• Maria Teresa Cassiano, Roberta Lanzillo, Bruno Alfano, Teresa Costabile, Marco Comerci, Anna Prinster, Marcello Moccia, Rosario Megna, MorraVincenzo BresciaVBDepartment of Neurosciences, Reproductive Science and Odontostomatology, University "Federico II", Naples, Italy., Mario Quarantelli, and Arturo Brunetti.
• Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80131 Naples, Italy.
• Neuroimage Clin. 2020 Jan 1; 26: 102201.

BackgroundRegional analyses of markers of microstructural gray matter (GM) changes, including relaxation rates, have shown inconsistent correlations with physical and cognitive impairment in MS.ObjectiveTo assess voxelwise the correlation of the R1 and R2 relaxation rates with the physical and cognitive impairment in MS.MethodsGM R1 and R2 relaxation rate maps were obtained in 241 relapsing-remitting MS patients by relaxometric segmentation of MRI studies. Correlations with the Expanded Disability Status Scale (EDSS) and the percentage of impaired cognitive test (Brief Repeatable Battery and Stroop Test, available in 186 patients) were assessed voxelwise, including voxel GM content as nuisance covariate to remove the effect of atrophy on the correlations.ResultsExtensive clusters of inverse correlation between EDSS and R2 were detected throughout the brain, while inverse correlations with R1 were mostly limited to perirolandic and supramarginal cortices. Cognitive impairment correlated negatively with R1, and to a lesser extent with R2, in the middle frontal, mesial temporal, midcingulate and medial parieto-occipital cortices.ConclusionIn relapsing-remitting MS patients, GM microstructural changes correlate diffusely with physical disability, independent of atrophy, with a preferential role of the sensorimotor cortices. Neuronal damage in the limbic system and dorsolateral prefrontal cortices correlates with cognitive dysfunction.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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