Diffuse and Focal Corticospinal Tract Disease and Its Impact on Patient Disability in Multiple Sclerosis

Tovar‐Moll, Fernanda; Evangelou, Iordanis E.; Chiu, Annie W.; Auh, Sungyoung; Chen, Christina; Ehrmantraut, Mary; Ohayon, Joan; Richert, Nancy; Bagnato, Francesca

doi:10.1111/jon.12171

Cited by 26 publications

(31 citation statements)

References 46 publications

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“…Conversely, such correlation between DTI parameters and EDSS has been previously reported in cross-sectional studies (Daams et al, 2015;Tovar-Moll et al, 2015).…”

Section: Edss Median (Range)mentioning

confidence: 57%

Diffusion tensor imaging and disability progression in multiple sclerosis: A 4‐year follow‐up study

et al. 2018

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ObjectivesDiffusion tensor imaging (DTI) is sensitive technique to detect widespread changes in water diffusivity in the normal‐appearing white matter (NAWM) that appears unaffected in conventional magnetic resonance imaging. We aimed to investigate the prognostic value and stability of DTI indices in the NAWM of the brain in an assessment of disability progression in patients with a relapsing‐onset multiple sclerosis (MS).MethodsForty‐six MS patients were studied for DTI indices (fractional anisotropy (FA), mean diffusivity (MD), radial (RD), and axial (AD) diffusivity) in the NAWM of the corpus callosum (CC) and the internal capsule at baseline and at 1 year after. DTI analysis for 10 healthy controls was also performed at baseline. Simultaneously, focal brain lesion volume and atrophy measurements were done at baseline for MS patients. Associations between DTI indices, volumetric measurements, and disability progression over 4 years were studied by multivariate logistic regression analysis.ResultsAt baseline, most DTI metrics differed significantly between MS patients and healthy controls. There was tendency for associations between baseline DTI indices in the CC and disability progression (p < 0.05). Changes in DTI indices over 1 year were observed only in the CC (p < 0.008), and those changes were not found to predict clinical worsening over 4 years. Clear‐cut association with disability progression was not detected for baseline volumetric measurements.ConclusionAberrant diffusivity measures in the NAWM of the CC may provide additional information for individual disability progression over 4 years in MS with the relapsing‐onset disease. CC may be a good target for DTI measurements in monitoring disease activity in MS, and more studies are needed to assess the related prognostic potential.

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“…Conversely, such correlation between DTI parameters and EDSS has been previously reported in cross-sectional studies (Daams et al, 2015;Tovar-Moll et al, 2015).…”

Section: Edss Median (Range)mentioning

confidence: 57%

Diffusion tensor imaging and disability progression in multiple sclerosis: A 4‐year follow‐up study

et al. 2018

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“…34 The PLIC FA reported in Table 2 is slightly higher than in that study and another tract-based CST analysis, though the standard deviations are similar. 32, 34 Our PLIC ROIs were carefully inspected to ensure anatomical accuracy, but it is possible that our ROI-based measure does not fully capture diffusion along the CST. Both tract-based CST studies showed a relationship between diffusion and EDSS.…”

Section: Discussionmentioning

confidence: 99%

The relationship between cognitive function and high-resolution diffusion tensor MRI of the cingulum bundle in multiple sclerosis

et al. 2015

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Background Imaging can provide noninvasive neural markers of disease progression in multiple sclerosis that are related to behavioral and cognitive symptoms. Past work suggests that diffusion tensor imaging (DTI) provides a measure of white matter pathology, including demyelination and axonal counts. Objectives In the current study, the authors investigate the relationship of DTI measures in the cingulum bundle to common deficits in MS, including episodic memory, working memory, and information processing speed. Methods Fifty-seven patients with MS and 17 age- and education-matched controls underwent high-spatial resolution diffusion scans and cognitive testing. Probabilistic tracking was used to generate tracks from the posterior cingulate cortex to the entorhinal cortex. Results Radial and axial diffusivity values were significantly different between patients and controls (p<0.031), and in patients bilateral diffusion measures were significantly related to measures of episodic memory and speed of processing (p<0.033). Conclusions The tractography-based measures of posterior cingulum integrity reported here support further development of DTI as a viable measure of axonal integrity and cognitive function in patients with MS.

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“…Walking performance has been associated with DTI (Naismith et al, 2013) and MTR (Zackowski et al, 2009) of the lateral columns in MS. T25FW performance (Tovar-Moll et al, 2015, Klineova et al, 2016, Hubbard et al, 2016) and walking velocity and endurance (Hubbard et al, 2016) were related to DTI measures, while both total EDSS and Functional Systems Score (FSS) pyramidal scores were related to FA of the brain CST measured from the pons to the cortex (Tovar-Moll et al, 2015), and total EDSS score was also correlated with cervical spinal cord area (Bernitsas et al, 2015). However, controls were not included in these studies, and relationships of quantitative measures of strength and walking to brain MTR have not been explored, and DTI of the whole-brain CST from medulla to cortex in relation to function is lacking in MS.…”

Section: Introductionmentioning

confidence: 99%

Quantitative measures of walking and strength provide insight into brain corticospinal tract pathology in multiple sclerosis

Fritz

Keller

Calabresi³

et al. 2017

NeuroImage: Clinical

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At least 85% of individuals with multiple sclerosis report walking dysfunction as their primary complaint. Walking and strength measures are common clinical measures to mark increasing disability or improvement with rehabilitation. Previous studies have shown an association between strength or walking ability and spinal cord MRI measures, and strength measures with brainstem corticospinal tract magnetization transfer ratio. However, the relationship between walking performance and brain corticospinal tract magnetization transfer imaging measures and the contribution of clinical measurements of walking and strength to the underlying integrity of the corticospinal tract has not been explored in multiple sclerosis. The objectives of this study were explore the relationship of quantitative measures of walking and strength to whole-brain corticospinal tract-specific MRI measures and to determine the contribution of quantitative measures of function in addition to basic clinical measures (age, gender, symptom duration and Expanded Disability Status Scale) to structural imaging measures of the corticospinal tract. We hypothesized that quantitative walking and strength measures would be related to brain corticospinal tract-specific measures, and would provide insight into the heterogeneity of brain pathology.Twenty-nine individuals with relapsing-remitting multiple sclerosis (mean(SD) age 48.7 (11.5) years; symptom duration 11.9(8.7); 17 females; median[range] Expanded Disability Status Scale 4.0 [1.0–6.5]) and 29 age and gender-matched healthy controls (age 50.8(11.6) years; 20 females) participated in clinical tests of strength and walking (Timed Up and Go, Timed 25 Foot Walk, Two Minute Walk Test ) as well as 3 T imaging including diffusion tensor imaging and magnetization transfer imaging.Individuals with multiple sclerosis were weaker (p = 0.0024) and walked slower (p = 0.0013) compared to controls. Quantitative measures of walking and strength were significantly related to corticospinal tract fractional anisotropy (r > 0.26; p < 0.04) and magnetization transfer ratio (r > 0.29; p < 0.03) measures. Although the Expanded Disability Status Scale was highly correlated with walking measures, it was not significantly related to either corticospinal tract fractional anisotropy or magnetization transfer ratio (p > 0.05). Walk velocity was a significant contributor to magnetization transfer ratio (p = 0.006) and fractional anisotropy (p = 0.011) in regression modeling that included both quantitative measures of function and basic clinical information.Quantitative measures of strength and walking are associated with brain corticospinal tract pathology. The addition of these quantitative measures to basic clinical information explains more of the variance in corticospinal tract fractional anisotropy and magnetization transfer ratio than the basic clinical information alone. Outcome measurement for multiple sclerosis clinical trials has been notoriously challenging; the use of quantitative measures of strength and walking alon...

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Diffuse and Focal Corticospinal Tract Disease and Its Impact on Patient Disability in Multiple Sclerosis

Cited by 26 publications

References 46 publications

Diffusion tensor imaging and disability progression in multiple sclerosis: A 4‐year follow‐up study

Diffusion tensor imaging and disability progression in multiple sclerosis: A 4‐year follow‐up study

The relationship between cognitive function and high-resolution diffusion tensor MRI of the cingulum bundle in multiple sclerosis

Quantitative measures of walking and strength provide insight into brain corticospinal tract pathology in multiple sclerosis

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