A multi-shell multi-tissue diffusion study of brain connectivity in early multiple sclerosis. (June 2020)

• Record Type: Journal Article
• 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
• Is Part Of: Multiple sclerosis. Volume 26:Number 7(2020)
• Page Start: 774
• Page End: 785
• Publication Date: 2020-06
• Subjects: Diffusion-weighted imaging -- multi-shell acquisitions -- multi-shell multi-tissue constrained spherical deconvolution -- tractography -- multiple sclerosis -- clinically isolated syndrome; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458519845105
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: 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. Objective: 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. Methods: 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. Results: Patients had lower mean nodal strength ( p = 0.003) and greater network modularity than controls ( p = 0.045). Greater modularity was associated with worse cognitive performance in patients, even after accounting for lesion load ( p = 0.002). Multi-shell-derived metrics outperformed single-shell-derived ones. Conclusion: 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.