Benefits of a mosaic approach for assessing cortical atrophy in individual multiple sclerosis patients

Tahedl, Marlene; Wiltgen, Tun; Voon, Cui Ci; Berthele, Achim; Kirschke, Jan S.; Hemmer, Bernhard; Muehlau, Mark; Zimmer, Claus und Wiestler, Benedikt (2023): Benefits of a mosaic approach for assessing cortical atrophy in individual multiple sclerosis patients. In: Brain and Behavior, Bd. 13, Nr. 12

Abstract

ObjectiveCortical gray matter (GM) atrophy plays a central role in multiple sclerosis (MS) pathology. However, it is not commonly assessed in clinical routine partly because a number of methodological problems hamper the development of a robust biomarker to quantify GM atrophy. In previous work, we have demonstrated the clinical utility of the mosaic approach (MAP) to assess individual GM atrophy in the motor neuron disease spectrum and frontotemporal dementia. In this study, we investigated the clinical utility of MAP in MS, comparing this novel biomarker to existing methods for computing GM atrophy in single patients. We contrasted the strategies based on correlations with established biomarkers reflecting MS disease burden.MethodsWe analyzed T1-weighted MPRAGE magnetic resonance imaging data from 465 relapsing-remitting MS patients and 89 healthy controls. We inspected how variations of existing strategies to estimate individual GM atrophy (standard approaches) as well as variations of MAP (i.e., different parcellation schemes) impact downstream analysis results, both on a group and an individual level. We interpreted individual cortical disease burden as single metric reflecting the fraction of significantly atrophic data points with respect to the control group. In addition, we evaluated the correlations to lesion volume (LV) and Expanded Disability Status Scale (EDSS).ResultsWe found that the MAP method yielded highest correlations with both LV and EDSS as compared to all other strategies. Although the parcellation resolution played a minor role in terms of absolute correlations with clinical variables, higher resolutions provided more clearly defined statistical brain maps which may facilitate clinical interpretability.ConclusionThis study provides evidence that MAP yields high potential for a clinically relevant biomarker in MS, outperforming existing methods to compute cortical disease burden in single patients. Of note, MAP outputs brain maps illustrating individual cortical disease burden which can be directly interpreted in daily clinical routine. Different strategies for assessing individual cortical disease burden in multiple sclerosis (MS) were compared. A mosaic approach (MAP), based on referencing parcelled individual CT to control data, was previously shown to be clinically relevant in motor neuron diseases (MND) and frontotemporal dementia (FTD) and was now evaluated for MS. MAP yielded highest correlations with clinical disability assessment scores in MS and thus yields high potential for a biomarker capturing clinically relevant cortical disease burden in MS, thereby highlighting the generalizability of MAP beyond MND and FTD. image

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Munich Cluster for Systems Neurology (SyNergy)
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Sprache: Englisch
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 390857198