title: Hippocampal microstructural damage correlates with memory impairment in clinically isolated syndrome suggestive of multiple sclerosis.
abstract: OBJECTIVE
  We investigated whether diffusion tensor imaging (DTI) could reveal early hippocampal damage and clinically relevant correlates of memory impairment in persons with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS).
  
  
  METHODS
  A total of 37 persons with CIS, 32 with MS and 36 controls prospectively included from 2011 to 2014 were tested for cognitive performances and scanned with 3T-magnetic resonance imaging (MRI) to assess volumetric and DTI changes within the hippocampus, whole brain volume and T2-lesion load.
  
  
  RESULTS
  While there was no hippocampal atrophy in the CIS group, hippocampal fractional anisotropy (FA) was significantly decreased compared to controls. Decrease in hippocampal FA together with increased mean diffusivity (MD) was even more prominent in MS patients. In CIS, hippocampal MD was correlated with episodic verbal memory performance ( r = -0.57, p = 0.0002 and odds ratio (OR) = 0.058, 95% confidence interval (CI) = 0.0057-0.59, p = 0.016 adjusted for age, gender, depression and T2-lesion load), but not with cognitive tasks unrelated to hippocampal functions. Hippocampal MD was the only variable discriminating memory-impaired from memory-preserved persons with CIS (area under the curve (AUC) = 0.77, sensitivity = 90.0%, specificity = 70.3%, positive predictive value (PPV) = 52.9%, negative predictive value (NPV) = 95.0%).
  
  
  CONCLUSIONS
  DTI alterations within the hippocampus might reflect early neurodegenerative processes that are correlated with episodic memory performance, discriminating persons with CIS according to their memory status.
authors: Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
authors: Vincent
authors: V
authors: Planche
authors: Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
authors: Aurélie
authors: A
authors: Ruet
authors: Laboratoire Bordelais de Recherche en Informatique (LaBRI), Talence, France.
authors: Pierrick
authors: P
authors: Coupé
authors: Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France.
authors: Delphine
authors: D
authors: Lamargue-Hamel
authors: Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
authors: Mathilde
authors: M
authors: Deloire
authors: Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
authors: Bruno
authors: B
authors: Pereira
authors: Universitat Politècnica de València, Valencia, Spain.
authors: José V
authors: JV
authors: Manjon
authors: Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France.
authors: Fanny
authors: F
authors: Munsch
authors: Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors: Nicola
authors: N
authors: Moscufo
authors: Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors: Dominik S
authors: DS
authors: Meier
authors: Universite de Bordeaux, Bordeaux, France/Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors: Charles Rg
authors: CR
authors: Guttmann
authors: Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
authors: Vincent
authors: V
authors: Dousset
authors: Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
authors: Bruno
authors: B
authors: Brochet
authors: Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
authors: Thomas
authors: T
authors: Tourdias
mesh_terms: D000328:Adult; D003711:Demyelinating Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000503:physiopathology*; D061212:Memory, Episodic; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult
keywords: Multiple sclerosis; clinically isolated syndrome; diffusion tensor imaging; hippocampus; memory impairment