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Abstract Details

Interhemispherical Substrates of Manual Dexterity in Patients with Multiple Sclerosis: A Structural and Functional MRI Study
Multiple Sclerosis
MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)
159

To assess the role of the corpus callosum (CC) in hand-dexterity and global disability in multiple sclerosis (MS), by evaluating the alterations in interhemispheric structural-functional connectivity between healthy controls (HC) and MS patients at different levels of disability.

Hand-dexterity impairment is common in MS, significantly limiting social participation and quality of life. Altered CC integrity has been associated to these impaired functions. However, a multiparametric advanced-MRI approach has not been applied to investigate its specific contribution.
3D T1-weighted, diffusion tensor and resting-state (RS) functional MRI scans were acquired from 340 MS patients and 130 age- and sex-matched HC. Probabilistic tractography was used to reconstruct corticospinal tracts (CSTs), transcallosal-fibers between primary hand-motor cortices (M1), supplementary motor areas (SMAs) and premotor cortices (PMCs). Voxel-mirror homotopic connectivity (VMHC) was used to investigate RS fMRI alterations between these regions. Random forest analysis identified the independent predictors of impaired hand-motor performance [9 Hole Peg Test (9HPT) and Finger Tapping (FT)], as well as different scores (3.0, 4.0, 6.0) of Expanded Disability Status Scale (EDSS).
Predictors of EDSS-3 were global measures of atrophy and lesions together with measures of damage of CST, PMCs and SMAs transcallosal-fibers (out-of-bag (OOB)-accuracy=0.86, p-range=<0.001-0.03). For EDSS-4 similar predictors were found, in addition to hand-M1 transcallosal-fibers damage (OOB-accuracy=0.90, p-range=<0.001-0.045). No MRI-variables were identified as predictors of EDSS-6. Impaired hand-dexterity was predicted mainly by alterations in SMAs and PMCs transcallosal-fibers (OOB-accuracy-range=0.71-0.76, p-range=<0.001-0.05), with a specific involvement of hand-M1 transcallosal-fibers in FT-performances. No VMHC alterations contribute to explain the clinical outcomes, even if hand-M1 VMHC resulted abnormal in advanced disease stages (p=0.045).
In MS patients, only measures of structural damage contribute to explain hand-dexterity impairment and different levels of global disability. Moreover, no functional interhemispheric substrate seems to play a relevant role in predicting motor outcome in advanced disease stages.
Authors/Disclosures
Paolo Preziosa (Ospedale San Raffaele)
PRESENTER 		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.
Claudio Cordani Claudio Cordani has nothing to disclose.
Paola Valsasina Paola Valsasina has nothing to disclose.
Alessandro Meani Alessandro Meani has nothing to disclose.
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 $10,000-$49,999 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.