Cortical lesions uniquely predict motor disability accrual and form rarely in the absence of new white matter lesions in multiple sclerosis.
| العنوان: | Cortical lesions uniquely predict motor disability accrual and form rarely in the absence of new white matter lesions in multiple sclerosis. |
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| المؤلفون: | Beck ES; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Mullins WA; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Dos Santos Silva J; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Filippini S; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.; Department of Neurosciences, Drug, and Child Health, University of Florence, Florence, Italy., Parvathaneni P; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Maranzano J; McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.; Department of Anatomy, University of Quebec, Trois-Rivieres, QC, Canada., Morrison M; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Suto DJ; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Donnay C; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Dieckhaus H; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Luciano NJ; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Sharma K; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Gaitán MI; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Liu J; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.; Advanced Imaging Research Center and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA., de Zwart JA; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., van Gelderen P; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Cortese I; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Narayanan S; McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada., Duyn JH; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA., Nair G; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Sati P; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.; Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Reich DS; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. |
| المصدر: | MedRxiv : the preprint server for health sciences [medRxiv] 2023 Sep 25. Date of Electronic Publication: 2023 Sep 25. |
| نوع المنشور: | Preprint |
| اللغة: | English |
| بيانات الدورية: | Country of Publication: United States NLM ID: 101767986 Publication Model: Electronic Cited Medium: Internet NLM ISO Abbreviation: medRxiv Subsets: PubMed not MEDLINE |
| مستخلص: | Background and Objectives: Cortical lesions (CL) are common in multiple sclerosis (MS) and associate with disability and progressive disease. We asked whether CL continue to form in people with stable white matter lesions (WML) and whether the association of CL with worsening disability relates to pre-existing or new CL. Methods: A cohort of adults with MS were evaluated annually with 7 tesla (T) brain magnetic resonance imaging (MRI) and 3T brain and spine MRI for 2 years, and clinical assessments for 3 years. CL were identified on 7T images at each timepoint. WML and brain tissue segmentation were performed using 3T images at baseline and year 2. Results: 59 adults with MS had ≥1 7T follow-up visit (mean follow-up time 2±0.5 years). 9 had "active" relapsing-remitting MS (RRMS), defined as new WML in the year prior to enrollment. Of the remaining 50, 33 had "stable" RRMS, 14 secondary progressive MS (SPMS), and 3 primary progressive MS. 16 total new CL formed in the active RRMS group (median 1, range 0-10), 7 in the stable RRMS group (median 0, range 0-5), and 4 in the progressive MS group (median 0, range 0-1) (p=0.006, stable RR vs PMS p=0.88). New CL were not associated with greater change in any individual disability measure or in a composite measure of disability worsening (worsening Expanded Disability Status Scale or 9-hole peg test or 25-foot timed walk). Baseline CL volume was higher in people with worsening disability (median 1010μl, range 13-9888 vs median 267μl, range 0-3539, p=0.001, adjusted for age and sex) and in individuals with RRMS who subsequently transitioned to SPMS (median 2183μl, range 270-9888 vs median 321μl, range 0-6392 in those who remained RRMS, p=0.01, adjusted for age and sex). Baseline WML volume was not associated with worsening disability or transition from RRMS to SPMS. Discussion: CL formation is rare in people with stable WML, even in those with worsening disability. CL but not WML burden predicts future worsening of disability, suggesting that the relationship between CL and disability progression is related to long-term effects of lesions that form in the earlier stages of disease, rather than to ongoing lesion formation. |
| تواريخ الأحداث: | Date Created: 20231027 Latest Revision: 20231106 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10602044 |
| DOI: | 10.1101/2023.09.22.23295974 |
| PMID: | 37886541 |
| قاعدة البيانات: | MEDLINE |
| DOI: | 10.1101/2023.09.22.23295974 |
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