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Increased total sodium concentration in gray matter better explains cognition than atrophy in MS

Adil Maarouf 1, 2, 3 Bertrand Audoin 1, 4 Fanelly Pariollaud Soraya Gherib 1 Audrey Rico 1 Elisabeth Soulier 1 Sylviane Confort-Gouny 1 Maxime Guye 3, 1 Lothar Schad Jean Pelletier 1, 5 Jean-Philippe Ranjeva 1 W Zaaraoui 1
1 CRMBM - Centre de résonance magnétique biologique et médicale
2 Hôpital Maison Blanche
3 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Marseille]
4 Neurologie, maladies neuro-musculaires [Hôpital de la Timone - APHM]
5 APHM - Assistance Publique - Hôpitaux de Marseille
Abstract : OBJECTIVE: To investigate whether brain total sodium accumulation assessed by (23)Na MRI is associated with cognitive deficit in relapsing-remitting multiple sclerosis (RRMS). METHODS: Eighty-nine participants were enrolled in the study (58 patients with RRMS with a disease duration ≤10 years and 31 matched healthy controls). Patients were classified as cognitively impaired if they failed at least 2 tasks on the Brief Repeatable Battery. MRI was performed at 3T using (23)Na MRI to obtain total sodium concentration (TSC) in the different brain compartments (lesions, normal-appearing white matter [NAWM], gray matter [GM]) and (1)H- magnetization-prepared rapid gradient echo to assess GM atrophy (GM fraction). RESULTS: The mean disease duration was 3.1 years and the median Expanded Disability Status Scale score was 1 (range 0-4.5). Thirty-seven patients were classified as cognitively preserved and 21 as cognitively impaired. TSC was increased in GM and NAWM in cognitively impaired patients compared to cognitively preserved patients and healthy controls. Voxel-wise analysis demonstrated that sodium accumulation was mainly located in the neocortex in cognitively impaired patients. Regression analysis evidenced than the 2 best independent predictors of cognitive impairment were GM TSC and age. Receiver operating characteristic analyses demonstrated that sensitivity and specificity of the GM TSC to classify patients according to their cognitive status were 76% and 71%, respectively. CONCLUSIONS: This study provides 2 main findings. (1) In RRMS, total sodium accumulation in the GM is better associated with cognitive impairment than GM atrophy; and (2) total sodium accumulation in patients with cognitive impairment is mainly located in the neocortex.
Keywords : crmbm
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Submitted on : Tuesday, January 3, 2017 - 3:55:43 PM
Last modification on : Wednesday, November 3, 2021 - 9:11:30 AM

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UNIV-AMU | CNRS | CRMBM

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Adil Maarouf, Bertrand Audoin, Fanelly Pariollaud, Soraya Gherib, Audrey Rico, et al.. Increased total sodium concentration in gray matter better explains cognition than atrophy in MS. Neurology, American Academy of Neurology, 2016, ⟨10.1212/WNL.0000000000003511⟩. ⟨hal-01425504⟩

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