A Comprehensive Approach to Disentangle the Effect of Cerebellar Damage on Physical Disability in Multiple Sclerosis
Cerebellar damage occurs frequently in multiple sclerosis (MS) patients, with a wide exhibition of symptoms particularly as impairments of balance and gait. Recent studies implementing new postprocessing magnetic resonance imaging (MRI) techniques showed how cerebellar subregional atrophy provides a...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-06-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00529/full |
| _version_ | 1818405554941329408 |
|---|---|
| author | Serena Ruggieri Serena Ruggieri Komal Bharti Luca Prosperini Costanza Giannì Nikolaos Petsas Silvia Tommasin Laura De Giglio Carlo Pozzilli Patrizia Pantano Patrizia Pantano |
| author_facet | Serena Ruggieri Serena Ruggieri Komal Bharti Luca Prosperini Costanza Giannì Nikolaos Petsas Silvia Tommasin Laura De Giglio Carlo Pozzilli Patrizia Pantano Patrizia Pantano |
| author_sort | Serena Ruggieri |
| collection | DOAJ |
| description | Cerebellar damage occurs frequently in multiple sclerosis (MS) patients, with a wide exhibition of symptoms particularly as impairments of balance and gait. Recent studies implementing new postprocessing magnetic resonance imaging (MRI) techniques showed how cerebellar subregional atrophy provides an explanation of disability in MS. The aim of this work was to evaluate the relationship between quantitative measures of physical disability, cerebellar subregional atrophy, and cerebellar peduncle disruption. Forty-nine MS patients and 32 healthy subjects as controls (HS) underwent a 3-Tesla MRI including 3D T1-weighted and diffusion tensor imaging. Patients underwent static posturography to calculate the body's center of pressure (COP) displacement, Expanded Disability Status Scale (EDSS), and 25-ft walking test (25-FWT). Cerebellar lobular volumes were automatically calculated using the Spatially Unbiased Infratentorial Toolbox. Tract-based spatial statistics (TBSS) in FSL was used to process diffusion tensor imaging (DTI) Fit-generated fractional anisotropy (FA) maps to assess structural connectivity of cerebellar peduncles. Stepwise multivariate linear regression analyses were used to explore relationships between variables. Cerebellar volumes (anterior and posterior, as well as lobular volumes from I to X) were significantly lower in patients with MS than HS (p < 0.05). FA in all cerebellar peduncles was lower in MS patients than in HS (p < 0.05). EDSS and 25-FWT showed an association with atrophy of lobule VIIIb (β = −0.37, p < 0.01, and β = −0.45, p < 0.001, respectively) COP measures inversely correlated with volume of lobules I–IV (β = −0.37, p < 0.01, and β = −0.36, p < 0.01). Lower FA in the three cerebellar peduncles of MS patients positively correlated with cerebellar lobular volumes. Our findings show how sensorimotor cerebellum atrophy and disruption of both afferent and efferent cerebellar connections contribute to physical disability in MS patients. |
| first_indexed | 2024-12-14T08:57:54Z |
| format | Article |
| id | doaj.art-e8f2f598b1e94f1c93a835dbaf226398 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-14T08:57:54Z |
| publishDate | 2020-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-e8f2f598b1e94f1c93a835dbaf2263982022-12-21T23:08:53ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-06-011110.3389/fneur.2020.00529536415A Comprehensive Approach to Disentangle the Effect of Cerebellar Damage on Physical Disability in Multiple SclerosisSerena Ruggieri0Serena Ruggieri1Komal Bharti2Luca Prosperini3Costanza Giannì4Nikolaos Petsas5Silvia Tommasin6Laura De Giglio7Carlo Pozzilli8Patrizia Pantano9Patrizia Pantano10Department of Human Neurosciences, “Sapienza” Rome University, Rome, ItalyDepartment of Neurosciences, San Camillo Forlanini Hospital, Rome, ItalyDepartment of Human Neurosciences, “Sapienza” Rome University, Rome, ItalyDepartment of Neurosciences, San Camillo Forlanini Hospital, Rome, ItalyDepartment of Human Neurosciences, “Sapienza” Rome University, Rome, ItalyDepartment of Radiology, IRCCS Neuromed, Pozzilli, ItalyDepartment of Human Neurosciences, “Sapienza” Rome University, Rome, ItalyDepartment of Human Neurosciences, “Sapienza” Rome University, Rome, ItalyDepartment of Human Neurosciences, “Sapienza” Rome University, Rome, ItalyDepartment of Human Neurosciences, “Sapienza” Rome University, Rome, ItalyDepartment of Radiology, IRCCS Neuromed, Pozzilli, ItalyCerebellar damage occurs frequently in multiple sclerosis (MS) patients, with a wide exhibition of symptoms particularly as impairments of balance and gait. Recent studies implementing new postprocessing magnetic resonance imaging (MRI) techniques showed how cerebellar subregional atrophy provides an explanation of disability in MS. The aim of this work was to evaluate the relationship between quantitative measures of physical disability, cerebellar subregional atrophy, and cerebellar peduncle disruption. Forty-nine MS patients and 32 healthy subjects as controls (HS) underwent a 3-Tesla MRI including 3D T1-weighted and diffusion tensor imaging. Patients underwent static posturography to calculate the body's center of pressure (COP) displacement, Expanded Disability Status Scale (EDSS), and 25-ft walking test (25-FWT). Cerebellar lobular volumes were automatically calculated using the Spatially Unbiased Infratentorial Toolbox. Tract-based spatial statistics (TBSS) in FSL was used to process diffusion tensor imaging (DTI) Fit-generated fractional anisotropy (FA) maps to assess structural connectivity of cerebellar peduncles. Stepwise multivariate linear regression analyses were used to explore relationships between variables. Cerebellar volumes (anterior and posterior, as well as lobular volumes from I to X) were significantly lower in patients with MS than HS (p < 0.05). FA in all cerebellar peduncles was lower in MS patients than in HS (p < 0.05). EDSS and 25-FWT showed an association with atrophy of lobule VIIIb (β = −0.37, p < 0.01, and β = −0.45, p < 0.001, respectively) COP measures inversely correlated with volume of lobules I–IV (β = −0.37, p < 0.01, and β = −0.36, p < 0.01). Lower FA in the three cerebellar peduncles of MS patients positively correlated with cerebellar lobular volumes. Our findings show how sensorimotor cerebellum atrophy and disruption of both afferent and efferent cerebellar connections contribute to physical disability in MS patients.https://www.frontiersin.org/article/10.3389/fneur.2020.00529/fullmultiple sclerosismagnetic resonance imagingcerebellumphysical disabilityatrophydiffusion tensor indexes |
| spellingShingle | Serena Ruggieri Serena Ruggieri Komal Bharti Luca Prosperini Costanza Giannì Nikolaos Petsas Silvia Tommasin Laura De Giglio Carlo Pozzilli Patrizia Pantano Patrizia Pantano A Comprehensive Approach to Disentangle the Effect of Cerebellar Damage on Physical Disability in Multiple Sclerosis Frontiers in Neurology multiple sclerosis magnetic resonance imaging cerebellum physical disability atrophy diffusion tensor indexes |
| title | A Comprehensive Approach to Disentangle the Effect of Cerebellar Damage on Physical Disability in Multiple Sclerosis |
| title_full | A Comprehensive Approach to Disentangle the Effect of Cerebellar Damage on Physical Disability in Multiple Sclerosis |
| title_fullStr | A Comprehensive Approach to Disentangle the Effect of Cerebellar Damage on Physical Disability in Multiple Sclerosis |
| title_full_unstemmed | A Comprehensive Approach to Disentangle the Effect of Cerebellar Damage on Physical Disability in Multiple Sclerosis |
| title_short | A Comprehensive Approach to Disentangle the Effect of Cerebellar Damage on Physical Disability in Multiple Sclerosis |
| title_sort | comprehensive approach to disentangle the effect of cerebellar damage on physical disability in multiple sclerosis |
| topic | multiple sclerosis magnetic resonance imaging cerebellum physical disability atrophy diffusion tensor indexes |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00529/full |
| work_keys_str_mv | AT serenaruggieri acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT serenaruggieri acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT komalbharti acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT lucaprosperini acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT costanzagianni acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT nikolaospetsas acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT silviatommasin acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT lauradegiglio acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT carlopozzilli acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT patriziapantano acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT patriziapantano acomprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT serenaruggieri comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT serenaruggieri comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT komalbharti comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT lucaprosperini comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT costanzagianni comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT nikolaospetsas comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT silviatommasin comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT lauradegiglio comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT carlopozzilli comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT patriziapantano comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis AT patriziapantano comprehensiveapproachtodisentangletheeffectofcerebellardamageonphysicaldisabilityinmultiplesclerosis |