A multi-shell multi-tissue diffusion study of brain connectivity in early multiple sclerosis

The potential of multi-shell diffusion imaging to produce accurate brain connectivity metrics able to unravel key pathophysiological processes in multiple sclerosis (MS) has scarcely been investigated. To test, in patients with a clinically isolated syndrome (CIS), whether multi-shell imaging-derive...

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Bibliographic Details
Published in:Multiple sclerosis Vol. 26; no. 7; p. 774
Main Authors: Tur, Carmen, Grussu, Francesco, Prados, Ferran, Charalambous, Thalis, Collorone, Sara, Kanber, Baris, Cawley, Niamh, Altmann, Daniel R, Ourselin, Sébastien, Barkhof, Frederik, Clayden, Jonathan D, Toosy, Ahmed T, Wheeler-Kingshott, Claudia Am Gandini, Ciccarelli, Olga
Format: Journal Article
Language:English
Published: England 01.06.2020
Subjects:
Adult
Cognitive Dysfunction - diagnostic imaging
Cognitive Dysfunction - etiology
Cognitive Dysfunction - pathology
Diffusion Tensor Imaging - methods
Female
Gray Matter - diagnostic imaging
Gray Matter - pathology
Humans
Male
Middle Aged
Multiple Sclerosis - complications
Multiple Sclerosis - diagnostic imaging
Multiple Sclerosis - pathology
Nerve Net - diagnostic imaging
Nerve Net - pathology
Retrospective Studies
White Matter - diagnostic imaging
White Matter - pathology
Diffusion-weighted imaging
multi-shell acquisitions
tractography
multi-shell multi-tissue constrained spherical deconvolution
clinically isolated syndrome
multiple sclerosis
ISSN:1477-0970, 1477-0970
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Summary:The potential of multi-shell diffusion imaging to produce accurate brain connectivity metrics able to unravel key pathophysiological processes in multiple sclerosis (MS) has scarcely been investigated. To test, in patients with a clinically isolated syndrome (CIS), whether multi-shell imaging-derived connectivity metrics can differentiate patients from controls, correlate with clinical measures, and perform better than metrics obtained with conventional single-shell protocols. Nineteen patients within 3 months from the CIS and 12 healthy controls underwent anatomical and 53-direction multi-shell diffusion-weighted 3T images. Patients were cognitively assessed. Voxel-wise fibre orientation distribution functions were estimated and used to obtain network metrics. These were also calculated using a conventional single-shell diffusion protocol. Through linear regression, we obtained effect sizes and standardised regression coefficients. Patients had lower mean nodal strength (  = 0.003) and greater network modularity than controls (  = 0.045). Greater modularity was associated with worse cognitive performance in patients, even after accounting for lesion load (  = 0.002). Multi-shell-derived metrics outperformed single-shell-derived ones. Connectivity-based nodal strength and network modularity are abnormal in the CIS. Furthermore, the increased network modularity observed in patients, indicating microstructural damage, is clinically relevant. Connectivity analyses based on multi-shell imaging can detect potentially relevant network changes in early MS.
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ISSN:1477-0970
1477-0970
DOI:10.1177/1352458519845105