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Research ArticleADULT BRAIN

Juxtacortical Lesions and Cortical Thinning in Multiple Sclerosis

D. Pareto, J. Sastre-Garriga, C. Auger, Y. Vives-Gilabert, J. Delgado, M. Tintoré, X. Montalban and A. Rovira
American Journal of Neuroradiology December 2015, 36 (12) 2270-2276; DOI: https://doi.org/10.3174/ajnr.A4485
D. Pareto
aFrom Unitat de Ressonància Magnètica (IDI), Servei de Radiologia (D.P., C.A., A.R.)
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J. Sastre-Garriga
bServei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia (Cemcat) (J.S.-G., M.T., X.M.)
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C. Auger
aFrom Unitat de Ressonància Magnètica (IDI), Servei de Radiologia (D.P., C.A., A.R.)
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Y. Vives-Gilabert
cHospital Universitari Vall d'Hebron, and Port d'Informació Científica (Y.V.-G., J.D.), Universitat Autònoma de Barcelona, Barcelona, Spain.
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J. Delgado
cHospital Universitari Vall d'Hebron, and Port d'Informació Científica (Y.V.-G., J.D.), Universitat Autònoma de Barcelona, Barcelona, Spain.
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M. Tintoré
bServei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia (Cemcat) (J.S.-G., M.T., X.M.)
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X. Montalban
bServei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia (Cemcat) (J.S.-G., M.T., X.M.)
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A. Rovira
aFrom Unitat de Ressonància Magnètica (IDI), Servei de Radiologia (D.P., C.A., A.R.)
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Article Figures & Data

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  • Fig 1.
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    Fig 1.

    Percentage cortical thickness loss in RRj relative to CISn for the different brain lobes (frontal, insula, parietal, temporal, and occipital). Values were color-coded and ranged from 0%–5%. Juxtacortical lesion probability map (right) for patients with CIS (cold scale) and patients with RRMS (warm scale), scaled to the maximum value (10%). Results were overlaid on the mean filled structural image of the whole cohort studied.

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    Fig 2.

    Inflated brain, displaying areas of reduced cortical thickness (red areas) in CISj compared with CISnj (significance level P < .01 for display purposes). Blue areas indicate regions where cortical thickness in CISnj is reduced compared with CISj. The CIS JL lesion probability map was overlaid in purple (right column, left hemisphere; left column, right hemisphere; superior row, lateral view; inferior row, medial view). The JL lesion probability map is a binary mask for display purposes. No overlap was seen between the areas, showing significant changes in thickness and the JL lesion probability map.

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    Fig 3.

    Inflated brain displaying areas of reduced cortical thickness (red areas) in RRj compared with RRnj (significance level P < .01, for display purposes). Blue areas indicate regions in which cortical thickness in RRnj is reduced compared with RRj. The RR JL lesion probability map was overlaid in purple (right column, left hemisphere; left column, right hemisphere; superior row, lateral view; inferior row, medial view). The JL lesion probability map was a binary mask, just for display purposes. No overlap was seen between the areas showing significant changes in thickness and the JL lesion probability map.

Tables

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    Table 1:

    Demographic and clinical features of the study sample

    CISnCISnjCISjRRnjRRj
    N (women)24 (15)33 (20)34 (20)10 (4)30 (20)
    Mean (SD) age, y36 ± 1036 ± 735 ± 834 ± 736 ± 7
    Mean (SD) EDSS1.4 ± 0.91.4 ± 0.91.9 ± 1.13.2 ± 2.02.5 ± 1.6
    Mean (SD) DIS3–5 mo3–5 mo3–5 mo10.4 ± 8.2 y10.6 ± 7.1 y
    LV mL (SD)00.75 ± 1.174.10 ± 6.383.12 ± 3.719.10 ± 7.86
    • Note:—EDSS indicates expanded disability scale; DIS, disease duration.

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    Table 2:

    Distribution of JLsa

    LobeLPMvol CIS, no. (%)LPMρ CIS, %LPMvol RRMS, no. (%)LPMρ RRMS, %
    Frontal11.6 (39.3)1.727.0 (46)4.0
    Insula1.3 (4.5)5.01.9 (3.2)7.0
    Parietal7.7 (26.2)2.014.2 (24.3)3.7
    Temporal7.7 (26.12)2.613.9 (23.8)4.7
    Occipital1.1 (3.9)0.71.6 (2.8)0.9
    • Note:—LPM indicates lesion probability map; LPMvol, absolute volume in milliliters of JL per lobe (percentage of global JL volume); LPMρ, percentage of JL volume relative to lobe volume.

    • ↵a Total JLV (LPMvol) in milliliters (percentage relative to global amount), and percentage relative to lobe volume in patients with CIS and patients with RRMS.

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    Table 3:

    Global and lobar mean cortical thickness (in mm) for the groups studied

    LobeP Value (Factor Group)aCISnCISnjCISjRRnjRRjP Value (R vs L)b
    Global_R.0642.50 (0.13)c2.47 (0.09)2.44 (0.16)2.47 (0.09)2.40 (0.13).806
    Global_L.0742.50 (0.13)2.48 (0.19)2.45 (0.16)2.49 (0.09)2.41 (0.13)
    Frontal_R.3892.55 (0.16)2.53 (0.16)2.51 (0.16)2.55 (0.11)2.49 (0.11).006
    Frontal_L.4242.52 (0.17)2.47 (0.11)2.46 (0.15)2.50 (0.13)2.46 (0.12)
    Insula_R.9443.01 (0.16)3.04 (0.14)3.02 (0.25)2.99 (0.15)3.03 (0.13).711
    Insula_L.8813.05 (0.19)3.05 (0.14)3.01 (0.24)3.03 (0.16)3.02 (0.15)
    Parietal_R.0562.22 (0.11)c2.17 (0.07)2.15 (0.17)2.19 (0.08)2.12 (0.13).414
    Parietal_L.0252.22 (0.11)c2.20 (0.09)2.17 (0.17)2.21 (0.09)2.12 (0.14)
    Temporal_R.1192.93 (0.14)2.90 (0.17)2.87 (0.21)2.91 (0.21)2.80 (0.21).002
    Temporal_L.0843.01 (0.14)2.97 (0.16)2.94 (0.20)2.96 (0.16)2.88 (0.19)
    Occipital_R.0142.29 (0.14)2.30 (0.11)c2.24 (0.17)2.29 (0.12)2.19 (0.14).224
    Occipital_L.0472.30 (0.13)2.31 (0.09)c2.28 (0.13)2.29 (0.11)2.22 (0.15)
    • Note:—R indicates right hemisphere; L, left hemisphere. Numbers in parentheses are the SD.

    • ↵a P value of the 1-way ANOVA test with group as a factor.

    • ↵b P value of the hemisphere effect (R vs L hemispheres values).

    • ↵c P < .05 compared with RRj.

    • View popup
    Table 4:

    Subcortical gray matter volumes percentage relative to total intracranial volume for the groups studied

    Subcortical Gray MatterP Value (Factor Group)aCISngCISnjgCISjgRRnjgRRjgP Value (R vs L)b
    Thal_R.0000.502 (0.041)f0.486 (0.060)e0.473 (0.058)e0.477 (0.092)0.424 (0.064).986
    Thal_L.0030.492 (0.042)e0.485 (0.053)e0.474 (0.062)0.476 (0.010)0.432 (0.066)
    Pallidum_R.0290.115 (0.013)c0.114 (0.016)d0.109 (0.015)0.110 (0.017)0.103 (0.017).000
    Pallidum_L.0030.132 (0.018)e0.129 (0.017)d0.118 (0.023)0.124 (0.027)0.113 (0.021)
    Caudate_R.0690.277 (0.037)0.278 (0.036)0.257 (0.041)0.271 (0.052)0.256 (0.035).015
    Caudate_L.0250.268 (0.036)0.266 (0.034)0.247 (0.037)0.259 (0.043)0.242 (0.038)
    Putamen_R.0090.428 (0.037)d0.427 (0.074)d0.408 (0.072)0.410 (0.085)0.369 (0.072).020
    Putamen_L.0020.452 (0.042)e0.452 (0.069)e0.428 (0.081)0.430 (0.082)0.384 (0.073)
    Accum_R.0010.054 (0.011)d0.056 (0.011)e0.052 (0.009)0.057 (0.012)d0.045 (0.013).745
    Accum_L.0020.053 (0.007)0.058 (0.012)e0.052 (0.009)0.054 (0.010)0.047 (0.010)
    Hippo_R.0640.305 (0.026)0.315(0.041)d0.306 (0.040)0.306 (0.053)0.283 (0.053).393
    Hippo_L.1210.301 (0.026)0.308 (0.041)0.303 (0.037)0.294 (0.056)0.282 (0.044)
    Amygdala_R.0050.129 (0.017)0.140 (0.023)e0.128 (0.020)0.131 (0.025)0.119 (0.024).440
    Amygdala_L.1580.126 (0.020)0.134 (0.021)0.129 (0.019)0.128 (0.021)0.120 (0.028)
    • Note:—Thal indicates thalamus; R, right; L, left; Accum, accumbens; Hippo, hippocampus.

    • ↵a P value of the 1-way ANOVA test with group as a factor.

    • ↵b P value of the hemisphere effect (R vs L hemispheres values).

    • ↵c P = .059.

    • ↵d P < .05.

    • ↵e P < .01.

    • ↵f P < .001 compared with RRj.

    • ↵g Data are expressed as mean (SD).

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American Journal of Neuroradiology: 36 (12)
American Journal of Neuroradiology
Vol. 36, Issue 12
1 Dec 2015
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Juxtacortical Lesions and Cortical Thinning in Multiple Sclerosis
D. Pareto, J. Sastre-Garriga, C. Auger, Y. Vives-Gilabert, J. Delgado, M. Tintoré, X. Montalban, A. Rovira
American Journal of Neuroradiology Dec 2015, 36 (12) 2270-2276; DOI: 10.3174/ajnr.A4485

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Juxtacortical Lesions and Cortical Thinning in Multiple Sclerosis
D. Pareto, J. Sastre-Garriga, C. Auger, Y. Vives-Gilabert, J. Delgado, M. Tintoré, X. Montalban, A. Rovira
American Journal of Neuroradiology Dec 2015, 36 (12) 2270-2276; DOI: 10.3174/ajnr.A4485
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