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Abstract Details

In-vivo Assessment of Cellular Soma and Neurite Density Abnormalities in Multiple Sclerosis Paramagnetic Rim and Core-sign Lesions
Multiple Sclerosis
P11 - Poster Session 11 (5:30 PM-6:30 PM)
6-006
In MS, PRLs and core-sign lesions may underlie different stages of WML evolution, that are associated with a more severe disease course. By evaluating both soma and neurite properties, SANDI model may provide more speci?c information about their heterogeneous pathological processes.
Using soma and neurite density imaging (SANDI) method based on diffusion-weighted MRI, we characterized in vivo the microstructural abnormalities of multiple sclerosis (MS) white matter lesions (WML) showing a paramagnetic rim (paramagnetic rim lesions [PRL]) or diffuse hypointensity (“core-sign”) on susceptibility-weighted imaging (SWI) and their clinical relevance.
Forty MS patients and 20 healthy controls (HC) underwent a 3T brain MRI. Using SANDI, the fractions of neurite (fneurite) and soma (fsoma) and size of soma (rsoma) were quantified in PRLs (including their core and rim separately), and core-sign lesions identified on SWI.
Among 1811 WML, 122 (6.7%) core-sign lesions and 97 (5.4%) PRLs were identified. Compared to HC and MS NAWM, all MS WML showed significantly lower fneurite and fsoma and significantly higher rsoma (false discovery rate [FDR]-p<0.001). Compared to isointense WML, core-sign lesions showed a significantly higher fneurite (FDR-p<0.001), and lower fsoma and rsoma (FDR-p≤0.001). Compared to isointense WML and core-sign lesions, PRLs showed a significantly lower fneurite (FDR-p<0.001), and higher fsoma (FDR-p≤0.005) and rsoma (FDR-p<0.001). In the direct comparison, the PRL core showed significantly lower fneurite (FDR-p<0.001), and higher rsoma (FDR-p<0.001) than PRL rim. Lower fneurite (β≤-0.006, FDR-p≤0.015) and higher rsoma (β≥0.032, FDR-p≤0.024) of PRLs were significantly associated with a longer disease duration and higher Expanded Disability Status Scale score. 
PRLs are clinically-relevant lesions characterized by significant neurite loss and increase of soma fraction and size, potentially reflecting higher amount of activated microglia and astrogliosis. Core-sign lesions exhibit milder axonal loss and amount of microglia and astrogliosis, supporting their less destructive nature.
Authors/Disclosures
Monica Margoni
PRESENTER
Monica Margoni has received research support from MAGNIMS. Monica Margoni has received research support from Merck-Serono. Monica Margoni has received research support from Sanofi-Genzyme.
Paolo Preziosa (Ospedale San Raffaele) Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Elisabetta Pagani No disclosure on file
Alessandro Meani No disclosure on file
Martina Rubin, MD (San Raffaele Hospital) Dr. Rubin has nothing to disclose.
Marco Palombo (CUBRIC) No disclosure on file
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit) Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi;. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi- Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Maria A. Rocca (Neuroimaging Research Unit) Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.