2023 American Academy of Neurology Abstract Website

Francesco Romanò¹, Maria Rocca², Paola Valsasina¹, Tetsu Morozumi⁴, Maria Amato⁵, Giampaolo Brichetto⁶, Nicolò Bruschi⁷, Jeremy Chataway⁸, Nancy Chiaravalloti⁹, Gary Cutter¹⁰, Ulrik Dalgas¹¹, John DeLuca⁹, Rachel Farrell⁸, Peter Feys¹², Jennifer Freeman¹³, Maria Matilde Inglese¹⁴, Cecilia Meza¹⁵, Amber Salter¹⁶, Brian M Sandroff⁹, Anthony Feinstein¹⁵, Robert Motl¹⁷, Massimo Filippi³
¹Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, ²Neuroimaging Research Unit, Division of Neuroscience, and Neurology Unit, ³Neuroimaging Research Unit, Division of Neuroscience, Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Service, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele Unviersity, ⁴Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, ⁵Department NEUROFARBA, Section Neurosciences, University of Florence, ⁶Italian MS Society, ⁷Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, and Center of Excellence for Biomedical Research, University of Genoa, ⁸Queen Square MS Centre, UCL Queen Square Institute of Neurology, ⁹Kessler Foundation, ¹⁰Department of Biostatistics, University of Alabama At Birmingham, ¹¹Exercise Biology, Department of Public Health, Aarhus University, ¹²REVAL, Faculty of Rehabilitation Sciences, Hasselt University, ¹³Faculty of Health, School of Health Professions, University of Plymouth, ¹⁴Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, and Center of Excellence for Biomedical Research, University of Genoa; IRCCS Ospedale Policlinico San Martino, ¹⁵Department of Psychiatry, University of Toronto and Sunnybrook Health Sciences Centre, ¹⁶Department of Neurology, Section on Statistical Planning and Analysis, UT Southwestern Medical Center, ¹⁷Department of Kinesiology and Nutrition, University of Illinois Chicago

Objective:

To assess thalamic structural and functional MRI alterations and investigate their correlations with physical activity (PA) and cardiorespiratory fitness (CRF) levels in progressive MS (PMS) patients.

Background:

Patients with PMS have insufficient levels of PA and CRF, which showed some associations with measures of structural MRI damage. Functional MRI (fMRI) correlates of reduced PA/fitness have never been explored. Given the role of thalamus in motor planning, sensory processing and cognition, abnormal thalamic resting state (RS) functional connectivity (FC) might explain PA/fitness levels in these patients.

Design/Methods:

Ninety-one PMS patients performed a cardiopulmonary exercise test and wore an accelerometer for 7 days to assess PA/CRF levels. They underwent, together with 37 matched healthy controls (HC), a structural and RS fMRI acquisition at 3.0T, used to derive whole-brain and thalamic atrophy and thalamic RS FC. Between-group comparisons of MRI measures and their correlations with PA/CRF variables were assessed.

Results:

PMS patients had whole-brain and subcortical atrophy compared to HC (all p<0.001). Patients showed decreased intra- and inter-thalamic RS FC, decreased RS FC of the thalamus with caudate nucleus, cerebellum and anterior cingulate cortex (ACC), and increased thalamic RS FC with the hippocampus and some occipital regions. Lower CRF correlated with lower white matter volume (r=range 0.28;0.31, p=range 0.003;0.01), decreased thalamic RS FC with the ACC (r=range 0.22;0.28, p=range 0.01;0.04), and increased thalamic RS FC with the hippocampus, calcarine cortex, and lingual gyrus (r=range -0.26;-0.21, p=range 0.01;0.04). Lower PA correlated with decreased inter-thalamic RS FC (r=0.27, p=0.02), and increased thalamic RS FC with the hippocampus (r=-0.3, p=0.01) and lingual gyrus (r=-0.23, p=0.04).

Conclusions:

Only white matter atrophy correlated with CRF. Conversely, abnormal RS FC in the thalamic network showed various maladaptive associations with PA/CRF in PMS patients. Thalamic RS FC might be used to monitor the efficacy of rehabilitative and disease-modifying treatments in PMS patients.