Structural disconnectivity from paramagnetic rim lesions is related to disability in multiple sclerosis.

TitleStructural disconnectivity from paramagnetic rim lesions is related to disability in multiple sclerosis.
Publication TypeJournal Article
Year of Publication2021
AuthorsTozlu C, Jamison K, Nguyen T, Zinger N, Kaunzner U, Pandya S, Wang Y, Gauthier S, Kuceyeski A
JournalBrain Behav
Volume11
Issue10
Paginatione2353
Date Published2021 10
ISSN2162-3279
KeywordsBrain, Gray Matter, Humans, Magnetic Resonance Imaging, Multiple Sclerosis, Myelin Sheath
Abstract

BACKGROUND: In people with multiple sclerosis (pwMS), lesions with a hyperintense rim (rim+) on Quantitative Susceptibility Mapping (QSM) have been shown to have greater myelin damage compared to rim- lesions, but their association with disability has not yet been investigated. Furthermore, how QSM rim+ and rim- lesions differentially impact disability through their disruptions to structural connectivity has not been explored. We test the hypothesis that structural disconnectivity due to rim+ lesions is more predictive of disability compared to structural disconnectivity due to rim- lesions.

METHODS: Ninety-six pwMS were included in our study. Individuals with Expanded Disability Status Scale (EDSS) <2 were considered to have lower disability (n = 59). For each gray matter region, a Change in Connectivity (ChaCo) score, that is, the percent of connecting streamlines also passing through a rim- or rim+ lesion, was computed. Adaptive Boosting was used to classify the pwMS into lower versus greater disability groups based on ChaCo scores from rim+ and rim- lesions. Classification performance was assessed using the area under ROC curve (AUC).

RESULTS: The model based on ChaCo from rim+ lesions outperformed the model based on ChaCo from rim- lesions (AUC = 0.67 vs 0.63, p-value < .05). The left thalamus and left cerebellum were the most important regions in classifying pwMS into disability categories.

CONCLUSION: rim+ lesions may be more influential on disability through their disruptions to the structural connectome than rim- lesions. This study provides a deeper understanding of how rim+ lesion location/size and resulting disruption to the structural connectome can contribute to MS-related disability.

DOI10.1002/brb3.2353
Alternate JournalBrain Behav
PubMed ID34498432
PubMed Central IDPMC8553317
Grant ListR01 NS104283 / NS / NINDS NIH HHS / United States
R01 NS105144 / NS / NINDS NIH HHS / United States
R21 NS104634 / NS / NINDS NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States
Related Institute: 
MRI Research Institute (MRIRI) Brain Health Imaging Institute (BHII)

Weill Cornell Medicine
Department of Radiology
525 East 68th Street New York, NY 10065