Highlights
- •The cerebellum is a common site for multiple sclerosis–related disability.
- •Greater superior cerebellar peduncle, middle cerebellar peduncle, and lobule volume is associated with better motor and cognitive function.
- •Greater diffusivity of superior cerebellar peduncle is related to better motor and cognitive function.
- •Understanding structure-function relationships is key for targeted therapeutics in multiple sclerosis.
Abstract
Objective
To evaluate relationships between specific cerebellar regions and common clinical
measures of motor and cognitive function in persons with multiple sclerosis (PwMS).
Design
Cross-sectional.
Setting
Laboratory.
Participants
Twenty-nine PwMS and 28 age- and sex-matched controls without multiple sclerosis (MS)
(N=57).
Interventions
Not applicable.
Main Outcome Measures
Both diffusion and lobule magnetic resonance imaging analyses and common clinical
measures of motor and cognitive function were used to examine structure-function relationships
in the cerebellum.
Results
PwMS demonstrate significantly worse motor and cognitive function than controls, including
weaker strength, slower walking, and poorer performance on the Symbol Digit Modalities
Test, but demonstrate no differences in cerebellar volume. However, PwMS demonstrate
significantly worse diffusivity (mean diffusivity: P=.0003; axial diffusivity: P=.0015; radial diffusivity: P=.0005; fractional anisotropy: P=.016) of the superior cerebellar peduncle, the primary output of the cerebellum.
Increased volume of the motor lobules (I-V, VIII) was significantly related to better
motor (P<.022) and cognitive (P=.046) performance, and increased volume of the cognitive lobules (VI-VII) was also
related to better motor (P<.032) and cognitive (P=.008) performance, supporting the role of the cerebellum in both motor and cognitive
functioning.
Conclusions
These data highlight the contributions of the cerebellum to both motor and cognitive
function in PwMS. Using novel neuroimaging techniques to examine structure-function
relationships in PwMS improves our understanding of individualized differences in
this heterogeneous group and may provide an avenue for targeted, individualized rehabilitation
aimed at improving cerebellar dysfunction in MS.
Keywords
List of abbreviations:
2MWT (2-minute walk test), AD (axial diffusivity), DTI (diffusion tensor imaging), FA (fractional anisotropy), ICP (inferior cerebellar peduncle), MCP (middle cerebellar peduncle), MD (mean diffusivity), MRI (magnetic resonance imaging), MS (multiple sclerosis), PwMS (persons with multiple sclerosis), RD (radial diffusivity), SCP (superior cerebellar peduncle), SDMT (Symbol Digit Modalities Test), SSST (Six Spot Step Test), T25FW (timed 25-foot walk), TUG (Timed Up and Go)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 05, 2022
Accepted:
December 13,
2021
Received in revised form:
October 25,
2021
Received:
July 2,
2021
Footnotes
This work was previously presented at the Consortium of Multiple Sclerosis Centers Annual Meeting, May 29, 2015, Indianapolis, IN.
Supported by a National Multiple Sclerosis Society Research Grant (K.M.Z.).
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
