Skip to main content
Log in

Peak width of skeletonized mean diffusivity (PSMD) and cognitive functions in relapsing-remitting multiple sclerosis

  • Brief Communication
  • Published:
Brain Imaging and Behavior Aims and scope Submit manuscript

Abstract

Peak width of skeletonized mean diffusivity (PSMD) is a new MRI marker, which has shown clinical relevance in some neurological conditions and, in preliminary data, in multiple sclerosis (MS). We aimed here to investigate, in a group of relapsing-remitting MS (RRMS) patients, the relationship between PSMD and cognitive performances, in comparison with other MRI measures. RRMS patients (n = 60) and normal controls (n = 15) underwent a 3 T MRI examination. MRI-based white matter (WM) lesion volume, microstructural integrity (assessed with Tract-Based Spatial Statistics of diffusion tensor imaging [DTI] images) and brain volumes (i.e., total brain, grey matter [GM] and WM) were computed. In addition, PSMD was calculated through “skeletonization” of WM tracts and diffusion histograms. Cognition was evaluated with Rao’s Brief Repeatable Battery (BRB), which incorporated tests of verbal and visual memory, attention, concentration, information processing speed and verbal fluency. PSMD closely correlated with symbol digit modalities test (SDMT) (r = −0.70, p < 0.001) and, to a lesser extent, with verbal and visual memory tests. Multiple regression analysis showed that PSMD explained SDMT variance (R2 = 0.54, p < 0.001) more than other MRI measures. Results point out the relevance of microstructural damage, as assessed by PSMD, as a reliable marker of cognition in MS, especially in explaining dysfunction in information processing speed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  • Amato, M. P., Portaccio, E., Goretti, B., Zipoli, V., Ricchiuti, L., De Caro, M. F., et al. (2006). The Rao's brief repeatable battery and stroop test: normative values with age, education and gender corrections in an Italian population. Multiple Sclerosis, 12(6), 787–793.1b.

    Article  CAS  Google Scholar 

  • Baykara, E., Gesierich, B., Adam, et al. (2016). A novel imaging marker for small vessel disease based on skeletonization of white matter tracts and diffuse histograms. Annals of Neurology, 80(4), 581–592.

    Article  Google Scholar 

  • Benedict Ralph, H. B., Amato, M. P., Boringa, J., et al. (2012). Brief International Assessment for MS (BICAMS): international standards for validation. BMC Neurology, 12, 55.

    Article  CAS  Google Scholar 

  • Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. J R Stat Soc Series B Stat Methodol, 57, 289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x.

    Article  Google Scholar 

  • Chiaravalloti, N. D., & DeLuca, J. (2008). Cognitive impairment in multiple sclerosis. Lancet Neurology, 7, 1139–1151.

    Article  Google Scholar 

  • Deary, I. J., Ritchie, S. J., Susana Muñoz Maniega, S. M., et al. (2019). Brain peak width of skeletonized mean diffusivity (PSMD) and cognitive function in later life. Frontiers in Psychiatry, 10, 524.

    Article  Google Scholar 

  • Filippi, M., Bruck, W., Chard, D., et al. (2019). Association between pathological and MRI findings in multiple sclerosis. Lancet Neurology, 18(2), 198–210.

    Article  Google Scholar 

  • Lam, B. Y. K., Leung, K. T., Yiu, B., et al. (2019). Peak width of skeletonized mean diffusivity and its association with age-related cognitive alterations and vascular risk factors. Alzheimer's & Dementia, 11, 721–729.

    Article  Google Scholar 

  • Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134(4), 382–389.

    Article  CAS  Google Scholar 

  • Rocca, M. A., Amato, M. P., De Stefano, N., et al. (2015). Clinical and imaging assessment of cognitive dysfunction in multiple sclerosis. Lancet Neurology, 14(3), 302–317.

    Article  Google Scholar 

  • Smith, S. M., Jenkinson, M., Johansen-Berg, H., et al. (2016). Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data. Neuroimage, 31(4), 1487–1505.

    Article  Google Scholar 

  • Thompson, A. J., Banwell, B. L., Barkhof, F., Carroll, W. M., Coetzee, T., Comi, G., Correale, J., Fazekas, F., Filippi, M., Freedman, M. S., Fujihara, K., Galetta, S. L., Hartung, H. P., Kappos, L., Lublin, F. D., Marrie, R. A., Miller, A. E., Miller, D. H., Montalban, X., Mowry, E. M., Sorensen, P. S., Tintoré, M., Traboulsee, A. L., Trojano, M., Uitdehaag, B. M. J., Vukusic, S., Waubant, E., Weinshenker, B. G., Reingold, S. C., & Cohen, J. A. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurology, 17, 162–173.

    Article  Google Scholar 

  • Vinciguerra, C., Giorgio, A., Zhang, J., di Donato, I., Stromillo, M. L., Tappa Brocci, R., Federico, A., Dotti, M. T., & de Stefano, N. (2019). Peak width of skeletonized mean diffusivity (PSMD) as marker of widespread white matter tissue damage in multiple sclerosis. Multiple Sclerosis and Related Disorders, 27, 294–297.

    Article  CAS  Google Scholar 

  • Wei N, Deng Yiming, Yao L et al., 2019. A neuroimaging marker based on diffusion tensor imaging and cognitive impairment due to cerebral white matter lesions. Frontiers in Neurology 2010. 10:81.

Download references

Acknowledgments

Luisa Pastò received editorial grants by Sanofi-Genzyme, Novartis, received grant from Novartis and speaker’s honoraria from Teva, served on scientific advisory board from Merk.

Maria Pia Amato is member of Advisory Boards for Biogen, Merck, Teva, Novartis, Sanofi Aventis, Genzyme, Almirall and Roche. She received honoraria for speaking from Biogen, Merck, Novartis, Teva, Genzyme, Almirall and Sanofi Aventis. She is member of Editorial Board and Associate Editor of BMC Neurology Member of the Editorial Board of Multiple Sclerosis Journal. She has received research grants from Biogen, Merk, Bayer, Sanofi Aventis, Teva. Nicola de Stefano is a consultant for Biogen, Merck KGaA, Novartis, Roche, Sanofi-Genzyme, Schering and Teva; has grants or grants pending from FISM and Novartis, is on the speaker bureaus of Biogen, Teva, Novartis, Sanofi-Genzyme, Roche, and Merck KGaA; has received travel funds from Merck KGaA, Novartis, Roche, Sanofi-Genzyme and Teva.

Author information

Authors and Affiliations

Authors

Contributions

Author contributions included conception and study design (Claudia Vinciguerra, Nicola De Stefano, Antonio Giorgio), data collection or acquisition or analysis (Claudia Vinciguerra, Jian Zhang, Maria Laura Stromillo, Riccardo Tappa Brocci, Luisa Pasto’, Claudia Niccolai, Marzia Mortilla), statistical analysis (Valerio Nardone, Claudia Vinciguerra), interpretation of results (Claudia Vinciguerra, Nicola De Stefano, Maria Pia Amato, Antonio Giorgio), drafting the manuscript (Claudia Vinciguerra, Nicola De Stefano, Antonio Giorgio) or revising it critically for important intellectual content (Nicola De Stefano, Maria Pia Amato,) and approval of final version to be published and agreement to be accountable for the integrity and accuracy of all aspects of the work (All authors).

Corresponding author

Correspondence to N. De Stefano.

Ethics declarations

Disclosures of potential conflict of interest

Claudia Vinciguerra, Antonio Giorgio, Jian Zhang, Riccardo Tappa Brocci, Claudia Niccolai, Maria Laura Stromillo and Marzia Mortilla, state that there are no conflicts of interest and that they did not receive any specific grant from funding agencies in the public, commercial, or not for profit sectors.

Ethical approval

The study was approved from the local Ethics Committee (Azienda Ospedaliera Universitaria Senese) and all procedures were in accordance with the 1964 Helsinki declaration.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vinciguerra, C., Giorgio, A., Zhang, J. et al. Peak width of skeletonized mean diffusivity (PSMD) and cognitive functions in relapsing-remitting multiple sclerosis. Brain Imaging and Behavior 15, 2228–2233 (2021). https://doi.org/10.1007/s11682-020-00394-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11682-020-00394-4

Keywords

Navigation