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. 2020 Oct 23;6(4):2055217320961409.
doi: 10.1177/2055217320961409. eCollection 2020 Oct-Dec.

Laminar analysis of the cerebellar cortex shows widespread damage in early MS patients: A pilot study at 7T MRI

Riccardo Galbusera  1   2 , Katrin Parmar  1 , Yohan Boillat  3 , Mario Joao Fartaria  4 , Alexandra-Ramona Todea  2 , Kieran O' Brien  5 , Anna Smolinski  2 , Ludwig Kappos  1 , Wietske van der Zwaag  6 , Cristina Granziera  1   2
Affiliations

Laminar analysis of the cerebellar cortex shows widespread damage in early MS patients: A pilot study at 7T MRI

Riccardo Galbusera et al. Mult Scler J Exp Transl Clin. .

Abstract

Background: To date, little is known about the presence and extent of cerebellar cortical pathology in early stages of MS.

Objective: The aims of this study were to (i) investigate microstructural changes in the normal-appearing cerebellar cortex of early MS patients by using 7 T MRI and (ii) evaluate the influence of those changes on clinical performance.

Methods: Eighteen RRMS patients and nine healthy controls underwent quantitative T1 and T2* measurement at 7 T MRI using high-resolution MP2RAGE and multi-echo gradient-echo imaging. After subtracting lesion masks, average T1 and T2* maps were computed for three layers in the cerebellar cortex and compared between groups using mixed effects models.

Results: The volume of the cerebellar cortex and its layers did not differ between patients and controls. In MS patients, significantly longer T1 values were observed in all vermis cortical layers and in the middle and external cortical layer of the cerebellar hemispheres. No between-group differences in T2* values were found. T1 values correlated with EDSS, SDMT and PASAT.

Conclusions: We found MRI evidence of damage in the normal-appearing cerebellar cortex at early MS stages and before volumetric changes. This microstructural alteration appears to be related to EDSS and cognitive performance.

Keywords: MRI; Multiple sclerosis; cerebellum; ultra-high field MRI.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Riccardo Galbusera reports no disclosures in relationship to this work Katrin Parmar reports no disclosures in relationship to this work Yohan Boillat reports no disclosures in relationship to this work Mario Joao Fartaria works for Siemens Switzerland Alexandra-Ramona Todea reports no disclosures in relationship to this work Kieran O’Brien works for Siemens Australia Anna Smolinski reports no disclosures in relationship to this work Ludwig Kappos reports no disclosures in relationship to this work Wietske van der Zwaag reports no disclosures in relationship to this work Cristina Granziera reports no disclosures in relationship to this work.

Figures

Figure 1.
Figure 1.
Summary of the processing pipeline to extract T1 and T2* RT from different cerebellar lobules and layers (a detailed description is provided in ref. 12). First, T1 and T2* maps are registered to the MNI space and a chroma atlas is registered to T1 and T2* maps. Then a Multiple Object Geometric Deformable Model (MGDM) segmentation is applied to the T1 maps to obtain cerebellar WM and GM masks, which are then manually corrected. Further, Fuzzy and Noise Tolerant Adaptive Segmentation Method (FANTASM) is subsequently applied to segment the masked cerebellum into WM, GM and CSF, followed by Cortical reconstruction using implicit surface (CRUISE) to differentiate the three cerebellar layers. T1 and T2* RT are then extracted using the three layers and lobules from the CHROMA atlas as masks.
Figure 2.
Figure 2.
Cerebellar cortical lesions in axial MP2RAGE uniform images.
Figure 3.
Figure 3.
Quantitative T1 RT in cerebellar vermis and hemispheres, comparison between healthy controls and MS patients. Significantly longer T1 RT are found in MS patients in all three vermis layers (p < 0.01 to < 0.02) and in the middle and external layer of the cerebellar hemispheres (p < 0.03).
See this image and copyright information in PMC

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