Abstract Details

Title Relevance of NODDI to Characterise in Vivo the Microstructural Abnormalities of Multiple Sclerosis Cortex and Cortical Lesions: A 3T Study

Topic Multiple Sclerosis

Presentation(s) S2 - Advances in MS Imaging (2:24 PM-2:32 PM)

Poster/Presentation
Number 003

Background

In MS, cortical damage is a relevant predictor of clinical disability and NODDI, a multi-compartment diffusion model, could improve the evaluation of MS-related damage to cortical microarchitecture complexity.

Objective To characterize, using neurite orientation dispersion and density imaging (NODDI), the microstructural abnormalities of normal-appearing cortex (NA-cortex) and cortical lesions (CLs) and their relations with multiple sclerosis (MS) phenotypes and clinical disability.

Design/Methods

One hundred and sixty-four MS patients (94 relapsing-remitting [RR], 70 progressive [P] MS) and 51 healthy controls (HC) underwent a brain 3T acquisition. Brain cortex was segmented from 3D T1-weighted sequence, whereas CLs were quantified on double inversion recovery. Using NODDI on diffusion-weighted sequence, intracellular (ICV_f) and extracellular volume fractions (ECV_f) and orientation dispersion index (ODI) were assessed in NA-cortex and CLs. Between-group comparisons and correlations with clinical and MRI measures were investigated.

Results One hundred and twelve (68.3%) MS patients had ≥1 CL. MS NA-cortex had a significant lower ICV_f vs HC NA-cortex (p=0.001). CLs showed a significant increased ECV_f (p<0.001) and decreased ICV_f and ODI vs NA-cortex of HC (p<0.001) and MS (p=0.035 and <0.001). PMS vs RRMS had a significant decreased NA-cortex ICV_f (p=0.024). Higher burden of CLs (p<0.001) were found in PMS vs RRMS, without microstructural differences. In MS patients, NA-cortex ICV_f, ECV_f and ODI were significantly correlated with disease duration, EDSS, cortical and white matter lesion volumes and whole brain and gray matter atrophy (r from -0.37 to 0.71, p from <0.001 to 0.048).

Conclusions

A significant neurite loss occurs in MS NA-cortex, being more severe with longer disease duration and higher disability. CLs show a further neurite density reduction, an increased extracellular space, possibly reflecting inflammation and gliosis, and a reduced ODI suggestive of a simplification of neurite complexity. NODDI is clinically relevant to investigate in vivo the heterogeneous pathological processes affecting MS cortex.

Authors/Disclosures
Paolo Preziosa (Ospedale San Raffaele) PRESENTER	Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Elisabetta Pagani	No disclosure on file
	No disclosure on file
Laura Cacciaguerra, MD, PhD (Mayo Clinic)	Dr. Cacciaguerra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Cacciaguerra has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BMS Celgene. Dr. Cacciaguerra has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Cacciaguerra has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BIOMEDIA.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi;. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi- Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.