Abstract Details

Title Cortical and Deep Gray Matter Perfusion is Associated with Physical and Cognitive Performance in Multiple Sclerosis Patients

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 9-018

Objective

To investigate associations between MRI-derived perfusion measures with clinical and cognitive performance of heterogeneous multiple sclerosis (MS) population.

Background

Limited intracranial perfusion studies show associations between hypoperfusion and isolated clinical or cognitive outcomes in MS patients.

Design/Methods

103 MS patients (63 relapsing-remitting MS and 40 progressive MS) underwent intracerebral perfusion assessment using 3T MRI dynamic susceptibility contrast (DSC) sequence. Clinical and neurocognitive examination included Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Score (MSSS), Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9HPT) and Symbol Digit Modalities Test (SDMT). Volumetric and perfusion-based measures of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of whole brain (WB), white matter (WM), gray matter (GM), cortex, deep GM (DGM) and individual nuclei of thalamus, caudate, putamen, globus pallidus and hippocampus were derived. The relative measures of CBV and CBF were normalized with the respective measures of normal-appearing WM. Simoa assay quantified serum neurofilament light chain (sNfL) levels. Step-wise regression models corrected for age, sex and years of education determined associations between MRI-derived structural and perfusion measures with clinical outcomes.

Results

MSSS (R²=0.186) as well as age and sex were associated with GM nCBF (p=0.035) and WBV (p=0.046) . T25FW performance (R²=0.278) was associated with hippocampus nCBV (p=0.03) and WBV (p=0.012) while. 9HPT performance (R²=0.401) was associated with thalamus MTT (p=0.032).and WBV (p=0.049). SDMT performance (R²=0.412) was explained by age, sex, years of education as well as GM nCBV (p=0.013) and,T2-LV (p=0.001), ,. Lower perfusion measures of total DGM, thalamus and caudate and nCBF of GM and cortex were associated with higher sNfL levels.

Conclusions Decreased GM and DGM perfusion is associated with poorer clinical and cognitive outcomes in MS patients. Lower cerebral perfusion is associated with higher neurodegeneration as measured by sNfL levels.

Authors/Disclosures
Dejan Jakimovski, MD, PhD (Buffalo Neuroimaging Analysis Center, University at Buffalo) PRESENTER	Dr. Jakimovski has nothing to disclose.
Niels Bergsland (Buffalo Neuroimaging Analysis Center / State University of New York At Buffalo)	Prof. Bergsland has nothing to disclose.
Michael G. Dwyer III, MD, PhD (Buffalo Neurological Analysis Center)	Dr. Dwyer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Dwyer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Keystone Heart, Ltd. Dr. Dwyer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Dwyer has received research support from Novartis. The institution of Dr. Dwyer has received research support from Keystone Heart, Ltd. The institution of Dr. Dwyer has received research support from Bristol Myers Squibb. The institution of Dr. Dwyer has received research support from Roche.
	No disclosure on file
Jesper Hagemeier	No disclosure on file
	No disclosure on file
Murali Ramanathan, PhD (University At Buffalo)	The institution of Dr. Ramanathan has received research support from DoD. Dr. Ramanathan has received publishing royalties from a publication relating to health care.
Jens Kuhle, MD	Dr. Kuhle has nothing to disclose.
Bianca Weinstock-Guttman, MD (Department of Neurology, University At Buffalo)	Dr. Weinstock-Guttman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme &Sanofi. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving as a Reviewer with NIH.
Ralph H. Benedict, PhD (University At Buffalo)	Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunic Therapeutics. Dr. Benedict has received intellectual property interests from a discovery or technology relating to health care.
Robert Zivadinov, MD, PhD, FAAN (Buffalo Neuroimaging Analysis Center)	The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Omnicuris. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Myrobalan. Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Zivadinov has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.