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Peak width of skeletonized mean diffusivity (PSMD) and cognitive functions in relapsing-remitting multiple sclerosis
C Vinciguerra1, A Giorgio1, J Zhang1
1Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
Brain Imaging and Behavior
|October 9, 2020
Summary
Peak width of skeletonized mean diffusivity (PSMD) is a novel MRI marker that accurately reflects cognitive function in relapsing-remitting multiple sclerosis (RRMS). PSMD is a superior predictor of information processing speed deficits compared to other MRI metrics.
Area of Science:
- Neuroimaging
- Neurology
- Cognitive Science
Background:
- Multiple Sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Cognitive impairment is a significant issue in MS patients, impacting quality of life.
- Existing MRI markers have limitations in fully capturing the extent of neurological damage and its cognitive correlates.
Purpose of the Study:
- To investigate the relationship between Peak Width of Skeletonized Mean Diffusivity (PSMD), a novel MRI marker, and cognitive performance in relapsing-remitting MS (RRMS) patients.
- To compare the efficacy of PSMD against other established MRI measures in explaining cognitive deficits.
- To assess the utility of PSMD as a reliable biomarker for cognitive dysfunction in MS.
Main Methods:
- Sixty RRMS patients and fifteen healthy controls underwent 3T MRI scans.
- MRI analysis included white matter (WM) lesion volume, diffusion tensor imaging (DTI) for microstructural integrity using Tract-Based Spatial Statistics, and brain volume measurements.
- PSMD was calculated via skeletonization of WM tracts and diffusion histograms. Cognitive function was assessed using Rao's Brief Repeatable Battery (BRB).
Main Results:
- PSMD showed a strong negative correlation with the Symbol Digit Modalities Test (SDMT) (r = -0.70, p < 0.001) and moderate correlations with verbal and visual memory tests.
- Multiple regression analysis revealed that PSMD significantly explained variance in SDMT performance (R² = 0.54, p < 0.001), outperforming other MRI measures.
- The findings highlight PSMD's sensitivity to microstructural damage impacting cognitive functions, particularly information processing speed.
Conclusions:
- PSMD is a relevant and sensitive MRI marker for assessing microstructural damage in MS.
- PSMD demonstrates significant clinical relevance by reliably reflecting cognitive impairments, especially in information processing speed, in RRMS patients.
- This study supports PSMD as a valuable tool for monitoring disease progression and cognitive status in MS.
