Abstract Details

Title Quantitative Spinal Cord MRI in MS patients with Sexual Dysfunction: A Cross-sectional Study.

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-032

Objective

To assess for correlations between sexual dysfunction(SD) and quantitative spinal cord(SC) MRI measures in people living with multiple sclerosis(MS).

Background

SD is frequently reported in MS and mediated partially by MS-related damage to the SC.

Design/Methods

17 MS patients with self-reported SD completed validated questionnaires assessing aspects of SD, mood, and fatigue:Sexual Quality of Life Questionnaire(SQoL),Multiple Sclerosis Intimacy and Sexuality Questionnaire-19(MSISQ-19),International Index of Erectile Function(IIEF),Female Sexual Function Index(FSFI),Hospital Anxiety and Depression Scale(HADS) Beck Depression Inventory–II(BDI-II) and Fatigue Impact Scale(FIM). All participants underwent 3T brain, cervical and thoracic SC-MRI. Quantitative brain and SC measures, including brain and SC atrophy, SC lesion count, SC diffusion-tensor imaging (DTI) indices[fractional anisotropy(FA),mean,perpendicular,parallel diffusivity(MD, λ⊥, λ||)] and magnetization-transfer-ratio(MTR) were obtained. Student’s t-test and multivariable linear regression assessed correlations between quantitative MRI measures and SD while controlling for psychiatric symptoms.

Results Study subjects had a mean age of 46.9 years and 71% were male. All subjects had self-reported SD(MSISQ-19=40.7,SQoL:55.9). 65% of patients had a concurrent psychiatric diagnosis(anxiety, depression, substance abuse, or paranoid psychosis). When correlations between SD severity were assessed with individual brain and SC MRI measures while controlling for psychiatric symptomatology: no correlations were found between SD and annualized relapse rate, global disability, disease duration, disease subtype and quantitative brain(gray and white matter volume, BPF)and SC-MRI measures(SC-CSA, lesion count, MTR and DTI indices). Anxiety showed an independent correlation with SD in a model assessing SC lesion count (p=0.03) and depression independently correlated with SD in models assessing brain measures(p=0.05,p=0.07,p=0.06 for BPF, gray matter and brain lesion volumes, respectively).

Conclusions Our findings suggest that the severity of SD in MS is predominately related to psychiatric well-being, independent of MS disease activity and tissue change in the brain and SC.The multifactorial nature of SD in patients with MS mandates a multidisciplinary approach.

Authors/Disclosures
Isobel A. Hawes (UCSF) PRESENTER	Ms. Hawes has nothing to disclose.
David D. Kim, MD (University Hospital)	No disclosure on file
	No disclosure on file
Courtney S. Casserly, MD, FAAN (London Health Sciences Center)	Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Soliris. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for biogen idec. Dr. Casserly has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for sanofi genzyme. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for roche. Dr. Casserly has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon Theraputics. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for roche. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Soliris. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for novartis. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen Idec. Dr. Casserly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMG Serono. The institution of Dr. Casserly has received research support from Biogen Idec. The institution of Dr. Casserly has received research support from Western Libraries. The institution of Dr. Casserly has received research support from Western University.
	No disclosure on file
	No disclosure on file
Jiwon Oh, MD, FAAN (St Michael's Hospital)	Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. The institution of Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen-Idec. Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD-Serono. Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astra Zeneca. Dr. Oh has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen-Idec. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. The institution of Dr. Oh has received research support from Biogen-Idec. The institution of Dr. Oh has received research support from Roche.

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