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Cortical diffusion kurtosis imaging and thalamic volume are associated with cognitive and walking performance in relapsing–remitting multiple sclerosis

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Abstract

Background

In multiple sclerosis (MS), pronounced neurodegeneration manifests itself as cerebral gray matter (GM) atrophy, which is associated with cognitive and physical impairments. Microstructural changes in GM estimated by diffusion kurtosis imaging (DKI) may reveal neurodegeneration that is undetectable by conventional structural MRI and thus serve as a more sensitive marker of disease progression.

Objective

The primary objective was to investigate the relationships between morphological and diffusional properties in cerebral GM and physical and cognitive performance in relapsing–remitting MS (RRMS) patients. A secondary objective was to investigate the relationship between GM microstructure and white matter (WM) injury, estimated by the volume of WM lesions.

Methods

Sixty-seven RRMS patients performed the brief repeatable battery of neuropsychological tests (BRB-N), the 6-minute walk test (6MWT), the six spot step test (SSST), and underwent MRI scans using structural and DKI protocols. GM volumetrics and DKI measurements were analyzed in the cortex and deep GM structures using a general linear model with demographics, physical- and cognitive performance as covariates.

Results

Mean diffusivity (MD) in the cortex was associated with the SSST, 6MWT, information processing, global cognitive performance, and volume of WM lesions. In addition, thalamic volume was associated with SSST (r2 = 0.21, 6MWT (r2 = 0.18), information processing (r2 = 0.21), and WM lesion volume (r2 = 0.60).

Conclusion

Cortical diffusion and thalamic volume are associated with walking and cognitive performance in RRMS patients and are highly affected by the presence of WM lesions.

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Data availability

Authors will review requests for access to the data that support the findings of this study and access will be granted upon reasonable request.

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Funding

This study was funded by Jascha Fonden, Fonden for Neurologisk Forskning, The Danish Multiple Sclerosis Society, Aase og Ejnar Danielsens Fond, Knud og Edith Eriksens Fond, Augustinus Foundation, Direktør Emil C. Hertz og Hustru Inger Hertz’s Fond, Else og Mogens Wedell-Wedellsborgs Fond, Karen A. Tolstrups Fond, and the Faculty of Health, Aarhus University.

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Authors and Affiliations

  1. Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Nørrebrogade 44, Building 1A, 8000, Aarhus C, Denmark

    Mikkel K. E. Nygaard & Simon F. Eskildsen

  2. Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark

    Martin Langeskov-Christensen & Ulrik Dalgas

Authors
  1. Mikkel K. E. Nygaard
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  2. Martin Langeskov-Christensen
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  4. Simon F. Eskildsen
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Correspondence to Mikkel K. E. Nygaard.

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Conflicts of interest

UD has received research support, travel grants, and/or teaching honorary from Biogen Idec, Merck Serono, Novartis, Bayer Schering, and Sanofi Aventis as well as honoraria from serving on scientific advisory boards of Biogen Idec and Genzyme.

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Nygaard, M.K.E., Langeskov-Christensen, M., Dalgas, U. et al. Cortical diffusion kurtosis imaging and thalamic volume are associated with cognitive and walking performance in relapsing–remitting multiple sclerosis. J Neurol 268, 3861–3870 (2021). https://doi.org/10.1007/s00415-021-10543-4

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  • DOI: https://doi.org/10.1007/s00415-021-10543-4

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