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