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Santini T, Chen C, Zhu W, Liou JJ, Walker E, Venkatesh S, Farhat N, Sajewski A, Alkhateeb S, Saranathan M, Xia Z, Ibrahim TS. Hippocampal subfields and thalamic nuclei associations with clinical outcomes in multiple sclerosis: An ultrahigh field MRI study. Mult Scler Relat Disord 2024; 86:105520. [PMID: 38582026 PMCID: PMC11081814 DOI: 10.1016/j.msard.2024.105520] [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: 11/03/2023] [Revised: 02/14/2024] [Accepted: 02/25/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Previous studies have shown that thalamic and hippocampal neurodegeneration is associated with clinical decline in Multiple Sclerosis (MS). However, contributions of the specific thalamic nuclei and hippocampal subfields require further examination. OBJECTIVE Using 7 Tesla (7T) magnetic resonance imaging (MRI), we investigated the cross-sectional associations between functionally grouped thalamic nuclei and hippocampal subfields volumes and T1 relaxation times (T1-RT) and subsequent clinical outcomes in MS. METHODS High-resolution T1-weighted and T2-weighted images were acquired at 7T (n=31), preprocessed, and segmented using the Thalamus Optimized Multi Atlas Segmentation (THOMAS, for thalamic nuclei) and the Automatic Segmentation of Hippocampal Subfields (ASHS, for hippocampal subfields) packages. We calculated Pearson correlations between hippocampal subfields and thalamic nuclei volumes and T1-RT and subsequent multi-modal rater-determined and patient-reported clinical outcomes (∼2.5 years after imaging acquisition), correcting for confounders and multiple tests. RESULTS Smaller volume bilaterally in the anterior thalamus region correlated with worse performance in gait function, as measured by the Patient Determined Disease Steps (PDDS). Additionally, larger volume in most functional groups of thalamic nuclei correlated with better visual information processing and cognitive function, as measured by the Symbol Digit Modalities Test (SDMT). In bilateral medial and left posterior thalamic regions, there was an inverse association between volumes and T1-RT, potentially indicating higher tissue degeneration in these regions. We also observed marginal associations between the right hippocampal subfields (both volumes and T1-RT) and subsequent clinical outcomes, though they did not survive correction for multiple testing. CONCLUSION Ultrahigh field MRI identified markers of structural damage in the thalamic nuclei associated with subsequently worse clinical outcomes in individuals with MS. Longitudinal studies will enable better understanding of the role of microstructural integrity in these brain regions in influencing MS outcomes.
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Affiliation(s)
- Tales Santini
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Chenyi Chen
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Wen Zhu
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jr-Jiun Liou
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Elizabeth Walker
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shruthi Venkatesh
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Nadim Farhat
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea Sajewski
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Salem Alkhateeb
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States.
| | - Tamer S Ibrahim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States.
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Song Y, Jiang W, Afridi SK, Wang T, Zhu F, Xu H, Nazir FH, Liu C, Wang Y, Long Y, Huang YWA, Qiu W, Tang C. Astrocyte-derived CHI3L1 signaling impairs neurogenesis and cognition in the demyelinated hippocampus. Cell Rep 2024; 43:114226. [PMID: 38733586 DOI: 10.1016/j.celrep.2024.114226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Cognitive dysfunction is a feature in multiple sclerosis (MS), a chronic inflammatory demyelinating disorder. A notable aspect of MS brains is hippocampal demyelination, which is closely associated with cognitive decline. However, the mechanisms underlying this phenomenon remain unclear. Chitinase-3-like (CHI3L1), secreted by activated astrocytes, has been identified as a biomarker for MS progression. Our study investigates CHI3L1's function within the demyelinating hippocampus and demonstrates a correlation between CHI3L1 expression and cognitive impairment in patients with MS. Activated astrocytes release CHI3L1 in reaction to induced demyelination, which adversely affects the proliferation and differentiation of neural stem cells and impairs dendritic growth, complexity, and spine formation in neurons. Our findings indicate that the astrocytic deletion of CHI3L1 can mitigate neurogenic deficits and cognitive dysfunction. We showed that CHI3L1 interacts with CRTH2/receptor for advanced glycation end (RAGE) by attenuating β-catenin signaling. The reactivation of β-catenin signaling can revitalize neurogenesis, which holds promise for therapy of inflammatory demyelination.
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Affiliation(s)
- Yanna Song
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Wei Jiang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Shabbir Khan Afridi
- State Key Laboratory for Molecular and Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Tongtong Wang
- Department of Clinical Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Fan Zhu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Huiming Xu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Faisal Hayat Nazir
- Nash Family Department of Neuroscience, Ronald M. Loeb Center for Alzheimer's Disease, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chunxin Liu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Youming Long
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, 250 Changgang East Road, Guangzhou 510260, Guangdong Province, China; Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, 250 Changgang East Road, Guangzhou 510260, Guangdong Province, China
| | - Yu-Wen Alvin Huang
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, 70 Ship Street, Providence, RI 02903, USA
| | - Wei Qiu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China.
| | - Changyong Tang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China; Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510630, China.
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Cortese R, Battaglini M, Stromillo ML, Luchetti L, Leoncini M, Gentile G, Gasparini D, Plantone D, Altieri M, D'Ambrosio A, Gallo A, Giannì C, Piervincenzi C, Pantano P, Pagani E, Valsasina P, Preziosa P, Tedone N, Rocca MA, Filippi M, De Stefano N. Regional hippocampal atrophy reflects memory impairment in patients with early relapsing remitting multiple sclerosis. J Neurol 2024:10.1007/s00415-024-12290-8. [PMID: 38743090 DOI: 10.1007/s00415-024-12290-8] [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: 10/26/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Research work has shown that hippocampal subfields are atrophic to varying extents in multiple sclerosis (MS) patients. However, studies examining the functional implications of subfield-specific hippocampal damage in early MS are limited. We aim to gain insights into the relationship between hippocampal atrophy and memory function by investigating the correlation between global and regional hippocampal atrophy and memory performance in early MS patients. METHODS From the Italian Neuroimaging Network Initiative (INNI) dataset, we selected 3D-T1-weighted brain MRIs of 219 early relapsing remitting (RR)MS and 246 healthy controls (HC) to identify hippocampal atrophic areas. At the time of MRI, patients underwent Selective-Reminding-Test (SRT) and Spatial-Recall-Test (SPART) and were classified as mildly (MMI-MS: n.110) or severely (SMI-MS: n:109) memory impaired, according to recently proposed cognitive phenotypes. RESULTS Early RRMS showed lower hippocampal volumes compared to HC (p < 0.001), while these did not differ between MMI-MS and SMI-MS. In MMI-MS, lower hippocampal volumes correlated with worse memory tests (r = 0.23-0.37, p ≤ 0.01). Atrophic voxels were diffuse in the hippocampus but more prevalent in cornu ammonis (CA, 79%) than in tail (21%). In MMI-MS, decreased subfield volumes correlated with decreases in memory, particularly in the right CA1 (SRT-recall: r = 0.38; SPART: r = 0.34, p < 0.01). No correlations were found in the SMI-MS group. CONCLUSION Hippocampal atrophy spreads from CA to tail from early disease stages. Subfield hippocampal atrophy is associated with memory impairment in MMI-MS, while this correlation is lost in SMI-MS. This plays in favor of a limited capacity for an adaptive functional reorganization of the hippocampi in MS patients.
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Affiliation(s)
- Rosa Cortese
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Marco Battaglini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
- SIENA Imaging SRL, 53100, Siena, Italy
| | - Maria Laura Stromillo
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Ludovico Luchetti
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
- SIENA Imaging SRL, 53100, Siena, Italy
| | - Matteo Leoncini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
- SIENA Imaging SRL, 53100, Siena, Italy
| | - Giordano Gentile
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
- SIENA Imaging SRL, 53100, Siena, Italy
| | - Daniele Gasparini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Domenico Plantone
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Manuela Altieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia, 2, 80138, Naples, Italy
| | - Alessandro D'Ambrosio
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia, 2, 80138, Naples, Italy
| | - Antonio Gallo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia, 2, 80138, Naples, Italy
| | - Costanza Giannì
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, IS, Italy
| | | | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, IS, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Valsasina
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Preziosa
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Nicolo' Tedone
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Assunta Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy.
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Meira T, Coelho A, Onat S, Ruano L, Cerqueira JJ. One-year regional brain volume changes as potential predictors of cognitive function in multiple sclerosis: a pilot study. Ir J Med Sci 2024; 193:957-965. [PMID: 37773245 PMCID: PMC10961282 DOI: 10.1007/s11845-023-03528-x] [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: 08/17/2023] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The most reliable magnetic resonance imaging (MRI) marker of cognitive dysfunction in multiple sclerosis (MS) is brain atrophy. However, 1-year volumetric changes prior to cognitive assessment were never studied as potential predictors of cognition, which we aim to assess with this pilot work. METHODS Twenty-two MS patients were submitted to a baseline measure of 83 regional brain volumes with MRI and re-evaluated 1 year later; they were also tested with the Brief International Cognitive Assessment for MS (BICAMS): sustained attention and processing speed were examined with the Symbol Digit Modalities Test (SDMT), verbal and visuo-spatial learning and memory with the learning trials from the California Verbal Learning Test-II (CVLT) and the Brief Visuo-spatial Memory Test-revised (BVMT), respectively. Controlling for age, sex, and years of education, a multivariate linear regression model was created for each cognitive score at 1-year follow-up in a backward elimination manner, considering cross-sectional regional volumes and 1-year volume changes as potential predictors. RESULTS Decreases in the volumes of the left amygdala and the right lateral orbitofrontal cortex in the year prior to assessment were identified as possible predictors of worse performance in verbal memory (P = 0.009) and visuo-spatial memory (P = 0.001), respectively, independently of cross-sectional brain regional volumes at time of testing. CONCLUSION Our work reveals novel 1-year regional brain volume changes as potential predictors of cognitive deficits in MS. This suggests a possible role of these regions in such deficits and might contribute to uncover cognitively deteriorating patients, whose detection is still unsatisfying in clinical practice.
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Affiliation(s)
- Torcato Meira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710-057, Braga, Portugal
- Neuroradiology Department, Hospital de Braga, Rua da Comunidades Lusíadas 133, Braga, Portugal
| | - Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710-057, Braga, Portugal
| | - Seyda Onat
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710-057, Braga, Portugal
| | - Luís Ruano
- Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Rua Dr. Cândido Pinho 5, 4520-211, Santa Maria da Feira, Portugal
- EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal
| | - João José Cerqueira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710-057, Braga, Portugal.
- Neurology Department, Hospital de Braga, Rua da Comunidades Lusíadas 133, Braga, Portugal.
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Preziosa P, Pagani E, Meani A, Storelli L, Margoni M, Yudin Y, Tedone N, Biondi D, Rubin M, Rocca MA, Filippi M. Chronic Active Lesions and Larger Choroid Plexus Explain Cognition and Fatigue in Multiple Sclerosis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200205. [PMID: 38350048 DOI: 10.1212/nxi.0000000000200205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/18/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND AND OBJECTIVES Chronic inflammation may contribute to cognitive dysfunction and fatigue in patients with multiple sclerosis (MS). Paramagnetic rim lesions (PRLs) and choroid plexus (CP) enlargement have been proposed as markers of chronic inflammation in MS being associated with a more severe disease course. However, their relation with cognitive impairment and fatigue has not been fully explored yet. Here, we investigated the contribution of PRL number and volume and CP enlargement to cognitive impairment and fatigue in patients with MS. METHODS Brain 3T MRI, neurologic evaluation, and neuropsychological assessment, including the Brief Repeatable Battery of Neuropsychological Tests and Modified Fatigue Impact Scale, were obtained from 129 patients with MS and 73 age-matched and sex-matched healthy controls (HC). PRLs were identified on phase images of susceptibility-weighted imaging, whereas CP volume was quantified using a fully automatic method on brain three-dimensional T1-weighted and fluid-attenuated inversion recovery MRI sequences. Predictors of cognitive impairment and fatigue were identified using random forest. RESULTS Thirty-six (27.9%) patients with MS were cognitively impaired, and 31/113 (27.4%) patients had fatigue. Fifty-nine (45.7%) patients with MS had ≥1 PRLs (median = 0, interquartile range = 0;2). Compared with HC, patients with MS showed significantly higher T2-hyperintense white matter lesion (WM) volume; lower normalized brain, thalamic, hippocampal, caudate, cortical, and WM volumes; and higher normalized CP volume (p from <0.001 to 0.040). The predictors of cognitive impairment (relative importance) (out-of-bag area under the curve [OOB-AUC] = 0.707) were normalized brain volume (100%), normalized caudate volume (89.1%), normalized CP volume (80.3%), normalized cortical volume (70.3%), number (67.3%) and volume (66.7%) of PRLs, and T2-hyperintense WM lesion volume (64.0%). Normalized CP volume was the only predictor of the presence of fatigue (OOB-AUC = 0.563). DISCUSSION Chronic inflammation, with higher number and volume of PRLs and enlarged CP, may contribute to cognitive impairment in MS in addition to gray matter atrophy. The contribution of enlarged CP in explaining fatigue supports the relevance of immune-related processes in determining this manifestation independently of disease severity. PRLs and CP enlargement may contribute to the pathophysiology of cognitive impairment and fatigue in MS, and they may represent clinically relevant therapeutic targets to limit the impact of these clinical manifestations in MS.
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Affiliation(s)
- Paolo Preziosa
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Pagani
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Meani
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Loredana Storelli
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Monica Margoni
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Yury Yudin
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicolò Tedone
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Diana Biondi
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Rubin
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria A Rocca
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- From the Neuroimaging Research Unit (P.P., E.P., A.M., L.S., M.M., Y.Y., N.T., D.B., M.R., M.A.R., M.F.), Division of Neuroscience; Neurology Unit (P.P., M.M., M.R., M.A.R., M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (P.P., M.R., M.A.R., M.F.); Neurorehabilitation Unit (M.M., M.F.); and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Milan, Italy
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Zhang C, Zhang K, Hu X, Cai X, Chen Y, Gao F, Wang G. Regional GABA levels modulate abnormal resting-state network functional connectivity and cognitive impairment in multiple sclerosis. Cereb Cortex 2024; 34:bhad535. [PMID: 38271282 DOI: 10.1093/cercor/bhad535] [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: 10/10/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
More evidence shows that changes in functional connectivity with regard to brain networks and neurometabolite levels correlated to cognitive impairment in multiple sclerosis. However, the neurological basis underlying the relationship among neurometabolite levels, functional connectivity, and cognitive impairment remains unclear. For this purpose, we used a combination of magnetic resonance spectroscopy and resting-state functional magnetic resonance imaging to study gamma-aminobutyric acid and glutamate concentrations in the posterior cingulate cortex, medial prefrontal cortex and left hippocampus, and inter-network functional connectivity in 29 relapsing-remitting multiple sclerosis patients and 34 matched healthy controls. Neuropsychological tests were used to evaluate the cognitive function. We found that relapsing-remitting multiple sclerosis patients demonstrated significantly reduced gamma-aminobutyric acid and glutamate concentrations and aberrant functional connectivity involving cognitive-related networks compared to healthy controls, and both alterations were associated with specific cognition decline. Moreover, mediation analyses indicated that decremented hippocampus gamma-aminobutyric acid levels in relapsing-remitting multiple sclerosis patients mediated the association between inter-network functional connectivity in various components of default mode network and verbal memory deficits. In summary, our findings shed new lights on the essential function of GABAergic system abnormalities in regulating network dysconnectivity and functional connectivity in relapsing-remitting multiple sclerosis patients, suggesting potential novel approach to treatment.
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Affiliation(s)
- Chao Zhang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
| | - Kaihua Zhang
- School of Psychology, Shandong Normal University, Jinan 250358, China
| | - Xin Hu
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Xianyun Cai
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Yufan Chen
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Fei Gao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Guangbin Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
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7
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Morozumi T, Preziosa P, Meani A, Albergoni M, Margoni M, Pagani E, Filippi M, Rocca MA. Influence of cardiorespiratory fitness and MRI measures of neuroinflammation on hippocampal volume in multiple sclerosis. J Neurol Neurosurg Psychiatry 2023; 95:29-36. [PMID: 37468307 DOI: 10.1136/jnnp-2023-331482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND The hippocampus is a clinically relevant region where neurogenesis and neuroplasticity occur throughout the whole lifespan. Neuroinflammation and cardiorespiratory fitness (CRF) may influence hippocampal integrity by modulating the processes promoting neurogenesis and neuroprotection that contribute to the preservation of functions. This study aimed to investigate the effects of neuroinflammation and CRF on hippocampal volume in multiple sclerosis (MS) patients with relapsing-remitting (RR) and progressive (P) clinical phenotypes. The influence of neuroinflammation and CRF on brain, grey matter (GM) and thalamic volumes was also assessed to determine whether the effects were specific for the hippocampus. METHOD Brain 3T structural MRI scans and maximum oxygen consumption (VO2max), a proxy of CRF, were acquired from 81 MS patients (27 RR and 54 P) and 45 age-matched and sex-matched healthy controls. T2-hyperintense white matter lesion volume (T2-LV) and choroid plexuses volume (CPV) were quantified as neuroinflammatory measures. Associations of demographic, clinical, neuroinflammatory and CRF measures with normalised brain, GM, hippocampal and thalamic volumes in relapsing-remitting MS (RRMS) and progressive MS patients were assessed using Shapley and best subset selection regression. RESULTS For most volumetric measures, the largest portions of variance were explained by T2-LV (variable importance (VI)=9.4-39.4) and CPV (VI=4.5-26.2). VO2max explained the largest portion of variance of normalised hippocampal volume only in RRMS patients (VI=16.9) and was retained as relevant predictor (standardised β=0.374, p=0.023) with T2-LV (standardised β=-0.330, p=0.016). CONCLUSIONS A higher CRF may play a specific neuroprotective role on MS patients' hippocampal integrity, but only in the RR phase of the disease.
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Affiliation(s)
- Tetsu Morozumi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Paolo Preziosa
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
- Neurology Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Alessandro Meani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Matteo Albergoni
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Monica Margoni
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
- Neurology Unit, IRCCS Ospedale San Raffaele, Milano, Italy
- Neurorehabilitation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
- Neurophysiology Service, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
- Neurology Unit, IRCCS Ospedale San Raffaele, Milano, Italy
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8
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Cacciaguerra L, Rocca MA, Filippi M. Understanding the Pathophysiology and Magnetic Resonance Imaging of Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders. Korean J Radiol 2023; 24:1260-1283. [PMID: 38016685 DOI: 10.3348/kjr.2023.0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 11/30/2023] Open
Abstract
Magnetic resonance imaging (MRI) has been extensively applied in the study of multiple sclerosis (MS), substantially contributing to diagnosis, differential diagnosis, and disease monitoring. MRI studies have significantly contributed to the understanding of MS through the characterization of typical radiological features and their clinical or prognostic implications using conventional MRI pulse sequences and further with the application of advanced imaging techniques sensitive to microstructural damage. Interpretation of results has often been validated by MRI-pathology studies. However, the application of MRI techniques in the study of neuromyelitis optica spectrum disorders (NMOSD) remains an emerging field, and MRI studies have focused on radiological correlates of NMOSD and its pathophysiology to aid in diagnosis, improve monitoring, and identify relevant prognostic factors. In this review, we discuss the main contributions of MRI to the understanding of MS and NMOSD, focusing on the most novel discoveries to clarify differences in the pathophysiology of focal inflammation initiation and perpetuation, involvement of normal-appearing tissue, potential entry routes of pathogenic elements into the CNS, and existence of primary or secondary mechanisms of neurodegeneration.
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Affiliation(s)
- Laura Cacciaguerra
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milano, Italy.
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9
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Motahharynia A, Pourmohammadi A, Adibi A, Shaygannejad V, Ashtari F, Adibi I, Sanayei M. A mechanistic insight into sources of error of visual working memory in multiple sclerosis. eLife 2023; 12:RP87442. [PMID: 37937840 PMCID: PMC10631758 DOI: 10.7554/elife.87442] [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] [Indexed: 11/09/2023] Open
Abstract
Working memory (WM) is one of the most affected cognitive domains in multiple sclerosis (MS), which is mainly studied by the previously established binary model for information storage (slot model). However, recent observations based on the continuous reproduction paradigms have shown that assuming dynamic allocation of WM resources (resource model) instead of the binary hypothesis will give more accurate predictions in WM assessment. Moreover, continuous reproduction paradigms allow for assessing the distribution of error in recalling information, providing new insights into the organization of the WM system. Hence, by utilizing two continuous reproduction paradigms, memory-guided localization (MGL) and analog recall task with sequential presentation, we investigated WM dysfunction in MS. Our results demonstrated an overall increase in recall error and decreased recall precision in MS. While sequential paradigms were better in distinguishing healthy control from relapsing-remitting MS, MGL were more accurate in discriminating MS subtypes (relapsing-remitting from secondary progressive), providing evidence about the underlying mechanisms of WM deficit in progressive states of the disease. Furthermore, computational modeling of the results from the sequential paradigm determined that imprecision in decoding information and swap error (mistakenly reporting the feature of other presented items) was responsible for WM dysfunction in MS. Overall, this study offered a sensitive measure for assessing WM deficit and provided new insight into the organization of the WM system in MS population.
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Affiliation(s)
- Ali Motahharynia
- Center for Translational Neuroscience, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
| | - Ahmad Pourmohammadi
- Center for Translational Neuroscience, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM)TehranIslamic Republic of Iran
| | - Armin Adibi
- Center for Translational Neuroscience, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
| | - Vahid Shaygannejad
- Center for Translational Neuroscience, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
| | - Fereshteh Ashtari
- Center for Translational Neuroscience, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
| | - Iman Adibi
- Center for Translational Neuroscience, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
| | - Mehdi Sanayei
- Center for Translational Neuroscience, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical SciencesIsfahanIslamic Republic of Iran
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM)TehranIslamic Republic of Iran
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10
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Shaw BC, Anders VR, Tinkey RA, Habean ML, Brock OD, Frostino BJ, Williams JL. Immunity impacts cognitive deficits across neurological disorders. J Neurochem 2023:10.1111/jnc.15999. [PMID: 37899543 PMCID: PMC11056485 DOI: 10.1111/jnc.15999] [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: 08/01/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/31/2023]
Abstract
Cognitive deficits are a common comorbidity with neurological disorders and normal aging. Inflammation is associated with multiple diseases including classical neurodegenerative dementias such as Alzheimer's disease (AD) and autoimmune disorders such as multiple sclerosis (MS), in which over half of all patients experience some form of cognitive deficits. Other degenerative diseases of the central nervous system (CNS) including frontotemporal lobe dementia (FTLD), and Parkinson's disease (PD) as well as traumatic brain injury (TBI) and psychological disorders like major depressive disorder (MDD), and even normal aging all have cytokine-associated reductions in cognitive function. Thus, there is likely commonality between these secondary cognitive deficits and inflammation. Neurological disorders are increasingly associated with substantial neuroinflammation, in which CNS-resident cells secrete cytokines and chemokines such as tumor necrosis factor (TNF)α and interleukins (ILs) including IL-1β and IL-6. CNS-resident cells also respond to a wide variety of cytokines and chemokines, which can have both direct effects on neurons by changing the expression of ion channels and perturbing electrical properties, as well as indirect effects through glia-glia and immune-glia cross-talk. There is significant overlap in these cytokine and chemokine expression profiles across diseases, with TNFα and IL-6 strongly associated with cognitive deficits in multiple disorders. Here, we review the involvement of various cytokines and chemokines in AD, MS, FTLD, PD, TBI, MDD, and normal aging in the absence of dementia. We propose that the neuropsychiatric phenotypes observed in these disorders may be at least partially attributable to a dysregulation of immunity resulting in pathological cytokine and chemokine expression from both CNS-resident and non-resident cells.
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Affiliation(s)
- Benjamin C. Shaw
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Victoria R. Anders
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Rachel A. Tinkey
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- School of Biomedical Sciences, Kent State University, Kent, OH, USA
- Brain Health Research Institute, Kent State University, Kent, OH, USA
| | - Maria L. Habean
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Neuroscience, Case Western Reserve University, Cleveland, OH, USA
| | - Orion D. Brock
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Molecular Medicine, Lerner Research Institute, Cleveland Clinic and Case Western Reserve University, Cleveland, OH, USA
| | - Benjamin J. Frostino
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- College of Science, University of Notre Dame, South Bend, IN, USA
| | - Jessica L. Williams
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- School of Biomedical Sciences, Kent State University, Kent, OH, USA
- Brain Health Research Institute, Kent State University, Kent, OH, USA
- Department of Neuroscience, Case Western Reserve University, Cleveland, OH, USA
- Molecular Medicine, Lerner Research Institute, Cleveland Clinic and Case Western Reserve University, Cleveland, OH, USA
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11
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Adebiyi OE, Bynoe MS. Roles of Adenosine Receptor (subtypes A 1 and A 2A) in Cuprizone-Induced Hippocampal Demyelination. Mol Neurobiol 2023; 60:5878-5890. [PMID: 37358743 DOI: 10.1007/s12035-023-03440-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/10/2023] [Indexed: 06/27/2023]
Abstract
Hippocampal demyelination in multiple sclerosis (MS) has been linked with cognitive deficits, however, patients could benefit from treatment that induces oligodendroglial cell function and promotes remyelination. We investigated the role of A1 and A2A adenosine receptors (AR) in regulating oligodendrocyte precursor cells (OPCs) and myelinating oligodendrocyte (OL) in the demyelinated hippocampus using the cuprizone model of MS. Spatial learning and memory were assessed in wild type C57BL/6 mice (WT) or C57BL/6 mice with global deletion of A1 (A1AR-/-) or A2A AR (A2AAR-/-) fed standard or cuprizone diet (CD) for four weeks. Histology, immunofluorescence, Western blot and TUNEL assays were performed to evaluate the extent of demyelination and apoptosis in the hippocampus. Deletion of A1 and A2A AR alters spatial learning and memory. In A1AR-/- mice, cuprizone feeding led to severe hippocampal demyelination, A2AAR-/- mice had a significant increase in myelin whereas WT mice had intermediate demyelination. The A1AR-/- CD-fed mice displayed significant astrocytosis and decreased expression of NeuN and MBP, whereas these proteins were increased in the A2AAR-/- CD mice. Furthermore, Olig2 was upregulated in A1AR-/- CD-fed mice compared to WT mice fed the standard diet. TUNEL staining of brain sections revealed a fivefold increase in the hippocampus of A1AR-/- CD-fed mice. Also, WT mice fed CD showed a significant decrease expression of A1 AR. A1 and A2A AR are involved in OPC/OL functions with opposing roles in myelin regulation in the hippocampus. Thus, the neuropathological findings seen in MS may be connected to the depletion of A1 AR.
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Affiliation(s)
- Olamide E Adebiyi
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Margaret S Bynoe
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
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12
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Margoni M, Preziosa P, Rocca MA, Filippi M. Depressive symptoms, anxiety and cognitive impairment: emerging evidence in multiple sclerosis. Transl Psychiatry 2023; 13:264. [PMID: 37468462 PMCID: PMC10356956 DOI: 10.1038/s41398-023-02555-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/21/2023] Open
Abstract
Neuropsychiatric abnormalities may be broadly divided in two categories: disorders of mood, affect, and behavior and abnormalities affecting cognition. Among these conditions, clinical depression, anxiety and neurocognitive disorders are the most common in multiple sclerosis (MS), with a substantial impact on patients' quality of life and adherence to treatments. Such manifestations may occur from the earliest phases of the disease but become more frequent in MS patients with a progressive disease course and more severe clinical disability. Although the pathogenesis of these neuropsychiatric manifestations has not been fully defined yet, brain structural and functional abnormalities, consistently observed with magnetic resonance imaging (MRI), together with genetic and immunologic factors, have been suggested to be key players. Even though the detrimental clinical impact of such manifestations in MS patients is a matter of crucial importance, at present, they are often overlooked in the clinical setting. Moreover, the efficacy of pharmacologic and non-pharmacologic approaches for their amelioration has been poorly investigated, with the majority of studies showing marginal or no beneficial effect of different therapeutic approaches, possibly due to the presence of multiple and heterogeneous underlying pathological mechanisms and intrinsic methodological limitations. A better evaluation of these manifestations in the clinical setting and improvements in the understanding of their pathophysiology may offer the potential to develop tools for differentiating these mechanisms in individual patients and ultimately provide a principled basis for treatment selection. This review provides an updated overview regarding the pathophysiology of the most common neuropsychiatric symptoms in MS, the clinical and MRI characteristics that have been associated with mood disorders (i.e., depression and anxiety) and cognitive impairment, and the treatment approaches currently available or under investigation.
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Affiliation(s)
- Monica Margoni
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Preziosa
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Vita-Salute San Raffaele University, Milan, Italy.
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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13
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Strautmane S, Balodis A, Teivane A, Grabovska D, Naudins E, Urbanovics D, Fisermans E, Mednieks J, Flintere-Flinte A, Priede Z, Millers A, Zolovs M. Functional Disability and Brain MRI Volumetry Results among Multiple Sclerosis Patients during 5-Year Follow-Up. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1082. [PMID: 37374286 DOI: 10.3390/medicina59061082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: We aimed to determine the link between brain volumetry results and functional disability calculated using the Expanded Disability Status Scale (EDSS) among multiple sclerosis (MS) patients in relation to the provided treatment (disease-modifying therapies (DMTs)) during a 5-year follow-up period. Materials and Methods: A retrospective cohort study was performed enrolling 66 consecutive patients with a confirmed diagnosis of MS, predominantly females (62% (n = 41)). Relapsing-remitting (RR) MS was noted in 92% (n = 61) of patients, with the rest being patients with secondary progressive (SP) MS. The mean age was 43.3 years (SD 8.3 years). All patients were evaluated clinically using the EDSS and "FreeSurfer© 7.2.0" radiologically during a 5-year follow-up. Results: A significant increase in patient functional disability was noted, calculated using the EDSS during a 5-year follow-up. The baseline EDSS ranged between 1 and 6 with a median of 1.5 (IQR 1.5-2.0), and after 5 years, the EDSS was between 1 and 7, with a median EDSS of 3.0 (IQR 2.4-3.6). Compared with RRMS patients, SPMS patients demonstrated a significant increase in EDSS score during a 5-year period, with a median EDSS of 2.5 in RRMS patients (IQR 2.0-3.3) and 7.0 (IQR 5.0-7.0) among SPMS patients. Significantly lower brain volumetry results in different brain areas were found, including cortical, total grey and white matter, p < 0.05. Statistically significant differences were observed between baseline volumetry results of the hippocampus and the middle anterior part of the corpus callosum and their volumetry results after 5 years, p < 0.001. In this study population, the thalamus did not demonstrate significant changes in volumetry results during follow-up, p > 0.05. The provided treatment (DMTs) did not demonstrate a significant impact on the brain MRI volumetry results during a 5-year follow-up, p > 0.05. Conclusions: Brain MRI volumetry seriously impacts the early detection of brain atrophic changes. In this study, significant relationship between brain magnetic resonance volumetry results and disability progression among MS patients with no important impact of the provided treatment was described. Brain MRI volumetry may aid in the identification of early disease progression among MS patients, as well as enrich the clinical evaluation of MS patients in clinical patient care.
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Affiliation(s)
- Sintija Strautmane
- Faculty of Residency, Riga Stradins University, LV-1007 Riga, Latvia
- Department of Neurology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | - Arturs Balodis
- Department of Radiology, Riga Stradins University, LV-1002 Riga, Latvia
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | - Agnete Teivane
- Faculty of Residency, Riga Stradins University, LV-1007 Riga, Latvia
- Department of Neurology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | - Dagnija Grabovska
- Department of Radiology, Riga Stradins University, LV-1002 Riga, Latvia
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | - Edgars Naudins
- Department of Radiology, Riga Stradins University, LV-1002 Riga, Latvia
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | | | - Edgars Fisermans
- Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia
| | - Janis Mednieks
- Department of Neurology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | - Alina Flintere-Flinte
- Department of Neurology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | - Zanda Priede
- Department of Neurology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
- Department of Neurology and Neurosurgery, Riga Stradins University, LV-1007 Riga, Latvia
| | - Andrejs Millers
- Department of Neurology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
- Department of Neurology and Neurosurgery, Riga Stradins University, LV-1007 Riga, Latvia
| | - Maksims Zolovs
- Statistics Unit, Riga Stradins University, LV-1007 Riga, Latvia
- Institute of Life Sciences and Technology, Daugavpils University, LV-5401 Daugavpils, Latvia
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14
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Yu C, Ruan Y, Sun X, Chen C, Shen T, Liu C, Qiu W, Lu Z, Chan SO, Wang L. rTMS ameliorates depression/anxiety-like behaviors in experimental autoimmune encephalitis by inhibiting neurotoxic reactive astrocytes. J Affect Disord 2023; 331:352-361. [PMID: 36958487 DOI: 10.1016/j.jad.2023.03.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023]
Abstract
One third of patients with multiple sclerosis (MS) suffered from depressive symptoms. The pathogenesis of depression in MS patients has been related to innate immune activation in certain regions of the brain such as hippocampus. However, pharmacotherapy lacks sufficient evidence for beneficial effects on depression in MS patients, urging for a novel treatment modality for this mental disorder. Treatment effects of rTMS on depression/anxiety-like behaviors in mice with experimental autoimmune encephalomyelitis (EAE) were assessed by behavioral tests. The role of innate immune response was examined by RNA sequencing, quantitative RT-PCR, and immunofluorescence techniques. Depressive symptom severity and astroglial activation in patients with MS were assessed by Beck Depression Inventory and serum glial fibrillary acidic protein (GFAP), respectively. EAE mice displayed depression/anxiety-like behaviors, which were ameliorated by rTMS. Transcriptome and gene-specific expression analysis of the hippocampus showed significant reduction in transcript levels associated with neurotoxic reactive astrocytes in EAE mice after rTMS treatment. This was confirmed by immunofluorescence studies. Complement component 3d, a marker of neurotoxic reactive astrocytes, was highly expressed in EAE hippocampus, but was reduced to a basal level after rTMS treatment. In patients with MS, astroglial activation, indicated by serum GFAP levels, was significantly elevated in those with moderate or major depressive symptoms. These findings support that the suppression of neurotoxic reactive astrocytes might be a potential target for treatment of depression in patients with MS, and suggest the potential of using rTMS as a potential therapeutic treatment for this disorder.
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Affiliation(s)
- Chao Yu
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China; Medical Examination Center, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China
| | - Yiwen Ruan
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, Guangdong 510632, China
| | - Xiaobo Sun
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China
| | - Chen Chen
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China
| | - Ting Shen
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China
| | - Chunxin Liu
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China
| | - Wei Qiu
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China
| | - Zhengqi Lu
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China
| | - Sun On Chan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Liqing Wang
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
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15
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Functional re-organization of hippocampal-cortical gradients during naturalistic memory processes. Neuroimage 2023; 271:119996. [PMID: 36863548 DOI: 10.1016/j.neuroimage.2023.119996] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 02/12/2023] [Accepted: 02/27/2023] [Indexed: 03/04/2023] Open
Abstract
The functional organization of the hippocampus mirrors that of the cortex, changing smoothly along connectivity gradients and abruptly at inter-areal boundaries. Hippocampal-dependent cognitive processes require flexible integration of these hippocampal gradients into functionally related cortical networks. To understand the cognitive relevance of this functional embedding, we acquired fMRI data while participants viewed brief news clips, either containing or lacking recently familiarized cues. Participants were 188 healthy mid-life adults and 31 adults with mild cognitive impairment (MCI) or Alzheimer's disease (AD). We employed a recently developed technique - connectivity gradientography - to study gradually changing patterns of voxel to whole brain functional connectivity and their sudden transitions. We observed that functional connectivity gradients of the anterior hippocampus map onto connectivity gradients across the default mode network during these naturalistic stimuli. The presence of familiar cues in the news clips accentuates a stepwise transition across the boundary from the anterior to the posterior hippocampus. This functional transition is shifted in the posterior direction in the left hippocampus of individuals with MCI or AD. These findings shed new light on the functional integration of hippocampal connectivity gradients into large-scale cortical networks, how these adapt with memory context and how these change in the presence of neurodegenerative disease.
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Tedone N, Preziosa P, Meani A, Pagani E, Vizzino C, Filippi M, Rocca MA. Regional white matter and gray matter damage and cognitive performances in multiple sclerosis according to sex. Mol Psychiatry 2023; 28:1783-1792. [PMID: 36806391 DOI: 10.1038/s41380-023-01996-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/22/2023]
Abstract
In this study, we investigated whether regional distribution of white matter (WM) lesions, normal-appearing [NA] WM microstructural abnormalities and gray matter (GM) atrophy may differently contribute to cognitive performance in multiple sclerosis (MS) patients according to sex. Using the same scanner, brain 3.0T MRI was acquired for 287 MS patients (females = 173; mean age = 42.1 [standard deviation, SD = 12.7] years; relapsing-remitting = 196, progressive = 91; median Expanded Disability Status Scale = 2.5 [interquartile range, IQR = 1.5-5.0]; median disease duration = 12.1 [IQR = 6.3-19.0] years; treatment: none = 70, first-line = 130, second-line = 87) and 172 healthy controls (HC) (females = 92; mean age = 39.3 [SD = 14.8] years). MS patients underwent also Rao's neuropsychological battery. Using voxel-wise analyses, we investigated in patients sex-related differences in the association of cognitive performances with WM lesions, NAWM fractional anisotropy (FA) and GM volumes (p < 0.01, family-wise error [FWE]). Sixty-six female (38%) and 48 male (42%) MS patients were cognitively impaired, with no significant between-group difference (p = 0.704). However, verbal memory performance was worse in males (p = 0.001), whereas verbal fluency performance was worse in females (p = 0.004). In both sexes, a higher T2-hyperintense lesion prevalence in cognitively-relevant WM tracts was significantly associated with worse cognitive performance (p ≤ 0.006), with stronger associations in females than males in global cognition (p ≤ 0.004). Compared to sex-matched HC, male and female MS patients had widespread lower NAWM FA and GM volume (p < 0.01). In both sexes, worse cognitive performance was associated with widespread reduced NAWM FA (p < 0.01), with stronger associations in females than males in global cognition and verbal memory (p ≤ 0.009). Worse cognitive performance was significantly associated with clusters of cortical GM atrophy in males (p ≤ 0.007) and mainly with deep GM atrophy in females (p ≤ 0.006). In this study, only limited differences in cognitive performances were found between male and female MS patients. A disconnection syndrome due to focal WM lesions and diffuse NAWM microstructural abnormalities seems to be more relevant in female MS patients to explain cognitive impairment.
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Affiliation(s)
- Nicolò Tedone
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Preziosa
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandro Meani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carmen Vizzino
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
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Schwarz K, Schmitz F. Synapse Dysfunctions in Multiple Sclerosis. Int J Mol Sci 2023; 24:ijms24021639. [PMID: 36675155 PMCID: PMC9862173 DOI: 10.3390/ijms24021639] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic neuroinflammatory disease of the central nervous system (CNS) affecting nearly three million humans worldwide. In MS, cells of an auto-reactive immune system invade the brain and cause neuroinflammation. Neuroinflammation triggers a complex, multi-faceted harmful process not only in the white matter but also in the grey matter of the brain. In the grey matter, neuroinflammation causes synapse dysfunctions. Synapse dysfunctions in MS occur early and independent from white matter demyelination and are likely correlates of cognitive and mental symptoms in MS. Disturbed synapse/glia interactions and elevated neuroinflammatory signals play a central role. Glutamatergic excitotoxic synapse damage emerges as a major mechanism. We review synapse/glia communication under normal conditions and summarize how this communication becomes malfunctional during neuroinflammation in MS. We discuss mechanisms of how disturbed glia/synapse communication can lead to synapse dysfunctions, signaling dysbalance, and neurodegeneration in MS.
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Mey GM, Mahajan KR, DeSilva TM. Neurodegeneration in multiple sclerosis. WIREs Mech Dis 2023; 15:e1583. [PMID: 35948371 PMCID: PMC9839517 DOI: 10.1002/wsbm.1583] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/28/2022] [Accepted: 07/11/2022] [Indexed: 01/31/2023]
Abstract
Axonal loss in multiple sclerosis (MS) is a key component of disease progression and permanent neurologic disability. MS is a heterogeneous demyelinating and neurodegenerative disease of the central nervous system (CNS) with varying presentation, disease courses, and prognosis. Immunomodulatory therapies reduce the frequency and severity of inflammatory demyelinating events that are a hallmark of MS, but there is minimal therapy to treat progressive disease and there is no cure. Data from patients with MS, post-mortem histological analysis, and animal models of demyelinating disease have elucidated patterns of MS pathogenesis and underlying mechanisms of neurodegeneration. MRI and molecular biomarkers have been proposed to identify predictors of neurodegeneration and risk factors for disease progression. Early signs of axonal dysfunction have come to light including impaired mitochondrial trafficking, structural axonal changes, and synaptic alterations. With sustained inflammation as well as impaired remyelination, axons succumb to degeneration contributing to CNS atrophy and worsening of disease. These studies highlight the role of chronic demyelination in the CNS in perpetuating axonal loss, and the difficulty in promoting remyelination and repair amidst persistent inflammatory insult. Regenerative and neuroprotective strategies are essential to overcome this barrier, with early intervention being critical to rescue axonal integrity and function. The clinical and basic research studies discussed in this review have set the stage for identifying key propagators of neurodegeneration in MS, leading the way for neuroprotective therapeutic development. This article is categorized under: Immune System Diseases > Molecular and Cellular Physiology Neurological Diseases > Molecular and Cellular Physiology.
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Affiliation(s)
- Gabrielle M. Mey
- Department of NeurosciencesLerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve UniversityClevelandOhioUSA
| | - Kedar R. Mahajan
- Department of NeurosciencesLerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve UniversityClevelandOhioUSA
- Mellen Center for MS Treatment and ResearchNeurological Institute, Cleveland Clinic FoundationClevelandOhioUSA
| | - Tara M. DeSilva
- Department of NeurosciencesLerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve UniversityClevelandOhioUSA
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Central Stimulatory Effect of Kynurenic Acid on BDNF-TrkB Signaling and BER Enzymatic Activity in the Hippocampal CA1 Field in Sheep. Int J Mol Sci 2022; 24:ijms24010136. [PMID: 36613581 PMCID: PMC9820639 DOI: 10.3390/ijms24010136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Deficiency of neurotrophic factors and oxidative DNA damage are common causes of many neurodegenerative diseases. Recently, the importance of kynurenic acid (KYNA), an active metabolite of tryptophan, has increased as a neuroprotective molecule in the brain. Therefore, the present study tested the hypothesis that centrally acting KYNA would positively affect: (1) brain-derived neurotrophic factor (BDNF)-tyrosine receptor kinase B (TrkB) signaling and (2) selected base excision repair (BER) pathway enzymes activities in the hippocampal CA1 field in sheep. Both lower (20 μg in total) and higher (100 μg in total) doses of KYNA infused into the third brain ventricle differentially increased the abundance of BDNF and TrkB mRNA in the CA1 field; additionally, the higher dose increased BDNF tissue concentration. The lower dose of KYNA increased mRNA expression for 8-oxoguanine glycosylase (OGG1), N-methylpurine DNA glycosylase (MPG), and thymine DNA glycosylase and stimulated the repair of 1,N6-ethenodeoxyadenosine and 3,N4-ethenodeoxy-cytosine as determined by the excision efficiency of lesioned nucleobases. The higher dose increased the abundance of OGG1 and MPG transcripts, however, its stimulatory effect on repair activity was less pronounced in all cases compared to the lower dose. The increased level of AP-endonuclease mRNA expression was dose-dependent. In conclusion, the potential neurotrophic and neuroprotective effects of KYNA in brain cells may involve stimulation of the BDNF-TrkB and BER pathways.
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Voskuhl RR, MacKenzie-Graham A. Chronic experimental autoimmune encephalomyelitis is an excellent model to study neuroaxonal degeneration in multiple sclerosis. Front Mol Neurosci 2022; 15:1024058. [PMID: 36340686 PMCID: PMC9629273 DOI: 10.3389/fnmol.2022.1024058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 09/30/2022] [Indexed: 08/19/2023] Open
Abstract
Animal models of multiple sclerosis (MS), specifically experimental autoimmune encephalomyelitis (EAE), have been used extensively to develop anti-inflammatory treatments. However, the similarity between MS and one particular EAE model does not end at inflammation. MS and chronic EAE induced in C57BL/6 mice using myelin oligodendrocyte glycoprotein (MOG) peptide 35-55 share many neuropathologies. Beyond both having white matter lesions in spinal cord, both also have widespread neuropathology in the cerebral cortex, hippocampus, thalamus, striatum, cerebellum, and retina/optic nerve. In this review, we compare neuropathologies in each of these structures in MS with chronic EAE in C57BL/6 mice, and find evidence that this EAE model is well suited to study neuroaxonal degeneration in MS.
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Affiliation(s)
- Rhonda R. Voskuhl
- UCLA MS Program, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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21
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Marzi C, d'Ambrosio A, Diciotti S, Bisecco A, Altieri M, Filippi M, Rocca MA, Storelli L, Pantano P, Tommasin S, Cortese R, De Stefano N, Tedeschi G, Gallo A. Prediction of the information processing speed performance in multiple sclerosis using a machine learning approach in a large multicenter magnetic resonance imaging data set. Hum Brain Mapp 2022; 44:186-202. [PMID: 36255155 PMCID: PMC9783441 DOI: 10.1002/hbm.26106] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/02/2022] [Accepted: 09/24/2022] [Indexed: 02/05/2023] Open
Abstract
Many patients with multiple sclerosis (MS) experience information processing speed (IPS) deficits, and the Symbol Digit Modalities Test (SDMT) has been recommended as a valid screening test. Magnetic resonance imaging (MRI) has markedly improved the understanding of the mechanisms associated with cognitive deficits in MS. However, which structural MRI markers are the most closely related to cognitive performance is still unclear. We used the multicenter 3T-MRI data set of the Italian Neuroimaging Network Initiative to extract multimodal data (i.e., demographic, clinical, neuropsychological, and structural MRIs) of 540 MS patients. We aimed to assess, through machine learning techniques, the contribution of brain MRI structural volumes in the prediction of IPS deficits when combined with demographic and clinical features. We trained and tested the eXtreme Gradient Boosting (XGBoost) model following a rigorous validation scheme to obtain reliable generalization performance. We carried out a classification and a regression task based on SDMT scores feeding each model with different combinations of features. For the classification task, the model trained with thalamus, cortical gray matter, hippocampus, and lesions volumes achieved an area under the receiver operating characteristic curve of 0.74. For the regression task, the model trained with cortical gray matter and thalamus volumes, EDSS, nucleus accumbens, lesions, and putamen volumes, and age reached a mean absolute error of 0.95. In conclusion, our results confirmed that damage to cortical gray matter and relevant deep and archaic gray matter structures, such as the thalamus and hippocampus, is among the most relevant predictors of cognitive performance in MS.
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Affiliation(s)
- Chiara Marzi
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly,Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi” – DEIAlma Mater Studiorum – University of BolognaBolognaItaly
| | - Alessandro d'Ambrosio
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi” – DEIAlma Mater Studiorum – University of BolognaBolognaItaly,Alma Mater Research Institute for Human‐Centered Artificial IntelligenceUniversity of BolognaBolognaItaly
| | - Alvino Bisecco
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly
| | - Manuela Altieri
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly,Department of PsychologyUniversity of Campania “Luigi Vanvitelli”NapoliItaly
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of NeuroscienceVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly,Neurology and Neurophysiology UnitVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly
| | - Maria Assunta Rocca
- Neuroimaging Research Unit, Division of NeuroscienceVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly,Neurology and Neurophysiology UnitVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly
| | - Loredana Storelli
- Neuroimaging Research Unit, Division of NeuroscienceVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly
| | - Patrizia Pantano
- Department of Human NeurosciencesSapienza University of RomeRomeItaly,IRCCS NeuromedPozzilliItaly
| | - Silvia Tommasin
- Department of Human NeurosciencesSapienza University of RomeRomeItaly
| | - Rosa Cortese
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly
| | - Nicola De Stefano
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly
| | - Gioacchino Tedeschi
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly
| | - Antonio Gallo
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly
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22
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Abuaf AF, Bunting SR, Klein S, Carroll T, Carpenter-Thompson J, Javed A, Cipriani V. Analysis of the extent of limbic system changes in multiple sclerosis using FreeSurfer and voxel-based morphometry approaches. PLoS One 2022; 17:e0274778. [PMID: 36137122 PMCID: PMC9499213 DOI: 10.1371/journal.pone.0274778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/05/2022] [Indexed: 12/03/2022] Open
Abstract
Background and purpose The limbic brain is involved in diverse cognitive, emotional, and autonomic functions. Injury of the various parts of the limbic system have been correlated with clinical deficits in MS. The purpose of this study was to comprehensively examine different regions of the subcortical limbic system to assess the extent of damage within this entire system as it may be pertinent in correlating with specific aspects of cognitive and behavioral dysfunction in MS by using a fully automated, unbiased segmentation approach. Methods Sixty-seven subjects were included in this study, including 52 with multiple sclerosis (MS) and 15 healthy controls. Only patients with stable MS disease, without any relapses, MRI activity, or disability progression were included. Subcortical limbic system segmentation was performed using the FreeSurfer pipeline ScLimbic, which provides volumes for fornix, mammillary bodies, hypothalamus, septal nuclei, nucleus accumbens, and basal forebrain. Hippocampus and anterior thalamic nuclei were added as additional components of the limbic circuitry, also segmented through FreeSurfer. Whole limbic region mask was generated by combining these structures and used for Voxel-based morphometry (VBM) analysis. Results The mean [95% confidence interval] of the total limbic system volume was lower (0.22% [0.21–0.23]) in MS compared to healthy controls (0.27%, [0.25–0.29], p < .001). Pairwise comparisons of individual limbic regions between MS and controls was significant in the nucleus accumbens (0.046%, [0.043–0.050] vs. 0.059%, [0.051–0.066], p = .005), hypothalamus (0.062%, [0.059–0.065] vs. 0.074%, [0.068–0.081], p = .001), basal forebrain (0.038%, [0.036–0.040] vs. 0.047%, [0.042–0.051], p = .001), hippocampus (0.47%, [0.45–0.49] vs. 0.53%, [0.49–0.57], p = .004), and anterior thalamus (0.077%, [0.072–0.082] vs. 0.093%, [0.084–0.10], p = .001) after Bonferroni correction. Volume of several limbic regions was significantly correlated with T2 lesion burden and brain parenchymal fraction (BPF). Multiple regression model showed minimal influence of BPF on limbic brain volume and no influence of other demographic and disease state variables. VBM analysis showed cluster differences in the fornix and anterior thalamic nuclei at threshold p < 0.05 after adjusting for covariates but the results were insignificant after family-wise error corrections. Conclusions The results show evidence that brain volume loss is fairly extensive in the limbic brain. Given the significance of the limbic system in many disease states including MS, such volumetric analyses can be expanded to studying cognitive and emotional disturbances in larger clinical trials. FreeSurfer ScLimbic pipeline provided an efficient and reliable methodology for examining many of the subcortical structures related to the limbic brain.
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Affiliation(s)
- Amanda Frisosky Abuaf
- Department of Neurology, The University of Wisconsin, Madison, WI, United States of America
| | - Samuel R. Bunting
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States of America
| | - Sara Klein
- Department of Neurology, The University of Chicago, Chicago, IL, United States of America
| | - Timothy Carroll
- Department of Radiology, The University of Chicago, Chicago, IL, United States of America
| | | | - Adil Javed
- Department of Neurology, The University of Chicago, Chicago, IL, United States of America
- * E-mail:
| | - Veronica Cipriani
- Department of Neurology, The University of Chicago, Chicago, IL, United States of America
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Miyazaki Y, Niino M, Takahashi E, Nomura T, Naganuma R, Amino I, Akimoto S, Minami N, Kikuchi S. Stages of brain volume loss and performance in the Brief International Cognitive Assessment for Multiple Sclerosis. Mult Scler Relat Disord 2022; 67:104183. [PMID: 36116381 DOI: 10.1016/j.msard.2022.104183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/28/2022] [Accepted: 09/11/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cognitive dysfunction occurs in a substantial proportion of patients with multiple sclerosis (MS), negatively affects their daily activities, and is associated with poor prognosis. Cognitive dysfunction in MS can extend across multiple cognitive domains, depending on the patterns and extent of the brain regions affected. Therefore, a combination of tests, including the Brief International Cognitive Assessment for MS (BICAMS), that assess different aspects of cognition is recommended to capture the full picture of cognitive impairment in each patient. However, the temporal relationships between the progression of the MS brain pathology and the performances in different cognitive tests remain unclear. METHODS Global and regional brain volume data were obtained based on T1-weighted magnetic resonance imaging from 61 patients with MS, and hierarchical cluster analysis was performed using these brain volume data. Cognitive function was assessed using the three subcomponents of the BICAMS: the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test Second Edition (CVLT2), and Brief Visuospatial Memory Test-Revised (BVMTR). Clinical characteristics, patterns of regional brain volume loss, and cognitive test scores were compared among clusters. RESULTS Cluster analysis of the global and regional brain volume data classified patients into three clusters (Clusters 1, 2, and 3) in order of decreasing global brain volume. A comparison of the clinical profiles of the patients suggested that those in Clusters 1, 2, and 3 are in the early, intermediate, and advanced stages of MS, respectively. Pair-wise analysis of regional brain volume among the three clusters suggested brain regions where volume loss starts early and continues throughout the disease course, occurs preferentially at the early phase, or evolves relatively slowly. SDMT scores differed significantly among the three clusters, with a decrease from Clusters 1 to 3. BVMTR scores also declined in this order, whereas the CVLT2 was significantly impaired only in Cluster 3. CONCLUSION Our results suggest that SDMT performance declines in conjunction with brain volume loss throughout the disease course of MS. Performance in the BVMTR also declines in line with the brain volume loss, but impairment in the CVLT2 becomes particularly apparent at the late phase of MS.
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Affiliation(s)
- Yusei Miyazaki
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan.
| | - Masaaki Niino
- Departments of Clinical Research, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Eri Takahashi
- Departments of Clinical Research, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Taichi Nomura
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Ryoji Naganuma
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Itaru Amino
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Sachiko Akimoto
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Naoya Minami
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Seiji Kikuchi
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
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Endogenous Neural Stem Cell Mediated Oligodendrogenesis in the Adult Mammalian Brain. Cells 2022; 11:cells11132101. [PMID: 35805185 PMCID: PMC9265817 DOI: 10.3390/cells11132101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 02/08/2023] Open
Abstract
Oligodendrogenesis is essential for replacing worn-out oligodendrocytes, promoting myelin plasticity, and for myelin repair following a demyelinating injury in the adult mammalian brain. Neural stem cells are an important source of oligodendrocytes in the adult brain; however, there are considerable differences in oligodendrogenesis from neural stem cells residing in different areas of the adult brain. Amongst the distinct niches containing neural stem cells, the subventricular zone lining the lateral ventricles and the subgranular zone in the dentate gyrus of the hippocampus are considered the principle areas of adult neurogenesis. In addition to these areas, radial glia-like cells, which are the precursors of neural stem cells, are found in the lining of the third ventricle, where they are called tanycytes, and in the cerebellum, where they are called Bergmann glia. In this review, we will describe the contribution and regulation of each of these niches in adult oligodendrogenesis.
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Chitnis T, Vandercappellen J, King M, Brichetto G. Symptom Interconnectivity in Multiple Sclerosis: A Narrative Review of Potential Underlying Biological Disease Processes. Neurol Ther 2022; 11:1043-1070. [PMID: 35680693 PMCID: PMC9338216 DOI: 10.1007/s40120-022-00368-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Fatigue, cognitive impairment, depression, and pain are highly prevalent symptoms in multiple sclerosis (MS). These often co-occur and may be explained by a common etiology. By reviewing existing literature, we aimed to identify potential underlying biological processes implicated in the interconnectivity between these symptoms. Methods A literature search was conducted to identify articles reporting research into the biological mechanisms responsible for the manifestation of fatigue, cognitive impairment, depression, and pain in MS. PubMed was used to search for articles published from July 2011 to July 2021. We reviewed and assessed findings from the literature to identify biological processes common to the symptoms of interest. Results Of 693 articles identified from the search, 252 were selected following screening of titles and abstracts and assessing reference lists of review articles. Four biological processes linked with two or more of the symptoms of interest were frequently identified from the literature: (1) direct neuroanatomical changes to brain regions linked with symptoms of interest (e.g., thalamic injury associated with cognitive impairment, fatigue, and depression), (2) pro-inflammatory cytokines associated with so-called ‘sickness behavior,’ including manifestation of fatigue, transient cognitive impairment, depression, and pain, (3) dysregulation of monoaminergic pathways leading to depressive symptoms and fatigue, and (4) hyperactivity of the hypothalamic–pituitary-adrenal (HPA) axis as a result of pro-inflammatory cytokines promoting the release of brain noradrenaline, serotonin, and tryptophan, which is associated with symptoms of depression and cognitive impairment. Conclusion The co-occurrence of fatigue, cognitive impairment, depression, and pain in MS appears to be associated with a common set of etiological factors, namely neuroanatomical changes, pro-inflammatory cytokines, dysregulation of monoaminergic pathways, and a hyperactive HPA axis. This association of symptoms and biological processes has important implications for disease management strategies and, eventually, could help find a common therapeutic pathway that will impact both inflammation and neuroprotection. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00368-2.
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Affiliation(s)
- Tanuja Chitnis
- Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
| | | | - Miriam King
- Novartis Pharma AG, Fabrikstrasse 12-2, 4056, Basel, Switzerland
| | - Giampaolo Brichetto
- Associazione Italiana Sclerosi Multipla Rehabilitation Center, Via Operai, 30, 16149, Genoa, GE, Italy
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26
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Rechtman A, Brill L, Zveik O, Uliel B, Haham N, Bick AS, Levin N, Vaknin-Dembinsky A. Volumetric Brain Loss Correlates With a Relapsing MOGAD Disease Course. Front Neurol 2022; 13:867190. [PMID: 35401390 PMCID: PMC8987978 DOI: 10.3389/fneur.2022.867190] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Myelin oligodendrocyte glycoprotein antibody disorders (MOGAD) have evolved as a distinct group of inflammatory, demyelinating diseases of the CNS. MOGAD can present with a monophasic or relapsing disease course with distinct clinical manifestations.However, data on the disease course and disability outcomes of these patients are scarce. We aim to compare brain volumetric changes for MOGAD patients with different disease phenotypes and HCs. Methods Brain magnetic resonance imaging (MRI) scans and clinical data were obtained for 22 MOGAD patients and 22 HCs. Volumetric brain information was determined using volBrain and MDbrain platforms. Results We found decreased brain volume in MOGAD patients compared to HCs, as identified in volume of total brain, gray matter, white matter and deep gray matter (DGM) structures. In addition, we found significantly different volumetric changes between patients with relapsing and monophasic disease course, with significantly decreased volume of total brain and DGM, cerebellum and hippocampus in relapsing patients during the first year of diagnosis. A significant negative correlation was found between EDSS and volume of thalamus. Conclusions Brain MRI analyses revealed volumetric differences between MOGAD patients and HCs, and between patients with different disease phenotypes. Decreased gray matter volume during the first year of diagnosis, especially in the cerebrum and hippocampus of MOGAD patients was associated with relapsing disease course.
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Affiliation(s)
- Ariel Rechtman
- Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah-Medical Center, Ein–Kerem, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Livnat Brill
- Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah-Medical Center, Ein–Kerem, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Omri Zveik
- Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah-Medical Center, Ein–Kerem, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Benjamin Uliel
- Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah-Medical Center, Ein–Kerem, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nitzan Haham
- Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah-Medical Center, Ein–Kerem, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Atira S. Bick
- Functional Imaging Unit, Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Netta Levin
- Functional Imaging Unit, Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Adi Vaknin-Dembinsky
- Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah-Medical Center, Ein–Kerem, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- *Correspondence: Adi Vaknin-Dembinsky
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27
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Vascular Mapping of the Human Hippocampus Using Ferumoxytol-Enhanced MRI. Neuroimage 2022; 250:118957. [PMID: 35122968 PMCID: PMC9484293 DOI: 10.1016/j.neuroimage.2022.118957] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/09/2021] [Accepted: 01/30/2022] [Indexed: 11/21/2022] Open
Abstract
The hippocampus is a small but complex grey matter structure that plays an important role in spatial and episodic memory and can be affected by a wide range of pathologies including vascular abnormalities. In this work, we introduce the use of Ferumoxytol, an ultra-small superparamagnetic iron oxide (USPIO) agent, to induce susceptibility in the arteries (as well as increase the susceptibility in the veins) to map the hippocampal micro-vasculature and to evaluate the quantitative change in tissue fractional vascular density (FVD), in each of its subfields. A total of 39 healthy subjects (aged 35.4 ± 14.2 years, from 18 to 81 years old) were scanned with a high-resolution (0.22×0.44×1 mm3) dual-echo SWI sequence acquired at four time points during a gradual increase in Ferumoxytol dose (final dose = 4 mg/kg). The volumes of each subfield were obtained automatically from the pre-contrast T1 -weighted data. The dynamically acquired SWI data were co-registered and adaptively combined to reduce the blooming artifacts from large vessels, preserving the contrast from smaller vessels. The resultant SWI data were used to segment the hippocampal vasculature and to measure the FVD ((volume occupied by vessels)/(total volume)) for each subfield. The hippocampal fissure, along with the fimbria, granular cell layer of the dentate gyrus and cornu ammonis layers (except for CA1), showed higher micro-vascular FVD than the other parts of hippocampus. The CA1 region exhibited a significant correlation with age (R = −0.37, p < 0.05). demonstrating an overall loss of hippocampal vascularity in the normal aging process. Moreover, the vascular density reduction was more prominent than the age correlation with the volume reduction (R = −0.1, p > 0.05) of the CA1 subfield, which would suggest that vascular degeneration may precede tissue atrophy.
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28
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De Meo E, Portaccio E, Prestipino E, Nacmias B, Bagnoli S, Razzolini L, Pastò L, Niccolai C, Goretti B, Bellinvia A, Fonderico M, Giorgio A, Stromillo ML, Filippi M, Sorbi S, De Stefano N, Amato MP. Effect of BDNF Val66Met polymorphism on hippocampal subfields in multiple sclerosis patients. Mol Psychiatry 2022; 27:1010-1019. [PMID: 34650209 DOI: 10.1038/s41380-021-01345-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 01/20/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism was shown to strongly affect BDNF function, but its role in modulating gray matter damage in multiple sclerosis (MS) patients is still not clear. Given BDNF relevance on the hippocampus, we aimed to explore BDNF Val66Met polymorphism effect on hippocampal subfield volumes and its role in cognitive functioning in MS patients. Using a 3T scanner, we obtained dual-echo and 3DT1-weighted sequences from 50 MS patients and 15 healthy controls (HC) consecutively enrolled. MS patients also underwent genotype analysis of BDNF, neurological and neuropsychological evaluation. Hippocampal subfields were segmented by using Freesurfer. The BDNF Val66Met polymorphism was found in 22 MS patients (44%). Compared to HC, MS patients had lower volume in: bilateral hippocampus-amygdala transition area (HATA); cornus ammonis (CA)1, granule cell layer of dentate gyrus (GCL-DG), CA4 and CA3 of the left hippocampal head; molecular layer (ML) of the left hippocampal body; presubiculum of right hippocampal body and right fimbria. Compared to BDNF Val66Val, Val66Met MS patients had higher volume in bilateral hippocampal tail; CA1, ML, CA3, CA4, and GCL-DG of left hippocampal head; CA1, ML, and CA3 of the left hippocampal body; left HATA and presubiculum of the right hippocampal head. In MS patients, higher lesion burden was associated with lower volume of presubiculum of right hippocampal body; lower volume of left hippocampal tail was associated with worse visuospatial memory performance; lower volume of left hippocampal head with worse performance in semantic fluency. Our findings suggest the BNDF Val66Met polymorphism may have a protective role in MS patients against both hippocampal atrophy and cognitive impairment. BDNF genotype might be a potential biomarker for predicting cognitive prognosis, and an interesting target to study for neuroprotective strategies.
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Affiliation(s)
- Ermelinda De Meo
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
| | - Emilio Portaccio
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Elio Prestipino
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy
| | - Benedetta Nacmias
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Silvia Bagnoli
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy
| | | | - Luisa Pastò
- Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | | | - Benedetta Goretti
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy
| | | | | | - Antonio Giorgio
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurology Unit,, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sandro Sorbi
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Maria Pia Amato
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
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29
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Comparison of the Effects of Cuprizone on Demyelination in the Corpus Callosum and Hippocampal Progenitors in Young Adult and Aged Mice. Neurochem Res 2022; 47:1073-1082. [DOI: 10.1007/s11064-021-03506-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 01/08/2023]
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30
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Bourel J, Planche V, Dubourdieu N, Oliveira A, Séré A, Ducourneau EG, Tible M, Maitre M, Lesté-Lasserre T, Nadjar A, Desmedt A, Ciofi P, Oliet SH, Panatier A, Tourdias T. Complement C3 mediates early hippocampal neurodegeneration and memory impairment in experimental multiple sclerosis. Neurobiol Dis 2021; 160:105533. [PMID: 34673149 DOI: 10.1016/j.nbd.2021.105533] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/09/2021] [Accepted: 10/17/2021] [Indexed: 12/26/2022] Open
Abstract
Memory impairment is one of the disabling manifestations of multiple sclerosis (MS) possibly present from the early stages of the disease and for which there is no specific treatment. Hippocampal synaptic dysfunction and dendritic loss, associated with microglial activation, can underlie memory deficits, yet the molecular mechanisms driving such hippocampal neurodegeneration need to be elucidated. In early-stage experimental autoimmune encephalomyelitis (EAE) female mice, we assessed the expression level of molecules involved in microglia-neuron interactions within the dentate gyrus and found overexpression of genes of the complement pathway. Compared to sham immunized mice, the central element of the complement cascade, C3, showed the strongest and 10-fold upregulation, while there was no increase of downstream factors such as the terminal component C5. The combination of in situ hybridization with immunofluorescence showed that C3 transcripts were essentially produced by activated microglia. Pharmacological inhibition of C3 activity, by daily administration of rosmarinic acid, was sufficient to prevent early dendritic loss, microglia-mediated phagocytosis of synapses in the dentate gyrus, and memory impairment in EAE mice, while morphological markers of microglial activation were still observed. In line, when EAE was induced in C3 deficient mice (C3KO), dendrites and spines of the dentate gyrus as well as memory abilities were preserved. Altogether, these data highlight the central role of microglial C3 in early hippocampal neurodegeneration and memory impairment in EAE and, therefore, pave the way toward new neuroprotective strategies in MS to prevent cognitive deficit using complement inhibitors.
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Affiliation(s)
- Julien Bourel
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | - Vincent Planche
- Univ. Bordeaux, CNRS, UMR 5293, Institut des Maladies Neurodégénératives, F-33000 Bordeaux, France
| | - Nadège Dubourdieu
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | - Aymeric Oliveira
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | - Alexandra Séré
- Univ. Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, F-33000 Bordeaux, France
| | | | - Marion Tible
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | - Marlène Maitre
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | | | - Agnes Nadjar
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France; Univ. Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, F-33000 Bordeaux, France
| | - Aline Desmedt
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | - Philippe Ciofi
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | - Stéphane H Oliet
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | - Aude Panatier
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France
| | - Thomas Tourdias
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, F-3300 Bordeaux, France; CHU de Bordeaux, Neuroimagerie diagnostique et thérapeutique, F-33000 Bordeaux, France.
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31
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Valdés Cabrera D, Smyth P, Blevins G, Emery D, Beaulieu C. Diffusion imaging of fornix and interconnected limbic deep grey matter is linked to cognitive impairment in multiple sclerosis. Eur J Neurosci 2021; 55:277-294. [PMID: 34806796 DOI: 10.1111/ejn.15539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/29/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022]
Abstract
Diffusion tensor imaging (DTI) and volumetric magnetic resonance imaging (MRI) have shown white matter (WM) and deep grey matter (GM) abnormalities in the limbic system of multiple sclerosis (MS) participants. Structures like the fornix have been associated with cognitive impairment (CI) in MS, but the diffusion metrics are often biased by partial volume effects from cerebrospinal fluid (CSF) due to its small bundle size and intraventricular location. These errors in DTI parameter estimation worsen with atrophy in MS. The goal here was to evaluate DTI parameters and volumes of the fornix, as well as associated deep GM structures like the thalamus and hippocampus, with high-resolution fluid-attenuated inversion recovery (FLAIR)-DTI at 3T in 43 MS patients, with and without CI, versus 43 controls. The fornix, thalamus and hippocampus displayed atrophy and/or abnormal diffusion metrics, with the fornix showing the most extensive changes within the structures studied here, mainly in CI MS. The affected fornix volumes and diffusion metrics were associated with thalamic atrophy and atypical diffusion metrics in interconnected limbic GM, larger total lesion volume and global brain atrophy. Lower fractional anisotropy (FA) and higher mean and radial diffusivity in the fornix, lower hippocampus FA and lower thalamus volume were strongly correlated with CI in MS. Hippocampus FA and thalamus atrophy were negatively correlated with fatigue and longer time since MS symptoms onset, respectively. FLAIR-DTI and volumetric analyses provided methodologically superior evidence for microstructural abnormalities and extensive atrophy of the fornix and interconnected deep GM in MS that were associated with cognitive deficits.
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Affiliation(s)
| | - Penelope Smyth
- Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Gregg Blevins
- Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Derek Emery
- Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Christian Beaulieu
- Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
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32
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Tan LSY, Francis HM, Lim CK. Exploring the roles of tryptophan metabolism in MS beyond neuroinflammation and neurodegeneration: A paradigm shift to neuropsychiatric symptoms. Brain Behav Immun Health 2021; 12:100201. [PMID: 34589733 PMCID: PMC8474511 DOI: 10.1016/j.bbih.2021.100201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 11/05/2022] Open
Abstract
The metabolism of tryptophan through the kynurenine pathway (KP) has been increasingly recognised in contributing to disease progression in the autoimmune and inflammatory disease multiple sclerosis (MS). In this review, the roles of inflammation and the KP are recontextualised to better understand the aetiology of the neuropsychiatric symptoms (depression, postpartum depression, suicidality, fatigue and cognitive dysfunction) in MS. These symptoms will be discussed in the context of cytokine-induced sickness behaviours, KP activation and levels of neurotoxicity and neuroprotection in MS. In particular, there will be emphasis on how neuropsychiatric symptoms in MS occur against the shared background of inflammation and KP dysregulation. The discourse of this review aims to promote future research in elucidating KP mechanisms in MS that would inevitably lead to more targeted treatment options for neuropsychiatric symptoms and disease progression. Research on tryptophan metabolism and neuroinflammation on neurodegeneration in multiple sclerosis (MS) is mounting. This review reframes the roles of neuroinflammation and tryptophan metabolism dysregulation on mental health issues in MS. The impact of neuroinflammation and tryptophan metabolism on depression, suicidality, fatigue, and cognitive impairment in MS are discussed.
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Affiliation(s)
- Lorraine S Y Tan
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Heather M Francis
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Chai K Lim
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
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33
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Complement-associated loss of CA2 inhibitory synapses in the demyelinated hippocampus impairs memory. Acta Neuropathol 2021; 142:643-667. [PMID: 34170374 PMCID: PMC8423657 DOI: 10.1007/s00401-021-02338-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 12/27/2022]
Abstract
The complement system is implicated in synapse loss in the MS hippocampus, but the functional consequences of synapse loss remain poorly understood. Here, in post-mortem MS hippocampi with demyelination we find that deposits of the complement component C1q are enriched in the CA2 subfield, are linked to loss of inhibitory synapses and are significantly higher in MS patients with cognitive impairments compared to those with preserved cognitive functions. Using the cuprizone mouse model of demyelination, we corroborated that C1q deposits are highest within the demyelinated dorsal hippocampal CA2 pyramidal layer and co-localized with inhibitory synapses engulfed by microglia/macrophages. In agreement with the loss of inhibitory perisomatic synapses, we found that Schaffer collateral feedforward inhibition but not excitation was impaired in CA2 pyramidal neurons and accompanied by intrinsic changes and a reduced spike output. Finally, consistent with excitability deficits, we show that cuprizone-treated mice exhibit impaired encoding of social memories. Together, our findings identify CA2 as a critical circuit in demyelinated intrahippocampal lesions and memory dysfunctions in MS.
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34
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Gu XQ, Liu Y, Gu JB, Li LF, Fu LL, Han XM. Correlations between hippocampal functional connectivity, structural changes, and clinical data in patients with relapsing-remitting multiple sclerosis: a case-control study using multimodal magnetic resonance imaging. Neural Regen Res 2021; 17:1115-1124. [PMID: 34558540 PMCID: PMC8552851 DOI: 10.4103/1673-5374.324855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Multiple sclerosis is associated with structural and functional brain alterations leading to cognitive impairments across multiple domains including attention, memory, and the speed of information processing. The hippocampus, which is a brain important structure involved in memory, undergoes microstructural changes in the early stage of multiple sclerosis. In this study, we analyzed hippocampal function and structure in patients with relapsing-remitting multiple sclerosis and explored correlations between the functional connectivity of the hippocampus to the whole brain, changes in local brain function and microstructure, and cognitive function at rest. We retrospectively analyzed data from 20 relapsing-remitting multiple sclerosis patients admitted to the Department of Neurology at the China-Japan Union Hospital of Jilin University, China, from April 2015 to November 2019. Sixteen healthy volunteers were recruited as the healthy control group. All participants were evaluated using a scale of extended disability status and the Montreal cognitive assessment within 1 week before and after head diffusion tensor imaging and functional magnetic resonance imaging. Compared with the healthy control group, the patients with relapsing-remitting multiple sclerosis had lower Montreal cognitive assessment scores and regions of simultaneously enhanced and attenuated whole-brain functional connectivity and local functional connectivity in the bilateral hippocampus. Hippocampal diffusion tensor imaging data showed that, compared with the healthy control group, patients with relapsing-remitting multiple sclerosis had lower hippocampal fractional anisotropy values and higher mean diffusivity values, suggesting abnormal hippocampal structure. The left hippocampus whole-brain functional connectivity was negatively correlated with the Montreal cognitive assessment score (r = −0.698, P = 0.025), and whole-brain functional connectivity of the right hippocampus was negatively correlated with extended disability status scale score (r = −0.649, P = 0.042). The mean diffusivity value of the left hippocampus was negatively correlated with the Montreal cognitive assessment score (r = −0.729, P = 0.017) and positively correlated with the extended disability status scale score (r = 0.653, P = 0.041). The right hippocampal mean diffusivity value was positively correlated with the extended disability status scale score (r = 0.684, P = 0.029). These data suggest that the functional connectivity and presence of structural abnormalities in the hippocampus in patients with relapse-remission multiple sclerosis are correlated with the degree of cognitive function and extent of disability. This study was approved by the Ethics Committee of China-Japan Union Hospital of Jilin University, China (approval No. 201702202) on February 22, 2017.
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Affiliation(s)
- Xin-Quan Gu
- China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ying Liu
- Cardre's Ward, Changchun Central hospital, Changchun, Jilin Province, China
| | - Jie-Bing Gu
- First Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Lin-Fang Li
- First Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ling-Ling Fu
- First Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Xue-Mei Han
- First Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
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35
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Ciolac D, Gonzalez-Escamilla G, Radetz A, Fleischer V, Person M, Johnen A, Landmeyer NC, Krämer J, Muthuraman M, Meuth SG, Groppa S. Sex-specific signatures of intrinsic hippocampal networks and regional integrity underlying cognitive status in multiple sclerosis. Brain Commun 2021; 3:fcab198. [PMID: 34514402 PMCID: PMC8417841 DOI: 10.1093/braincomms/fcab198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/27/2021] [Accepted: 07/15/2021] [Indexed: 11/24/2022] Open
Abstract
The hippocampus is an anatomically compartmentalized structure embedded in highly wired networks that are essential for cognitive functions. The hippocampal vulnerability has been postulated in acute and chronic neuroinflammation in multiple sclerosis, while the patterns of occurring inflammation, neurodegeneration or compensation have not yet been described. Besides focal damage to hippocampal tissue, network disruption is an important contributor to cognitive decline in multiple sclerosis patients. We postulate sex-specific trajectories in hippocampal network reorganization and regional integrity and address their relationship to markers of neuroinflammation, cognitive/memory performance and clinical severity. In a large cohort of multiple sclerosis patients (n = 476; 337 females, age 35 ± 10 years, disease duration 16 ± 14 months) and healthy subjects (n = 110, 54 females; age 34 ± 15 years), we utilized MRI at baseline and at 2-year follow-up to quantify regional hippocampal volumetry and reconstruct single-subject hippocampal networks. Through graph analytical tools we assessed the clustered topology of the hippocampal networks. Mixed-effects analyses served to model sex-based differences in hippocampal network and subfield integrity between multiple sclerosis patients and healthy subjects at both time points and longitudinally. Afterwards, hippocampal network and subfield integrity were related to clinical and radiological variables in dependency of sex attribution. We found a more clustered network architecture in both female and male patients compared to their healthy counterparts. At both time points, female patients displayed a more clustered network topology in comparison to male patients. Over time, multiple sclerosis patients developed an even more clustered network architecture, though with a greater magnitude in females. We detected reduced regional volumes in most of the addressed hippocampal subfields in both female and male patients compared to healthy subjects. Compared to male patients, females displayed lower volumes of para- and presubiculum but higher volumes of the molecular layer. Longitudinally, volumetric alterations were more pronounced in female patients, which showed a more extensive regional tissue loss. Despite a comparable cognitive/memory performance between female and male patients over the follow-up period, we identified a strong interrelation between hippocampal network properties and cognitive/memory performance only in female patients. Our findings evidence a more clustered hippocampal network topology in female patients with a more extensive subfield volume loss over time. A stronger relation between cognitive/memory performance and the network topology in female patients suggests greater entrainment of the brain’s reserve. These results may serve to adapt sex-targeted neuropsychological interventions.
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Affiliation(s)
- Dumitru Ciolac
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz 55131, Germany.,Department of Neurology, Institute of Emergency Medicine, Chisinau 2004, Moldova.,Laboratory of Neurobiology and Medical Genetics, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau 2004, Moldova
| | - Gabriel Gonzalez-Escamilla
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz 55131, Germany
| | - Angela Radetz
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz 55131, Germany
| | - Vinzenz Fleischer
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz 55131, Germany
| | - Maren Person
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz 55131, Germany
| | - Andreas Johnen
- Department of Neurology with Institute of Translational Neurology, University Hospital of Münster, Münster 48149, Germany
| | - Nils C Landmeyer
- Department of Neurology with Institute of Translational Neurology, University Hospital of Münster, Münster 48149, Germany
| | - Julia Krämer
- Department of Neurology with Institute of Translational Neurology, University Hospital of Münster, Münster 48149, Germany
| | - Muthuraman Muthuraman
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz 55131, Germany
| | - Sven G Meuth
- Department of Neurology, Heinrich Heine University, Düsseldorf 40225, Germany
| | - Sergiu Groppa
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz 55131, Germany
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36
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Haines S, Butler E, Stuckey S, Hester R, Grech LB. Relationship Between Interpersonal Depressive Symptoms and Reduced Amygdala Volume in People with Multiple Sclerosis: Considerations for Clinical Practice. Int J MS Care 2021; 23:178-185. [PMID: 34483757 DOI: 10.7224/1537-2073.2020-015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background The lifetime prevalence of depression in people with multiple sclerosis (MS) is approximately 50% compared with around 15% in the general population. There is a relationship between depression and quality of life in people with MS and evidence that depression may contribute to disease progression. Methods This cross-sectional pilot study assessed the association between depression and regional brain atrophy, including amygdala and hippocampal volume. Forty-nine participants with MS recruited through a hospital MS clinic were administered the Center for Epidemiological Studies Depression Scale Revised (CESD-R) to investigate whether higher endorsements on the items depressive affect and interpersonal symptoms were associated with volumetric magnetic resonance imaging measurements of hippocampal and amygdala atrophy. Results Regression analysis revealed an association between depression-related interpersonal symptoms and right amygdala volume. No association was found between depression and hippocampal volume. Conclusions These results provide preliminary support for a unilateral, biologically based relationship between the right amygdala and characteristic interpersonal depressive symptoms expressed by people with MS and add to the growing body of literature implicating regional brain atrophy in MS-associated depression. Given that the interpersonal subcomponent of the CESD-R measures social functioning, and the neural networks in the amygdala are known to be implicated in processing social stimuli, this research suggests that targeted diagnosis and treatments for depression in people with MS may be particularly beneficial. Further confirmatory research of this relationship is required.
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37
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Cacciaguerra L, Valsasina P, Meani A, Riccitelli GC, Radaelli M, Rocca MA, Filippi M. Volume of hippocampal subfields and cognitive deficits in neuromyelitis optica spectrum disorders. Eur J Neurol 2021; 28:4167-4177. [PMID: 34415660 DOI: 10.1111/ene.15073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 07/28/2021] [Accepted: 08/17/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Aquaporin-4 (AQP4) water channel is involved in hippocampal plasticity and is the target of neuromyelitis optica spectrum disorders (NMOSD) autoimmunity. We measured volumes of hippocampal subfields and their association with cognitive performance in AQP4-seropositive NMOSD patients. METHODS Global and regional hippocampal volumes were derived from 28 AQP4-seropositive NMOSD patients and 101 healthy controls (HC) from 3D-T1-weighted images. Normalized brain volumes were also calculated. A neuropsychological evaluation, including the Brief Repeatable Battery of Neuropsychological Tests, was performed in patients. Based on HC data, we estimated mean z-scores of volumes in the whole NMOSD group and compared them according to the status of global and domain-selective cognitive impairment. RESULTS Global cognitive impairment was detected in 46.4% of NMOSD patients, with attentive (60.7%) and executive (21.4%) domains being the most affected. NMOSD patients had left hippocampal atrophy at global (p = 0.012) and regional level (fimbria, Cornu Ammonis [CA] 3, molecular layer, dentate gyrus [DG], and subicular complex, p values ranging between 0.033 and <0.001). On the right side the fimbria and hippocampal tail were atrophic (p = 0.024 for both). Cognitively impaired patients showed atrophy in the left CA3 and CA4 (p = 0.025-0.028), while patients presenting verbal and visual memory impairment had significant CA3 and DG atrophy. Those patients with attentive or executive impairment had preserved brain and hippocampal volumes. CONCLUSIONS NMOSD patients showed hippocampal atrophy associated with verbal and visual memory impairment. Such damage did not explain attention and executive function alterations, which were the most common cognitive deficits in this population.
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Affiliation(s)
- Laura Cacciaguerra
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Valsasina
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Meani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gianna C Riccitelli
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marta Radaelli
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
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38
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Ontaneda D, Raza PC, Mahajan KR, Arnold DL, Dwyer MG, Gauthier SA, Greve DN, Harrison DM, Henry RG, Li DKB, Mainero C, Moore W, Narayanan S, Oh J, Patel R, Pelletier D, Rauscher A, Rooney WD, Sicotte NL, Tam R, Reich DS, Azevedo CJ. Deep grey matter injury in multiple sclerosis: a NAIMS consensus statement. Brain 2021; 144:1974-1984. [PMID: 33757115 PMCID: PMC8370433 DOI: 10.1093/brain/awab132] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/13/2022] Open
Abstract
Although multiple sclerosis has traditionally been considered a white matter disease, extensive research documents the presence and importance of grey matter injury including cortical and deep regions. The deep grey matter exhibits a broad range of pathology and is uniquely suited to study the mechanisms and clinical relevance of tissue injury in multiple sclerosis using magnetic resonance techniques. Deep grey matter injury has been associated with clinical and cognitive disability. Recently, MRI characterization of deep grey matter properties, such as thalamic volume, have been tested as potential clinical trial end points associated with neurodegenerative aspects of multiple sclerosis. Given this emerging area of interest and its potential clinical trial relevance, the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative held a workshop and reached consensus on imaging topics related to deep grey matter. Herein, we review current knowledge regarding deep grey matter injury in multiple sclerosis from an imaging perspective, including insights from histopathology, image acquisition and post-processing for deep grey matter. We discuss the clinical relevance of deep grey matter injury and specific regions of interest within the deep grey matter. We highlight unanswered questions and propose future directions, with the aim of focusing research priorities towards better methods, analysis, and interpretation of results.
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Affiliation(s)
- Daniel Ontaneda
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Praneeta C Raza
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Kedar R Mahajan
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Douglas L Arnold
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, The State University of New York, Buffalo, NY 14214, USA
| | - Susan A Gauthier
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA
| | - Douglas N Greve
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02129, USA
| | - Daniel M Harrison
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Roland G Henry
- Department of Neurology, Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
- The UC San Francisco and Berkeley Bioengineering Graduate Group, University of California San Francisco, San Francisco, CA 94143, USA
| | - David K B Li
- Department of Radiology and Medicine (Neurology), University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
| | - Caterina Mainero
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02129, USA
| | - Wayne Moore
- Department of Pathology and Laboratory Medicine, and International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Sridar Narayanan
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Jiwon Oh
- Division of Neurology, St. Michael’s Hospital, University of Toronto, Toronto, Ontario M5B 1W8, Canada
| | - Raihaan Patel
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec H4H 1R3, Canada
- Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Daniel Pelletier
- Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
| | - Alexander Rauscher
- Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health and Science University, Portland, OR 97239, USA
| | - Nancy L Sicotte
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Roger Tam
- Department of Radiology and Medicine (Neurology), University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
- Biomedical Engineering, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Daniel S Reich
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20824, USA
| | - Christina J Azevedo
- Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
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Zheng F, Li Y, Zhuo Z, Duan Y, Cao G, Tian D, Zhang X, Li K, Zhou F, Huang M, Li H, Li Y, Zeng C, Zhang N, Sun J, Yu C, Han X, Hallar S, Barkhof F, Liu Y. Structural and functional hippocampal alterations in Multiple sclerosis and neuromyelitis optica spectrum disorder. Mult Scler 2021; 28:707-717. [PMID: 34379008 DOI: 10.1177/13524585211032800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Hippocampal involvement may differ between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). OBJECTIVE To investigate the morphometric, diffusion and functional alterations in hippocampus in MS and NMOSD and the clinical significance. METHODS A total of 752 participants including 236 MS, 236 NMOSD and 280 healthy controls (HC) were included in this retrospective multi-center study. The hippocampus and subfield volumes, fractional anisotropy (FA) and mean diffusivity (MD), amplitude of low frequency fluctuation (ALFF) and degree centrality (DC) were analyzed, and their associations with clinical variables were investigated. RESULTS The hippocampus showed significantly lower volume, FA and greater MD in MS compared to NMOSD and HC (p < 0.05), while no abnormal ALFF or DC was identified in any group. Hippocampal subfields were affected in both diseases, though subiculum, presubiculum and fimbria showed significantly lower volume only in MS (p < 0.05). Significant correlations between diffusion alterations, several subfield volumes and clinical variables were observed in both diseases, especially in MS (R = -0.444 to 0.498, p < 0.05). FA and MD showed fair discriminative power between MS and HC, NMOSD and HC (AUC > 0.7). CONCLUSIONS Hippocampal atrophy and diffusion abnormalities were identified in MS and NMOSD, partly explaining how clinical disability and cognitive impairment are differentially affected.
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Affiliation(s)
- Fenglian Zheng
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuxin Li
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhizheng Zhuo
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yunyun Duan
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guanmei Cao
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Decai Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xinghu Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China/Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, China
| | - Muhua Huang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China/Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, China
| | - Haiqing Li
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yongmei Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chun Zeng
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ningnannan Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Sun
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Xuemei Han
- Department of Neurology, China-Japan Union hospital of Jilin University, Changchun, China
| | - Sven Hallar
- Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland/Department of Surgical Sciences, Radiology, Uppsala University, Sweden/Faculty of Medicine of the University of Geneva, Switzerland/Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, The Netherlands/Queen Square Institute of Neurology and Center for Medical Image Computing, University College London, London, UK
| | - Yaou Liu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Conti L, Preziosa P, Meani A, Pagani E, Valsasina P, Marchesi O, Vizzino C, Rocca MA, Filippi M. Unraveling the substrates of cognitive impairment in multiple sclerosis: A multiparametric structural and functional magnetic resonance imaging study. Eur J Neurol 2021; 28:3749-3759. [PMID: 34255918 DOI: 10.1111/ene.15023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cognitive impairment frequently affects multiple sclerosis (MS) patients. However, its neuroanatomical correlates still need to be fully explored. We investigated the contribution of structural and functional magnetic resonance imaging (MRI) abnormalities in explaining cognitive impairment in MS. METHODS Brain dual-echo, diffusion tensor, 3D T1-weighted and resting-state (RS) MRI sequences were acquired from 276 MS patients and 102 healthy controls. Using random forest analysis, the contribution of regional white matter (WM) lesions, WM fractional anisotropy (FA) abnormalities, gray matter (GM) atrophy and RS functional connectivity (FC) alterations to cognitive impairment in MS patients was investigated. RESULTS Eighty-four MS patients (30.4%) were cognitively impaired. The best MRI predictors of cognitive impairment (relative importance [%]) (out-of-bag area under the curve [AUC] = 0.795) were (a) WM lesions in the right superior longitudinal fasciculus (100%), left anterior thalamic radiation (93.4%), left posterior corona radiata (78.5%), left medial lemniscus (74.2%), left inferior longitudinal fasciculus (70.4%), left optic radiation (68.7%), right middle cerebellar peduncle (60.6%) and right optic radiation (53.5%); (b) decreased FA in the splenium of the corpus callosum (64.3%), left optic radiation (61.0%), body of the corpus callosum (51.9%) and fornix (50.9%); and (c) atrophy of the left precuneus (91.4%), right cerebellum crus I (84.4%), right caudate nucleus (78.6%), left thalamus (76.2%) and left supplementary motor area (59.8%). The relevance of these MRI measures in explaining cognitive impairment was confirmed in a cross-validation analysis (AUC =0.765). CONCLUSION Structural damage in strategic WM and GM regions explains cognitive impairment in MS patients more than RS FC abnormalities.
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Affiliation(s)
- Lorenzo Conti
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Preziosa
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Meani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Valsasina
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Olga Marchesi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carmen Vizzino
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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41
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Fabri TL, Datta R, O'Mahony J, Barlow-Krelina E, De Somma E, Longoni G, Gur RE, Gur RC, Bacchus M, Ann Yeh E, Banwell BL, Till C. Memory, processing of emotional stimuli, and volume of limbic structures in pediatric-onset multiple sclerosis. Neuroimage Clin 2021; 31:102753. [PMID: 34273791 PMCID: PMC8319518 DOI: 10.1016/j.nicl.2021.102753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The limbic system is involved in memory and in processing of emotional stimuli. We measured volume of the hippocampus, amygdala, and thalamus, and assessed their relative contribution to episodic memory and emotion identification in POMS. METHOD Sixty-five POMS participants (Mage = 18.3 ± 3.9 years; 48 female (73.8%)), average disease duration = 3.8 ± 3.8 years) and 76 age- and sex-matched controls (Mage = 18.1 ± 4.6 years; 49 female (64.5%)) completed the Penn Computerized Neurocognitive Battery (PCNB); 59 of 65 POMS participants and 69 out of 76 controls underwent 3 T MRI scanning. We derived age-adjusted Z-scores on accuracy and response time (RT) measures of episodic memory and emotion identification of the PCNB. Magnetic resonance imaging (MRI) volumetrics were normalized using the scaling factor computed by SIENAx. On PCNB tests that differed between groups, we used multiple linear regression to assess relationships between regional brain volumes and either episodic memory or emotion identification outcomes controlling for age, sex, accuracy/RT, and parental education. RESULTS POMS participants were slower and less accurate than controls on the episodic memory domain but did not differ from controls on emotion outcomes. At the subtest level, POMS participants showed reduced accuracy on Word Memory (p = .002) and slower performance on Face Memory (p = .04) subtests. POMS participants had smaller total and regional brain volumes of the hippocampus, amygdala, and thalamus (p values ≤ 0.01). Collapsing across groups, both hippocampal and thalamic volume were significant predictors of Word Memory accuracy; hippocampal volume (B = 0.24, SE = 0.10, p = .02) was more strongly associated with Word Memory performance than thalamic volume (B = 0.16, SE = 0.05, p = .003), though the estimate with was less precise. CONCLUSIONS POMS participants showed reduced episodic memory performance compared to controls. Aspects of episodic memory performance were associated with hippocampal and thalamic volume. Emotion identification was intact, despite volume loss in the amygdala.
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Affiliation(s)
| | - Ritobrato Datta
- Division of Neurology, Children's Hospital of Philadelphia, United States
| | - Julia O'Mahony
- Departments of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Giulia Longoni
- Department of Paediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada
| | - Raquel E Gur
- Penn-CHOP Lifespan Brain Institute, Departments of Psychiatry, Neurology, and Radiology, University of Pennsylvania School of Medicine, United States
| | - Ruben C Gur
- Penn-CHOP Lifespan Brain Institute, Departments of Psychiatry, Neurology, and Radiology, University of Pennsylvania School of Medicine, United States
| | - Micky Bacchus
- Division of Neurology, Children's Hospital of Philadelphia, United States
| | - E Ann Yeh
- Department of Paediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada
| | - Brenda L Banwell
- Division of Neurology, Children's Hospital of Philadelphia, United States; Perelman School of Medicine, University of Pennsylvania, United States
| | - Christine Till
- Department of Psychology, York University, Canada; Department of Paediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada.
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Clarelli F, Assunta Rocca M, Santoro S, De Meo E, Ferrè L, Sorosina M, Martinelli Boneschi F, Esposito F, Filippi M. Assessment of the genetic contribution to brain magnetic resonance imaging lesion load and atrophy measures in multiple sclerosis patients. Eur J Neurol 2021; 28:2513-2522. [PMID: 33864731 DOI: 10.1111/ene.14872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/22/2021] [Accepted: 04/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE Multiple sclerosis (MS) susceptibility is influenced by genetics; however, little is known about genetic determinants of disease expression. We aimed at assessing genetic factors influencing quantitative neuroimaging measures in two cohorts of progressive MS (PMS) and relapsing-remitting MS (RRMS) patients. METHODS Ninety-nine PMS and 214 RRMS patients underwent a 3-T brain magnetic resonance imaging (MRI) scan, with the measurement of five MRI metrics including T2 lesion volumes and measures of white matter, grey matter, deep grey matter, and hippocampal volumes. A candidate pathway strategy was adopted; gene set analysis was carried out to estimate cumulative contribution of genes to MRI phenotypes, adjusting for relevant confounders, followed by single nucleotide polymorphism (SNP) regression analysis. RESULTS Seventeen Kyoto Encyclopedia of Genes and Genomes pathways and 42 Gene Ontology (GO) terms were tested. We additionally included in the analysis genes with enriched expression in brain cells. Gene set analysis revealed a differential pattern of association across the two cohorts, with processes related to sodium homeostasis being associated with grey matter volume in PMS (p = 0.002), whereas inflammatory-related GO terms such as adaptive immune response and regulation of inflammatory response appeared to be associated with T2 lesion volume in RRMS (p = 0.004 and p = 0.008, respectively). As for SNPs, the rs7104613T mapping to SPON1 gene was associated with reduced deep grey matter volume (β = -0.731, p = 3.2*10-7 ) in PMS, whereas we found evidence of association between white matter volume and rs740948A mapping to SEMA3A gene (β = 22.04, p = 5.5*10-6 ) in RRMS. CONCLUSIONS Our data suggest a different pattern of associations between MRI metrics and functional processes across MS disease courses, suggesting different phenomena implicated in MS.
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Affiliation(s)
- Ferdinando Clarelli
- Laboratory of Human Genetics of Neurological Disorders, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Assunta Rocca
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Silvia Santoro
- Laboratory of Human Genetics of Neurological Disorders, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ermelinda De Meo
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Ferrè
- Laboratory of Human Genetics of Neurological Disorders, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Melissa Sorosina
- Laboratory of Human Genetics of Neurological Disorders, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Filippo Martinelli Boneschi
- Department of Pathophysiology and Transplantation, Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan, Italy.,Neurology Unit and MS Centre, Foundation IRCCS Ca, Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Esposito
- Laboratory of Human Genetics of Neurological Disorders, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Aghjayan SL, Lesnovskaya A, Esteban-Cornejo I, Peven JC, Stillman CM, Erickson KI. Aerobic exercise, cardiorespiratory fitness, and the human hippocampus. Hippocampus 2021; 31:817-844. [PMID: 34101305 PMCID: PMC8295234 DOI: 10.1002/hipo.23337] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 01/27/2023]
Abstract
The hippocampus is particularly susceptible to neurodegeneration. Physical activity, specifically increasing cardiorespiratory fitness via aerobic exercise, shows promise as a potential method for mitigating hippocampal decline in humans. Numerous studies have now investigated associations between the structure and function of the hippocampus and engagement in physical activity. Still, there remains continued debate and confusion about the relationship between physical activity and the human hippocampus. In this review, we describe the current state of the physical activity and exercise literature as it pertains to the structure and function of the human hippocampus, focusing on four magnetic resonance imaging measures: volume, diffusion tensor imaging, resting-state functional connectivity, and perfusion. We conclude that, despite significant heterogeneity in study methods, populations of interest, and scope, there are consistent positive findings, suggesting a promising role for physical activity in promoting hippocampal structure and function throughout the lifespan.
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Affiliation(s)
- Sarah L Aghjayan
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alina Lesnovskaya
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Irene Esteban-Cornejo
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,College of Science, Health, Engineering, and Education, Murdoch University, Perth, Western Australia
| | - Jamie C Peven
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chelsea M Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,College of Science, Health, Engineering, and Education, Murdoch University, Perth, Western Australia
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44
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Sumowski JF, Horng S, Brandstadter R, Krieger S, Leavitt VM, Katz Sand I, Fabian M, Klineova S, Graney R, Riley CS, Lublin FD, Miller AE, Varga AW. Sleep disturbance and memory dysfunction in early multiple sclerosis. Ann Clin Transl Neurol 2021; 8:1172-1182. [PMID: 33951348 PMCID: PMC8164863 DOI: 10.1002/acn3.51262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Sleep-dependent memory processing occurs in animals including humans, and disturbed sleep negatively affects memory. Sleep disturbance and memory dysfunction are common in multiple sclerosis (MS), but little is known about the contributions of sleep disturbance to memory in MS. We investigated whether subjective sleep disturbance is linked to worse memory in early MS independently of potential confounders. METHODS Persons with early MS (n = 185; ≤5.0 years diagnosed) and demographically matched healthy controls (n = 50) completed four memory tests to derive a memory composite, and four speeded tests to derive a cognitive efficiency composite. Z-scores were calculated relative to healthy controls. Sleep disturbance was defined by the Insomnia Severity Index score ≥ 10. ANCOVAs examined differences in memory and cognitive efficiency between patients with and without sleep disturbance controlling for potential confounds (e.g., mood, fatigue, disability, T2 lesion volume, gray matter volume). Comparisons were made to healthy controls. RESULTS Seventy-four (40%) patients reported sleep disturbance. Controlling for all covariates, patients with sleep disturbance had worse memory (z = -0.617; 95% CI: -0.886, -0.348) than patients without disturbance (z = -0.171, -0.425, 0.082, P = .003). Cognitive efficiency did not differ between groups. Relative to healthy controls, memory was worse among patients with sleep disturbance, but not among patients without sleep disturbance. INTERPRETATION Sleep disturbance contributes to MS memory dysfunction, which may help explain differential risk for memory dysfunction in persons with MS, especially since sleep disturbance is common in MS. Potential mechanisms linking sleep disturbance and memory are discussed, as well as recommendations for further mechanistic and interventional research.
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Affiliation(s)
- James F. Sumowski
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Sam Horng
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Rachel Brandstadter
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Stephen Krieger
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Victoria M. Leavitt
- Department of NeurologyColumbia University Medical CenterNew YorkNew YorkUSA
| | - Ilana Katz Sand
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Michelle Fabian
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Sylvia Klineova
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Robin Graney
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Claire S. Riley
- Department of NeurologyColumbia University Medical CenterNew YorkNew YorkUSA
| | - Fred D. Lublin
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Aaron E. Miller
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Andrew W. Varga
- Icahn School of Medicine at Mount SinaiDivision of PulmonaryCritical Care and Sleep MedicineNew YorkNew YorkUSA
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45
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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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46
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Baltan S, Jawaid SS, Chomyk AM, Kidd GJ, Chen J, Battapady HD, Chan R, Dutta R, Trapp BD. Neuronal hibernation following hippocampal demyelination. Acta Neuropathol Commun 2021; 9:34. [PMID: 33648591 PMCID: PMC7923530 DOI: 10.1186/s40478-021-01130-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/11/2021] [Indexed: 12/15/2022] Open
Abstract
Cognitive dysfunction occurs in greater than 50% of individuals with multiple sclerosis (MS). Hippocampal demyelination is a prominent feature of postmortem MS brains and hippocampal atrophy correlates with cognitive decline in MS patients. Cellular and molecular mechanisms responsible for neuronal dysfunction in demyelinated hippocampi are not fully understood. Here we investigate a mouse model of hippocampal demyelination where twelve weeks of treatment with the oligodendrocyte toxin, cuprizone, demyelinates over 90% of the hippocampus and causes decreased memory/learning. Long-term potentiation (LTP) of hippocampal CA1 pyramidal neurons is considered to be a major cellular readout of learning and memory in the mammalian brain. In acute slices, we establish that hippocampal demyelination abolishes LTP and excitatory post-synaptic potentials of CA1 neurons, while pre-synaptic function of Schaeffer collateral fibers is preserved. Demyelination also reduced Ca2+-mediated firing of hippocampal neurons in vivo. Using three-dimensional electron microscopy, we investigated the number, shape (mushroom, stubby, thin), and post-synaptic densities (PSDs) of dendritic spines that facilitate LTP. Hippocampal demyelination did not alter the number of dendritic spines. Surprisingly, dendritic spines appeared to be more mature in demyelinated hippocampi, with a significant increase in mushroom-shaped spines, more perforated PSDs, and more astrocyte participation in the tripartite synapse. RNA sequencing experiments identified 400 altered transcripts in demyelinated hippocampi. Gene transcripts that regulate myelination, synaptic signaling, astrocyte function, and innate immunity were altered in demyelinated hippocampi. Hippocampal remyelination rescued synaptic transmission, LTP, and the majority of gene transcript changes. We establish that CA1 neurons projecting demyelinated axons silence their dendritic spines and hibernate in a state that may protect the demyelinated axon and facilitates functional recovery following remyelination.
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Affiliation(s)
- Selva Baltan
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue/NC30, Cleveland, OH, 44195, USA
- Department of Perioperative Medicine, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Safdar S Jawaid
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue/NC30, Cleveland, OH, 44195, USA
- Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA
- Department of Biomedical Engineering, School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Anthony M Chomyk
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue/NC30, Cleveland, OH, 44195, USA
| | - Grahame J Kidd
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue/NC30, Cleveland, OH, 44195, USA
| | - Jacqueline Chen
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue/NC30, Cleveland, OH, 44195, USA
- Imaging Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Harsha D Battapady
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue/NC30, Cleveland, OH, 44195, USA
| | - Ricky Chan
- Cleveland Institute for Computational Biology, Cleveland, OH, 44106, USA
| | - Ranjan Dutta
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue/NC30, Cleveland, OH, 44195, USA
| | - Bruce D Trapp
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue/NC30, Cleveland, OH, 44195, USA.
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47
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Levman J, Das A, MacDonald A, MacDonald P, Berrigan L, Takahashi E. Clinically detectable structural abnormalities in pediatric-onset multiple sclerosis: A large-scale magnetic resonance imaging analysis. Int J Dev Neurosci 2021; 81:200-208. [PMID: 33434299 DOI: 10.1002/jdn.10090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/24/2020] [Accepted: 12/22/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Multiple Sclerosis is characterized by neural demyelination. Structural magnetic resonance imaging (MRI) provides soft tissue contrast, which forms the basis of techniques for extracting regional biomarkers across a participant's brain. OBJECTIVES To investigate the clinical presentation of multiple sclerosis in a large-scale MRI analysis that includes thorough consideration of extractable structural measurements (average and variability of regional cortical thicknesses, cortical surface measurements, and volumes). METHODS We performed a large-scale retrospective analysis of 370 T1 structural volumetric MRIs from 64 participants with multiple sclerosis and compared them with a large cohort of neurotypical participants, consisting of 993 MRIs from 988 participants. Regionally distributed measurements of cortical thickness (average and standard deviation) were extracted along with surface area, surface curvature, and volumetric measurements. RESULTS The largest observed finding involved regionally distributed reductions in average cortical thickness, with the parahippocampal region exhibiting the largest effect size, a finding that may be linked with known hippocampal atrophy in multiple sclerosis. Group-wise differences were also observed in terms of distributed volume, surface area, and surface curvature measurements. CONCLUSIONS Participants with pediatric-onset multiple sclerosis present clinically with a variety of structural abnormalities, including perirhinal cortex thickness abnormalities not previously reported in the literature.
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Affiliation(s)
- Jacob Levman
- Department of Computer Science, St. Francis Xavier University, Antigonish, NS, Canada
| | - Avilash Das
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Allissa MacDonald
- Department of Biology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Patrick MacDonald
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lindsay Berrigan
- Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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48
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Morgan BP, Gommerman JL, Ramaglia V. An "Outside-In" and "Inside-Out" Consideration of Complement in the Multiple Sclerosis Brain: Lessons From Development and Neurodegenerative Diseases. Front Cell Neurosci 2021; 14:600656. [PMID: 33488361 PMCID: PMC7817777 DOI: 10.3389/fncel.2020.600656] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
The last 15 years have seen an explosion of new findings on the role of complement, a major arm of the immune system, in the central nervous system (CNS) compartment including contributions to cell migration, elimination of synapse during development, aberrant synapse pruning in neurologic disorders, damage to nerve cells in autoimmune diseases, and traumatic injury. Activation of the complement system in multiple sclerosis (MS) is typically thought to occur as part of a primary (auto)immune response from the periphery (the outside) against CNS antigens (the inside). However, evidence of local complement production from CNS-resident cells, intracellular complement functions, and the more recently discovered role of early complement components in shaping synaptic circuits in the absence of inflammation opens up the possibility that complement-related sequelae may start and finish within the brain itself. In this review, the complement system will be introduced, followed by evidence that implicates complement in shaping the developing, adult, and normal aging CNS as well as its contribution to pathology in neurodegenerative conditions. Discussion of data supporting "outside-in" vs. "inside-out" roles of complement in MS will be presented, concluded by thoughts on potential approaches to therapies targeting specific elements of the complement system.
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Affiliation(s)
- B. Paul Morgan
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, United Kingdom
| | | | - Valeria Ramaglia
- Department of Immunology, University of Toronto, Toronto, ON, Canada
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49
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Toko M, Kitamura J, Ueno H, Ohshita T, Nemoto K, Ochi K, Higaki T, Akiyama Y, Awai K, Maruyama H. Prospective Memory Deficits in Multiple Sclerosis: Voxel-based Morphometry and Double Inversion Recovery Analysis. Intern Med 2021; 60:39-46. [PMID: 33390470 PMCID: PMC7835463 DOI: 10.2169/internalmedicine.5058-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective Prospective memory (PM) is an important social cognitive function in everyday life. PM is one of the most affected cognitive domains in multiple sclerosis (MS) patients. Gray matter (GM) atrophy and plaques have been attracting attention for various cognitive impairments in MS patients. This study aimed to clarify the atrophic GM regions associated with PM deficits and investigate the relationship between the atrophic GM regions and GM plaques. Methods Twenty-one MS patients and 10 healthy controls (HCs) underwent neuropsychological tests and MRI. PM was assessed using subtests of the Rivermead Behavioural Memory Test. A lesion symptom analysis was performed using voxel-based morphometry (VBM). We then evaluated GM plaques in the corresponding areas using double inversion recovery (DIR). Results MS patients showed lower PM scores than HCs (p=0.0064). The GM volume of MS patients tended to be lower than those of HCs. VBM analyses revealed correlations of the PM score with the orbital part of the left inferior frontal gyrus, the left hippocampus, and the right parahippocampus. There was no GM plaque in the orbital part of the left inferior frontal gyrus and the right parahippocampus. Only one patient (4.8%) had GM plaque in the left hippocampus. Conclusion The left inferior frontal gyrus, the left hippocampus, and the right parahippocampus were associated with PM in MS, whereas these atrophic GM regions were not associated with GM plaque. Regardless of the location of plaques on DIR, both PM deficit and GM atrophy should be detected using neuropsychological tests and VBM in MS patients.
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Affiliation(s)
- Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Juri Kitamura
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
- Department of Neurology, National Hospital Organization Higashihiroshima Medical Center, Japan
| | - Hiroki Ueno
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Tomohiko Ohshita
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Kazuhide Ochi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
- Department of Neurology, Hiroshima City Asa Citizens Hospital, Japan
| | - Toru Higaki
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Yuji Akiyama
- Department of Clinical Radiology, Hiroshima University Hospital, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
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50
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Berger T, Adamczyk-Sowa M, Csépány T, Fazekas F, Fabjan TH, Horáková D, Ledinek AH, Illes Z, Kobelt G, Jazbec SŠ, Klímová E, Leutmezer F, Rejdak K, Rozsa C, Sellner J, Selmaj K, Štouracˇ P, Szilasiová J, Turcˇáni P, Vachová M, Vanecková M, Vécsei L, Havrdová EK. Factors influencing daily treatment choices in multiple sclerosis: practice guidelines, biomarkers and burden of disease. Ther Adv Neurol Disord 2020; 13:1756286420975223. [PMID: 33335562 PMCID: PMC7724259 DOI: 10.1177/1756286420975223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/23/2020] [Indexed: 12/23/2022] Open
Abstract
At two meetings of a Central European board of multiple sclerosis (MS) experts in
2018 and 2019 factors influencing daily treatment choices in MS, especially
practice guidelines, biomarkers and burden of disease, were discussed. The
heterogeneity of MS and the complexity of the available treatment options call
for informed treatment choices. However, evidence from clinical trials is
generally lacking, particularly regarding sequencing, switches and escalation of
drugs. Also, there is a need to identify patients who require highly efficacious
treatment from the onset of their disease to prevent deterioration. The recently
published European Committee for the Treatment and Research in Multiple
Sclerosis/European Academy of Neurology clinical practice guidelines on
pharmacological management of MS cover aspects such as treatment efficacy,
response criteria, strategies to address suboptimal response and safety concerns
and are based on expert consensus statements. However, the recommendations
constitute an excellent framework that should be adapted to local regulations,
MS center capacities and infrastructure. Further, available and emerging
biomarkers for treatment guidance were discussed. Magnetic resonance imaging
parameters are deemed most reliable at present, even though complex assessment
including clinical evaluation and laboratory parameters besides imaging is
necessary in clinical routine. Neurofilament-light chain levels appear to
represent the current most promising non-imaging biomarker. Other immunological
data, including issues of immunosenescence, will play an increasingly important
role for future treatment algorithms. Cognitive impairment has been recognized
as a major contribution to MS disease burden. Regular evaluation of cognitive
function is recommended in MS patients, although no specific disease-modifying
treatment has been defined to date. Finally, systematic documentation of
real-life data is recognized as a great opportunity to tackle unresolved daily
routine challenges, such as use of sequential therapies, but requires joint
efforts across clinics, governments and pharmaceutical companies.
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Affiliation(s)
- Thomas Berger
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Tünde Csépány
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Tanja Hojs Fabjan
- Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | - Dana Horáková
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | | | - Zsolt Illes
- Department of Neurology, University of Southern Denmark, Odense, Denmark
| | | | - Saša Šega Jazbec
- Department of Neurology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - Eleonóra Klímová
- Department of Neurology, University of Prešov and Teaching Hospital of J. A. Reiman, Prešov, Slovakia
| | - Fritz Leutmezer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Csilla Rozsa
- Department of Neurology, Jahn Ferenc Dél-pesti Hospital, Budapest, Hungary
| | - Johann Sellner
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria, and Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - Krzysztof Selmaj
- Department of Neurology, University of Warmia-Mazury, Olsztyn, Poland
| | - Pavel Štouracˇ
- Department of Neurology, Masaryk University, Brno, Czech Republic
| | - Jarmila Szilasiová
- Department of Neurology, P. J. Šafárik University Košice and University Hospital of L. Pasteur Košice, Slovakia
| | - Peter Turcˇáni
- Department of Neurology, Comenius University, Bratislava, Slovakia
| | | | - Manuela Vanecková
- Department of Radiology, MRI Unit, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - László Vécsei
- Department of Neurology and MTA-SZTE Neuroscience Research Group, University of Szeged, Szeged, Hungary
| | - Eva Kubala Havrdová
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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