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. 2022 Jun;12(6):e2591.
doi: 10.1002/brb3.2591. Epub 2022 May 13.

Skeletonized mean diffusivity and neuropsychological performance in relapsing-remitting multiple sclerosis

Magdalena Chylińska  1 , Bartosz Karaszewski  1 , Jakub Komendziński  1 , Adam Wyszomirski  1 , Agnieszka Sabisz  2 , Marek Halas  1 , Edyta Szurowska  2
Affiliations

Skeletonized mean diffusivity and neuropsychological performance in relapsing-remitting multiple sclerosis

Magdalena Chylińska et al. Brain Behav. 2022 Jun.

Abstract

Background: Peak width of Skeletonized Mean Diffusivity (PSMD), as a novel marker of white matter (WM) microstructure damage, is associated with cognitive decline in several WM pathologies (i.e., small vessel disorders). We hypothesized that markers combining alterations in whole WM could be associated with cognitive dysfunction in relapsing-remitting multiple sclerosis (RRMS) patients.

Methods: We used PSMD based on tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) magnetic resonance (MR) scans. We investigated RRMS patients (n = 73) undergoing interferon beta (IFN-β) therapy. In this cross-sectional study, we investigated the association between neuropsychological data and clinical and MRI variables: PSMD, WM hypointensities, and normalized brain volume (NBV).

Results: In our cohort, 37 (50.7%) patients were recognized as cognitively impaired (CI) and 36 (49.3%) patients were cognitively normal (CN). In regression analysis, PSMD was a statistically significant contributor in the California Verbal Learning Test (CVLT) list A (p = 0.04) and semantic fluency (p = 0.036). PSMD (p < 0.001, r2 = 0.35), NBV (p = 0.002, r2 = 2.6) and WM hypointensities (p < 0.001, r2 = 0.40) were major contributors to upper extremity disability (9HPT) in the CN subgroup. A significant contributor in the majority of neuropsychological measures was education attainment.

Conclusion: We investigated PSMD as a new parameter of WM microstructure damage that is a contributor in complex cognitive tasks, CVLT performance, and semantic fluency. PSMD was a statistically significant contributor to upper extremity disability (9HPT) together with WM hypointensities and NBV. Education attainment proved to be relevant in the majority of cognitive domains. Further studies are needed to estimate PSMD relevance as a marker of CI in MS.

Keywords: DTI; MRI; PSMD; cognition; multiple sclerosis.

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Conflict of interest statement

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

FIGURE 1
FIGURE 1
A. Example of an FA map with the superimposed skeletonized FA data of an RRMS patient. The images prepared are based on the tract‐based spatial statistics procedure in the step before the calculation of PSMD values. B. Example of an MD map with the superimposed skeletonized MD data of an RRMS patient. The images prepared are based on the tract‐based spatial statistics procedure in the step before the calculation of PSMD values
FIGURE 2
FIGURE 2
Correlation between PSMD and neuropsychological measures
See this image and copyright information in PMC

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