univariate correlations with structural measures and depressive symptoms identified potential contributors to cognitive performance and subsequent linear regression determined their relative effects on performance in each domain. For significant predictors, we also explored the effects of laterality and axial versus radial diffusivity. Results RRMS patients had worse performance on the Symbol Digit Modalities Test, but no significant impairment in the 4 cognitive domains. RRMS had reduced mean FA of all 3 pathways and reduced thalamic and hippocampal volumes compared to controls. In RRMS we found that thalamic volume and BDI predicted attention/executive function, UF FA predicted processing speed, thalamic volume predicted verbal memory, and UF FA and BDI predicted spatial memory. Conclusions Hippocampal–thalamic–prefrontal disruption affects cognitive performance in early RRMS with mild to minimal cognitive impairment, confirming both white and gray matter involvement in MS and demonstrating utility in assessing functional networks to monitor cognition. We detect limbic white matter and gray matter insult in early RRMS patients with mild to minimal cognitive impairment. Thalamic atrophy and uncinate fasciculus microstructural changes are associated with cognitive performance in early RRMS. Depressive symptomatology also independently predicts cognitive performance
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Key Words
- AD, axial diffusivity
- BDI, Beck Depression Inventory
- BSRT, Buschke Selective Reminding Test
- BVMT, Brief Visuospatial Memory Test
- BVRT, Benton Visual Retention Test
- CVLT-II, California Verbal Learning Test II
- Cognition
- DTI, diffusion tensor imaging
- Diffusion tensor imaging
- EDSS, Expanded Disability Status Scale
- FA, fractional anisotropy
- FAST, FMRIB's Automated Segmentation Tool
- FLAIR, Fluid Attenuated Inversion Recovery
- FOV, field of view
- FSL, Functional MRI of the Brain Software Library
- GM, gray matter
- Limbic system
- MPRAGE, Magnetization Prepared Rapid Acquisition Gradient Echo
- MRI
- MRI, magnetic resonance image
- Memory
- Multiple sclerosis
- NEX, number of excitations
- PASAT, Paced Auditory Serial Addition Test
- RAVLT, Rey Auditory Verbal Learning Test
- RD, radial diffusivity
- ROI, region of interest
- RRMS, relapsing remitting multiple sclerosis
- SDMT, Symbol Digit Modalities Test
- TBSS, Tract-based Spatial Statistics
- TE, echo time
- TI, inversion time
- TR, repetition time
- UF, uncinate fasciculus
- WAIS, Wechsler Adult Intelligence Scale
- WM, white matter.
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Affiliation(s)
- Kyle C. Kern
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Stefan M. Gold
- Institute for Neuroimmunology and Clinical Multiple Sclerosis Research, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Brian Lee
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Michael Montag
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Jessica Horsfall
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Nancy L. Sicotte
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
- Corresponding Author: Department of Neurology, Cedars-Sinai Medical Center, Rm 6414, 127 S. San Vicente Blvd., AHSP, Los Angeles, CA 90048, USA. Tel.:1-310 423 1320.
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Di Filippo M, de Iure A, Durante V, Gaetani L, Mancini A, Sarchielli P, Calabresi P. Synaptic plasticity and experimental autoimmune encephalomyelitis: implications for multiple sclerosis. Brain Res 2014; 1621:205-13. [PMID: 25498984 DOI: 10.1016/j.brainres.2014.12.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 11/26/2014] [Accepted: 12/01/2014] [Indexed: 12/22/2022]
Abstract
Structural and functional neuronal plasticity could play a crucial role during the course of multiple sclerosis (MS). The immune system and the central nervous system (CNS) strictly interact in physiologic conditions and during inflammation to modulate neuroplasticity and in particular the ability of the synapses to undergo long-term changes in the efficacy of synaptic transmission, such as long-term potentiation (LTP). During MS, neuro-inflammation might deeply influence the ability of neuronal networks to express physiologic plasticity, reducing the plastic reserve of the brain, with a negative impact on symptoms progression and cognitive performances. In this manuscript we review the evidence on synaptic plasticity alterations in experimental autoimmune encephalomyelitis (EAE), the most diffuse and widely utilized experimental model of MS, together with their potential underlying mechanisms and clinical relevance. This article is part of a Special Issue entitled SI: Brain and Memory.
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Affiliation(s)
- Massimiliano Di Filippo
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy.
| | - Antonio de Iure
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy
| | - Valentina Durante
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy
| | - Lorenzo Gaetani
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy
| | - Andrea Mancini
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy
| | - Paola Sarchielli
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy
| | - Paolo Calabresi
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy; IRCCS Fondazione S Lucia, Rome, Italy
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Efficacy of the selective progesterone receptor agonist Nestorone for chronic experimental autoimmune encephalomyelitis. J Neuroimmunol 2014; 276:89-97. [DOI: 10.1016/j.jneuroim.2014.08.619] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/14/2014] [Accepted: 08/19/2014] [Indexed: 11/17/2022]
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