Highlights
- •Cortical thickness is reduced in African Americans compared to Caucasian Americans.
- •Cortical thickness correlates with disability measures only in Caucasian Americans.
- •Subcortical volumes (SCV) did not differ between the two groups.
- •Several SCV correlate with ambulation in the entire cohort and both races.
- •SCV atrophy might drive MS-related disability in African Americans.
Abstract
Background
The interplay between cortical surface thickness (CTh), subcortical volumes (SCV)
and disability in patients with relapsing remitting multiple sclerosis (RRMS) is still
not clear.
Objective
To examine the relationship between CTh, SCV, and disability and investigate differences
in CTh, SCV and disability between African Americans (AA) and Caucasian Americans
(CA).
Methods
Sixty-five RRMS (33AA, 32 CA) participants underwent Expanded Disability Status Scale
and Multiple Sclerosis Functional Composite (MSFC) assessments, including timed 25-foot
walk (T25FW), nine-hole peg test (9HPT) on dominant (D) and non-dominant hand (ND)
and paced auditory serial addition test (PASAT-3). Symbol digit modalities test (SDMT)
was also administered. All participants underwent 3T brain MRI. CTh was measured in
the Frontal (FA), Parietal (PA), Temporal (TA), Occipital (OA), Cingulate (CA), and
Global (GA) cortical surface areas (CSA). SCV measurements included Thalamus (TV),
Caudate (CV), Putamen (PV), Pallidum (PaV), Hippocampus (HV), Amygdala (AV), Accumbens
(AcV), Brain Stem (BSV), and Deep Gray Matter Total Volume (DGMTV). A general linear
model with multivariate analysis (MANOVA) was used to determine the differences between
the two cohorts (SPSS vs 25). Spearman rank correlation analysis was performed to
investigate the relationship between CTh and MSFC.
Results
AA have significantly decreased FA, PA, TA, GA CTh compared to CA (p = 0.004, p = 0.018,
p = 0.013, p = 0.015, respectively). SCV measurements were not significantly different.
Only in CA, the MSFC measures correlate significantly with regional CSA CTh. In both
races and in the entire group, T25FW correlates with TV, PV, AV, AcV and DGMTV (p < 0.05).
Only in AA and the entire cohort, PASAT-3 correlates with TV and AcV(p = 0.041, p = 0.006,
p = 0.006, p = 0.000 respectively).
Conclusions
Differences in CSA CTh reinforce the different disease pathobiology between AA and
CA. Regional CTh may represent a useful biomarker related to multi-domain disability
only in CA, while in AA DGM injury might be a more important contributor to disability.
Longitudinal, large-scale studies are warranted to confirm our findings.
Keywords
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References
- Differential Impact of Multiple Sclerosis on Cortical and Deep Gray Matter Structures in African Americans and Caucasian Americans.J. Neuroimag. 2017; 27: 333-338https://doi.org/10.1111/jon.12393
- Structural and neuronal integrity measures of fatigue severity in multiple sclerosis.Brain Sci. 2017; https://doi.org/10.3390/brainsci7080102
- Cortical atrophy is relevant in multiple sclerosis at clinical onset.J. Neurol. 2007; 254: 1212-1220https://doi.org/10.1007/s00415-006-0503-6
- Widespread cortical thinning characterizes patients with MS with mild cognitive impairment.Neurology. 2010; 74: 321-328
- Brain and retinal atrophy in African-Americans versus Caucasian-Americans with multiple sclerosis: a longitudinal study.Brain. 2018; 141: 3115-3129
- Focal atrophy in multiple sclerosis: relation to lesion load and disability.NeuroImage. 2007; 34: 509-517
- Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis.Neurology. 2004; 63: 2039-2045https://doi.org/10.1212/01.wnl.0000145762.60562.5d
- Modification of Multiple Sclerosis Phenotypes by African Ancestry at HLA.Arch. Neurol. 2009; 66: 226-233https://doi.org/10.1001/archneurol.2008.541
- Cortical surface-based analysis. I. Segmentation and surface reconstruction.Neuroimage. 1999; 9: 179-194https://doi.org/10.1006/nimg.1998.0395
- Measuring the thickness of the human cerebral cortex from magnetic resonance images.P. Natl. Acad. Sci. USA. 2000; 97: 11050-11055
- Whole brain segmentation: automated labeling of neuroanatomical structures in the human brain.Neuron. 2002; 33: 341-355
- Longitudinal cortical thinning progression differs across multiple sclerosis phenotypes and is clinically relevant: A multicentre study.Mult. Scler. 2020; 141352458520940548https://doi.org/10.1177/1352458520940548
- MRI correlates of disability in African-Americans with multiple sclerosis.PLoS One. 2012; 7: e43061https://doi.org/10.1371/journal.pone.0043061
- Multiple sclerosis: severity and progression rate in African Americans compared with whites.Am. J. Phys. Med. Rehabil. 2003; 82: 582-590https://doi.org/10.1097/01.PHM.0000078199.99484.E2
- Multiple sclerosis in US minority populations: Clinical practice insights.Neurol. Clin. Pract. 2015; 5: 132-142https://doi.org/10.1212/CPJ.0000000000000112
- Rapid disease course in African Americans with multiple sclerosis.Neurology. 2010; 75: 217-223
- Racial differences in retinal neurodegeneration as a surrogate marker for cortical atrophy in multiple sclerosis.Mult. Scler. Relat. Disord. 2019; 31: 141-147
- The impact of deep grey matter volume on cognition in multiple sclerosis.Mult. Scler. Relat. Disord. 2020; 45102351https://doi.org/10.1016/j.msard.2020.102351
- Structural abnormality in schizophrenia versus bipolar disorder: a whole brain cortical thickness, surface area, volume and gyrification analyses.Neuroimage Clin. 2020; 25102131
- Does multiple sclerosis–associated disability differ between races?.Neurology. 2006; 6612351240https://doi.org/10.1212/01.wnl.0000208505.81912.82
- African Americans experience disproportionate neurodegenerative changes in the medulla and upper cervical cord in early multiple sclerosis.Mult. Scler. Relat. Disord. 2020; 45102429https://doi.org/10.1016/j.msard.2020.102429
- Phenotype and prognosis in African-Americans with multiple sclerosis: a retrospective chart review.Mult. Scler. 2006; 12: 775-781https://doi.org/10.1177/1352458506070923
- Regional cortical thickness in relapsing-remitting MS: a multi-center study.NeuroImage Clin. 2013; 2: 120-131
- Longitudinal assessment of hand function in individuals with multiple sclerosis.Mult. Scl. Relat. Disord. 2019; 32: 107-113
- Subcortical grey matter volumes predict subsequent walking function in early multiple sclerosis.J. Neurol. Sci. 2016; 366 (Jul 15Epub 2016 May 6. PMID: 27288812): 229-233https://doi.org/10.1016/j.jns.2016.04.054
- Cortical thickness and surface area relate to specific symptoms in early relapsing-remitting multiple sclerosis.Mult. Scler. 2015; 21: 402-414
- Thalamic atrophy predicts cognitive impairment in relapsing remitting multiple sclerosis. Effect on instrumental activities of daily living and employment status.J. Neurol. Sci. 2015; 358 (2015 15): 236-242
- An MRI evaluation of grey matter damage in African Americans with MS.Mult. Scler. Relat. Disord. 2018; 25: 29-36https://doi.org/10.1016/j.msard.2018.06.007
- Optic neuritis in African Americans.Arch. Neurol. 1998; 55: 186-192
- DispImage: a display and analysis tool for medical images.Riv. Neuroradiol. 1992; 5: 489-495
- Extent of cerebellum, subcortical and cortical atrophy in patients with MS: a case-control study.J. Neurol. Sci. 2009; 282: 47-54
- Higher IgG index found in African Americans versus Caucasians with multiple sclerosis.Neurology. 2007; 69: 68-72https://doi.org/10.1212/01.wnl.0000265057.79843.d9
- Brain MRI atrophy quantification in MS: from methods to clinical application.Neurology. 2017; 88: 403-413
- Assessing disability progression with the Multiple Sclerosis Functional Composite.Mult. Scler. 2009; 15: 984-997https://doi.org/10.1002/hbm.24940
- Focal thinning of the cerebral cortex in multiple sclerosis.Brain. 2003; 126: 1734-1744https://doi.org/10.1093/brain/awg175
- Brain atrophy in multiple sclerosis: clinical relevance and technical aspects.Neuroimag. Clin. N. Am. 2017; 27: 289-300
- Characterizing retinal structure injury in African-Americans with multiple sclerosis.Mult. Scler. Relat. Disord. 2016; 7: 16-20https://doi.org/10.1016/j.msard.2016.02.009
- Cerebral gray matter atrophy is associated with the CSF IgG index in African American with Multiple Sclerosis.J. Neuroimag. 2017; 27: 476-480https://doi.org/10.1111/jon.12435
- Multiple Sclerosis Outcome Assessments Consortium (MSOAC). Symbol digit modalities test: a valid clinical trial endpoint for measuring cognition in multiple sclerosis.Mult. Scler. 2019; 25: 1781-1790https://doi.org/10.1177/1352458518808204
- Cortical thinning and ventricle enlargement in neuromyelitis optica spectrum disorders.Front. Neurol. 2020; 11: 872
- Longitudinal patterns of cortical thinning in multiple sclerosis.Hum. Brain Mapp. 2020; 41: 2198-2215
- Hispanic Americans and African Americans with multiple sclerosis have more severe disease course than Caucasian Americans.Mult. Scler. 2017; 23: 1554-1557https://doi.org/10.1177/1352458516679894
- Increased tissue damage and lesion volumes in African American with multiple sclerosis.Neurology. 2010; 74: 538-544
- Multiple Sclerosis Fatigue: a longitudinal structural MRI and diffusion tensor imaging study.J. Neuroimag. 2018; 28: 650-655https://doi.org/10.1111/jon.12548
Article info
Publication history
Published online: May 19, 2021
Accepted:
May 8,
2021
Received in revised form:
April 25,
2021
Received:
February 14,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
