Abstract Details

Title Advanced Diffusion-Weighted Imaging Models Better Characterize White Matter Neurodegeneration and Clinical Outcomes in Multiple Sclerosis

Topic Multiple Sclerosis

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

Poster/Presentation
Number 311

Objective We assessed white matter (WM) atrophy in multiple sclerosis (MS) patients both cross-sectionally and longitudinally with advanced diffusion-weighted imaging (DWI) techniques and explored whether these measures better explain clinical and cognitive deficits compared with conventional measures.

Background WM atrophy is relevant in MS, but the methods of analysis currently used are not specific for microstructural changes.

Design/Methods In this prospective study (from 2018 to 2020), 3D T1-weighted and multi-shell DWI pulse sequences were applied to 86 MS patients (mean age, 44 years ± 12; 53 women) and 55 healthy controls (HC) (mean age, 42 years ± 10; 27 women) at baseline and after one-year. Maps of fractional anisotropy and mean diffusivity were derived from DWI; intra-cellular volume (vic) maps were computed from neurite orientation dispersion and density imaging model. Fixel-based morphometry analysis was applied to estimate voxel-wise fiber-bundle cross-section (FC) atrophy in MS and compare it to HC.

Results Both at baseline and after one year, only FC measure showed a significant atrophy in relapsing-remitting (RR) MS compared to HC and in progressive MS patients compared to RRMS, mainly located in the corticospinal tract, splenium of the corpus callosum, optic radiation and cingulum (p-value < .05). Global baseline FC and vic were significantly associated with the Expanded Disability Status Scale and the Symbol Digit Memory Test, being the selected predictors of clinical (R-sq=0.33, p = .007) and cognitive scores (R-sq=0.29, p = .0014) in a linear regression model.

Conclusions By identifying tract-specific differences, voxel-based analyses confirmed the ability of FC measures to detect WM atrophy with greater anatomical specificity compared to other measures, and to distinguish MS clinical phenotypes and assess their WM degeneration over time. FC and vic measured at baseline were the best predictors of clinical disability and cognitive impairment.

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.
Loredana Storelli	Loredana Storelli has nothing to disclose.
Elisabetta Pagani	Elisabetta Pagani 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.

��ɫ��

��ɫ��