Abstract Details

Title Lesion Location Matters in Multiple Sclerosis: Clinical and Cognitive Correlates of Juxtacortical and Subventricular Zone Lesions

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 299

Objective To assess the influence of juxtacortical (JC) and periventricular lesions on physical and cognitive impairment in multiple sclerosis (MS).

Background

Periventricular and juxtacortical regions are typically involved by MS focal damage. The first highly overlaps with the subventricular zone (SVZ), an adult stem cells niche which plays also a role in neuroprotection and cognition. On the other hand, cortical lesions have been associate with faster disability progression. Since most MRI-visible cortical lesions also involve the white matter, we hypothesize that JC lesions could be associate with disability as well.

Design/Methods In this longitudinal study, 43 MS patients underwent 3.0 T MRI, a clinical evaluation with the 25-timed Foot Walking Test (25FWT) and a neuropsychological assessment with the Rao’s Brief Repeatable Battery at baseline and after a median follow-up of 1.3 years. At both timepoints, global and regional (i.e., in the SVZ and JC) brain T2-hyperintense lesions were segmented and registered on fractional anisotropy and mean diffusivity (MD) maps. Age- and sex-adjusted linear models, partial correlations and stepwise multiple regressions were used to identify predictors of physical and cognitive performance. Patients were considered physically or cognitively worsened if having a >20% elongation of 25FWT or a 4-point decrease at symbol digit modalities test (SDMT), respectively.

Results At baseline, higher brain T2-hyperintense lesion volume (LV) and SVZ LV inversely correlated with performance at selective reminding test, spatial recall test (SPART) and SDMT (p<0.03, r: -0.33; -0.53). Higher MD in the normal-appearing SVZ was associated with worse performance at SPART (p=0.02, r: -0.34). At follow-up, 13/43 (30.2%) and 7/43 (16.3%) were physically and cognitively worsened. A higher JC LV at baseline predicted 25FWT worsening (p=0.009, adjusted R²=0.27).

Conclusions

In MS, SVZ lesions are associated with ongoing cognitive dysfunction, while JC lesions predict short-term physical worsening.

Authors/Disclosures
Laura Cacciaguerra, MD, PhD (Mayo Clinic) PRESENTER	Dr. Cacciaguerra has nothing to disclose.
Mor Gueye	No disclosure on file
Nicolò Tedone (San Raffaele hospital)	Nicolò Tedone has nothing to disclose.
Carmen Vizzino	No disclosure on file
Damiano Mistri, MSC (Università Vita-Salute San Raffaele)	Mr. Mistri has nothing to disclose.
Elisabetta Pagani	Elisabetta Pagani 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.

��ɫ��

��ɫ��