Abstract Details

Title Disconnection of Cerebellar Motor Areas and Motor Impairment in Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-003

Objective To assess atrophy and T2-hyperintense lesion load in the anterior (ACMA) and posterior (PCMA) cerebellar motor areas and investigate their correlations with motor impairment in patients with multiple sclerosis (MS).

Background

The cerebellum is susceptible to damage in patients with MS. Two motor representations have been described in cerebellar functional topography: lobules I–V (ACMA) and lobule VIII (PCMA). A primary role of the ACMA and a secondary role of the PCMA have been suggested, but their specific functions and involvement in MS are unclear.

Design/Methods

Eighty-nine MS patients and 65 healthy controls (HC) underwent a functional assessment (gait function and hand dexterity) and structural MRI acquisition at 3.0T, used to extract cerebral and cerebellar volumes and T2-hyperintense lesion loads. Cerebellar lobules were segmented using the SUIT atlas. Between-groups comparisons and age/sex-corrected partial correlations were assessed.

Results Compared to HC, both ACMA and PCMA were atrophic in MS (p<0.001), with similar reductions between the two areas. More than 60% of MS patients had lesions in either motor lobule. ACMA volume was lower than PCMA in HC and MS (p<0.001), whereas T2-hyperintense lesion load was higher in the ACMA than PCMA in MS (p=0.040). Patients with lesions in both areas had worse motor performances than those without lesions in either area (p<0.001 for all). Patients with lesions only in the ACMA or PCMA had similar motor abilities. In patients, lower ACMA and PCMA volumes correlated only with worse left-hand dexterity (p<0.001), whereas higher T2-hyperintense lesion loads in both ACMA and PCMA correlated with worse performances in all motor tests (r range=-0.358;-0.445, p≤0.001 for all).

Conclusions

The non-homogeneous distribution of lesions suggests an increased susceptibility of the ACMA to focal demyelinating lesions. Considering correlation analyses, disconnection of cerebellar motor areas, rather than localised lobular atrophy, seems to better explain motor impairment in MS.

Authors/Disclosures
Monica Margoni PRESENTER	Monica Margoni has received research support from MAGNIMS. Monica Margoni has received research support from Merck-Serono. Monica Margoni has received research support from Sanofi-Genzyme.
Francesco Romano (San Raffaele Hospital)	Francesco Romano has nothing to disclose.
Benedetta Signoracci	No disclosure on file
Paolo Preziosa (Ospedale San Raffaele)	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.
Elisabetta Pagani	Elisabetta Pagani has nothing to disclose.
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.
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.

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