Evidence for early, non-lesional cerebellar damage in patients with multiple sclerosis: DTI measures correlate with disability, atrophy, and disease duration

Deppe M, Tabelow K, Krämer J, Tenberge J, Schiffler P, Bittner S, Schwindt W, Zipp F, Wiendl H, Meuth SG

Research article (journal) | Peer reviewed

Abstract

Background: Common symptoms of multiple sclerosis (MS) such as gait ataxia, poor coordination of the hands, and intention tremor are usually the result of dysfunctionality in the cerebellum. Magnetic resonance imaging (MRI) has frequently failed to detect cerebellar damage in the form of inflammatory lesions in patients presenting with symptoms of cerebellar dysfunction. Objective: To detect microstructural cerebellar tissue alterations in early MS patients with a €normal appearing€ cerebellum using diffusion tensor imaging (DTI). Methods: A total of 68 patients with relapsing-remitting MS (RRMS) and without cerebellar lesions and 26 age-matched healthy controls were admitted to high-resolution MRI and DTI to assess microstructure and volume of the cerebellar white matter (CBWM). Results: We found cerebellar fractional anisotropy (FA) and CBWM volume reductions in the group of 68 patients. Interestingly, a subgroup of these patients that was derived by including only patients with early and mild MS (N=23, median age 30 years, median Expanded Disability Status Scale =1.5, median duration 28 months) showed already cerebellar FA but no CBWM volume reductions. FA reductions were correlated with disability, atrophy, and disease duration. Conclusion: €Normal appearing€ cerebellar white matter can be damaged in a very early stage of RRMS. DTI seems to be a sensitive tool for detecting this hidden cerebellar damage.

Details about the publication

JournalMultiple Sclerosis (Mult Scler)
Volume22
Issue1
Page range73-84
StatusPublished
Release year2016
Language in which the publication is writtenEnglish
DOI10.1177/1352458515579439
Link to the full texthttp://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84951033492&origin=inward
Keywordsatrophy; cerebellum; degeneration; Diffusion tensor imaging; multiple sclerosis

Authors from the University of Münster

Deppe, Michael
Department for Neurology
Meuth, Sven
Department for Neurology
Schiffler, Patrick
Department for Neurology
Tenberge, Jan-Gerd
Department for Neurology