Laminar analysis of the cerebellar cortex shows widespread damage in early MS patients: A pilot study at 7T MRI

Riccardo Galbusera; Katrin Parmar; Yohan Boillat; Mario Joao Fartaria; Alexandra-Ramona Todea; Kieran O' Brien; Anna Smolinski; Ludwig Kappos; Wietske van der Zwaag; Cristina Granziera

doi:10.1177/2055217320961409

Laminar analysis of the cerebellar cortex shows widespread damage in early MS patients: A pilot study at 7T MRI

Mult Scler J Exp Transl Clin. 2020 Oct 23;6(4):2055217320961409. doi: 10.1177/2055217320961409. eCollection 2020 Oct-Dec.

Authors

Affiliations

¹ Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.
² Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.
³ Laboratory for Functional and Metabolic Imaging, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
⁴ Advanced Clinical Imaging Technology, Siemens Healthcare AG (HC CMEA SUI DI BM PI), Lausanne, Switzerland.
⁵ Siemens Healthcare Pty Ltd., Bowen Hills, Australia; Centre for Advanced Imaging, University of Queensland, Australia.
⁶ Spinoza Centre for Neuroimaging, Amsterdam, Netherlands.

Abstract

Background: To date, little is known about the presence and extent of cerebellar cortical pathology in early stages of MS.

Objective: The aims of this study were to (i) investigate microstructural changes in the normal-appearing cerebellar cortex of early MS patients by using 7 T MRI and (ii) evaluate the influence of those changes on clinical performance.

Methods: Eighteen RRMS patients and nine healthy controls underwent quantitative T₁ and T₂* measurement at 7 T MRI using high-resolution MP2RAGE and multi-echo gradient-echo imaging. After subtracting lesion masks, average T₁ and T₂* maps were computed for three layers in the cerebellar cortex and compared between groups using mixed effects models.

Results: The volume of the cerebellar cortex and its layers did not differ between patients and controls. In MS patients, significantly longer T₁ values were observed in all vermis cortical layers and in the middle and external cortical layer of the cerebellar hemispheres. No between-group differences in T₂* values were found. T₁ values correlated with EDSS, SDMT and PASAT.

Conclusions: We found MRI evidence of damage in the normal-appearing cerebellar cortex at early MS stages and before volumetric changes. This microstructural alteration appears to be related to EDSS and cognitive performance.

Keywords: MRI; Multiple sclerosis; cerebellum; ultra-high field MRI.