Abstract
Background: The relationship between cortical lesions (CLs) and white matter lesions (WMLs) in multiple sclerosis (MS) is poorly understood. Pathological studies support a topographical association between CLs and underlying subcortical WMLs and suggest CLs may play a role in both disease initiation and progression. We hypothesized that cortical MS lesions are physically connected to white matter MS lesions via axonal connections. Objective: To assess the presence of CL-WML connectivity utilizing novel magnetic resonance imaging (MRI) methodology. Methods: In all, 28 relapsing-remitting MS patients and 25 controls received 3 T MRI scans, including double inversion recovery (DIR) for CL detection coupled with diffusion tensor imaging (DTI). CL and WML maps were created, and DTI was used to calculate inter-lesional connectivity and volumetric connectivity indices. Results: All patients showed inter-lesional WML connectivity (median 76% of WMLs connected to another WML; interquartile range (IQR), 58%-88%). On average, 52% of detected CLs per patient were connected to at least one WML (IQR, 42%-71%). Volumetric connectivity analysis showed significantly elevated cortical lesion ratios in MS patients (median, 2.3; IQR, 1.6-3.3) compared to null MS and healthy control datasets (p < 0.001). Conclusion: These findings provide strong evidence of inter-lesional connectivity between CLs and WMLs, supporting our hypothesis of intrinsic CL-WML connectivity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 973-981 |
| Number of pages | 9 |
| Journal | Multiple Sclerosis |
| Volume | 23 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jun 1 2017 |
Fingerprint
Keywords
- Magnetic resonance imaging
- multiple sclerosis
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
Cite this
In vivo detection of connectivity between cortical and white matter lesions in early MS. / Tillema, Jan-Mendelt; Weigand, Stephen D.; Mandrekar, Jayawant; Shu, Yunhong; Lucchinetti, Claudia F; Pirko, Istvan; Port, John D.
In: Multiple Sclerosis, Vol. 23, No. 7, 01.06.2017, p. 973-981.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - In vivo detection of connectivity between cortical and white matter lesions in early MS
AU - Tillema, Jan-Mendelt
AU - Weigand, Stephen D.
AU - Mandrekar, Jayawant
AU - Shu, Yunhong
AU - Lucchinetti, Claudia F
AU - Pirko, Istvan
AU - Port, John D
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background: The relationship between cortical lesions (CLs) and white matter lesions (WMLs) in multiple sclerosis (MS) is poorly understood. Pathological studies support a topographical association between CLs and underlying subcortical WMLs and suggest CLs may play a role in both disease initiation and progression. We hypothesized that cortical MS lesions are physically connected to white matter MS lesions via axonal connections. Objective: To assess the presence of CL-WML connectivity utilizing novel magnetic resonance imaging (MRI) methodology. Methods: In all, 28 relapsing-remitting MS patients and 25 controls received 3 T MRI scans, including double inversion recovery (DIR) for CL detection coupled with diffusion tensor imaging (DTI). CL and WML maps were created, and DTI was used to calculate inter-lesional connectivity and volumetric connectivity indices. Results: All patients showed inter-lesional WML connectivity (median 76% of WMLs connected to another WML; interquartile range (IQR), 58%-88%). On average, 52% of detected CLs per patient were connected to at least one WML (IQR, 42%-71%). Volumetric connectivity analysis showed significantly elevated cortical lesion ratios in MS patients (median, 2.3; IQR, 1.6-3.3) compared to null MS and healthy control datasets (p < 0.001). Conclusion: These findings provide strong evidence of inter-lesional connectivity between CLs and WMLs, supporting our hypothesis of intrinsic CL-WML connectivity.
AB - Background: The relationship between cortical lesions (CLs) and white matter lesions (WMLs) in multiple sclerosis (MS) is poorly understood. Pathological studies support a topographical association between CLs and underlying subcortical WMLs and suggest CLs may play a role in both disease initiation and progression. We hypothesized that cortical MS lesions are physically connected to white matter MS lesions via axonal connections. Objective: To assess the presence of CL-WML connectivity utilizing novel magnetic resonance imaging (MRI) methodology. Methods: In all, 28 relapsing-remitting MS patients and 25 controls received 3 T MRI scans, including double inversion recovery (DIR) for CL detection coupled with diffusion tensor imaging (DTI). CL and WML maps were created, and DTI was used to calculate inter-lesional connectivity and volumetric connectivity indices. Results: All patients showed inter-lesional WML connectivity (median 76% of WMLs connected to another WML; interquartile range (IQR), 58%-88%). On average, 52% of detected CLs per patient were connected to at least one WML (IQR, 42%-71%). Volumetric connectivity analysis showed significantly elevated cortical lesion ratios in MS patients (median, 2.3; IQR, 1.6-3.3) compared to null MS and healthy control datasets (p < 0.001). Conclusion: These findings provide strong evidence of inter-lesional connectivity between CLs and WMLs, supporting our hypothesis of intrinsic CL-WML connectivity.
KW - Magnetic resonance imaging
KW - multiple sclerosis
UR - http://www.scopus.com/inward/record.url?scp=85020195971&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85020195971&partnerID=8YFLogxK
U2 - 10.1177/1352458516671027
DO - 10.1177/1352458516671027
M3 - Article
C2 - 27698248
AN - SCOPUS:85020195971
VL - 23
SP - 973
EP - 981
JO - Multiple Sclerosis
JF - Multiple Sclerosis
SN - 1352-4585
IS - 7
ER -