Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Paramagnetic Rim Lesion Burden and Choroid Plexus Enlargement Contribute to Cognitive Impairment and Fatigue in Multiple Sclerosis
Multiple Sclerosis
P11 - Poster Session 11 (5:30 PM-6:30 PM)
6-012
Chronic inflammation may worsen cognitive performance and fatigue in MS patients. Since PRLs and CP enlargement represent markers of chronic inflammation in MS, they may be associated with cognitive impairment and fatigue.
To investigate the contribution of paramagnetic rim lesions (PRL) number and volume and choroid plexus (CP) enlargement to cognitive impairment and fatigue in multiple sclerosis (MS) patients.
Brain 3T magnetic resonance imaging (MRI), neurological evaluation and neuropsychological assessment, including the Brief Repeatable Battery of Neuropsychological Tests and Modified Fatigue Impact Scale were obtained from 129 MS patients and 73 age- and sex-matched healthy controls (HC). PRLs were identified on phase images of susceptibility-weighted imaging (SWI), whereas CP volume was quantified using a fully-automatic method on brain three-dimensional T1-weighted and FLAIR MRI sequences. Predictors of cognitive impairment and fatigue were identified using random forest.

Thirty-six (27.9%) MS patients were cognitively impaired, whereas 31/113 (24.0%) had fatigue. Fifty-nine (45.7%) MS patients had ≥1 PRLs (median=0, interquartile range=0;2). Compared to HC, MS patients showed significantly higher T2-hyperintense white matter (WM) lesion volume, lower normalized brain, thalamic, hippocampal, caudate, cortical and WM volumes, and higher normalized CP volume (p≤0.048). The predictors of cognitive impairment (relative importance) (out-of-bag area under the curve [OOB-AUC]= 0.727) were lower normalized brain volume (100%), lower normalized caudate volume (89.1%), higher normalized CP volume (80.3%), lower normalized cortical volume (70.3%%), higher number (67.3%) and volume of PRLs (66.7%) and higher T2-hyperintense WM volume (64.0%). Higher normalized CP volume was the only predictor of the presence of fatigue (OOB-AUC=0.563).

Chronic inflammation, typified by higher number and volume of PRLs and enlarged CP, may contribute to cognitive impairment in MS in addition to atrophy. The association of enlarged CP with fatigue underscores the role of immune-related processes in determining this manifestation, regardless of disease severity.
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.
Yury Yudin No disclosure on file
Elisabetta Pagani No disclosure on file
Alessandro Meani No disclosure on file
Loredana Storelli Loredana Storelli has nothing to disclose.
Nicolò Tedone (San Raffaele hospital) No disclosure on file
Diana Biondi No disclosure on file
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.
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.