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Putaminal alteration in multiple sclerosis patients with spinal cord lesions

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Typical multiple sclerosis (MS) lesions occur in the brain as well as in the spinal cord. However, two extreme magnetic resonance imaging phenotypes appear occasionally: those with predominantly spinal cord lesions (MS + SL) and those with cerebral lesions and no detectable spinal lesions (MS + CL). We assessed whether morphological differences can be found between these two extreme phenotypes. We examined 19 patients with MS + SL, 18 with MS + CL and 20 controls. All subjects were examined using magnetic resonance imaging, including anatomical and diffusion tensor imaging sequences. Voxel-based morphologic and regions of interest-based analyses and tract-based spatial statistics were performed. Patients also underwent neuropsychological testing. Demographic, clinical and neuropsychological characteristics did not differ between MS + SL and MS + CL patients. Patients with MS + SL showed significantly larger putamen volumes than those with MS + CL which correlated negatively with disability. Compared to controls, only MS + CL revealed clear cortical and deep gray matter atrophy, which correlated with cerebral lesion volume. Additionally, extensive white matter microstructural damage was found only in MS + CL compared to MS + SL and controls in the tract-based spatial statistics. Higher putamen volumes in MS + SL could suggest compensatory mechanisms in this area responsible for motor control. Widely reduced fractional anisotropy values in MS + CL were caused by higher cerebral lesion volume and thus presumably stronger demyelination, which subsequently leads to higher global gray matter atrophy.

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Acknowledgments

This study was supported by the Ministry of Science and Education/German Competence Network for Multiple Sclerosis (BMBF/KKNMS, B7.3 to FZ).

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    Authors and Affiliations

    1. Department of Neurology and Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany

      Hilga Zimmermann, Hans O. Rolfsnes, Swantje Montag, Janine Wilting, Amgad Droby, Eva Reuter, Frauke Zipp & Adriane Gröger

    2. Institute of Neuroradiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany

      Joachim Gawehn

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    1. Hilga Zimmermann
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    2. Hans O. Rolfsnes
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    Correspondence to Adriane Gröger.

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    F. Zipp and A. Gröger contributed equally to this work.

    The work presented in this paper was part of the doctoral thesis of Swantje Montag.

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    Zimmermann, H., Rolfsnes, H.O., Montag, S. et al. Putaminal alteration in multiple sclerosis patients with spinal cord lesions. J Neural Transm 122, 1465–1473 (2015). https://doi.org/10.1007/s00702-015-1406-4

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    • DOI: https://doi.org/10.1007/s00702-015-1406-4

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