MRI Hippocampal Microstructure and Episodic Memory in Early Multiple Sclerosis
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Interventional

Summary: 
      Clinically isolated syndrome (CIS) can evolve into multiple sclerosis. In CIS patients,
      episodic memory is frequently impaired. Memory disorders could be preceded by microstructural
      abnormalities without visible atrophy in hippocampus. A recent MRI imaging of diffusion
      called NODDI (Neurite Orientation Dispersion and Density Imaging) can measure specifically
      microstructural abnormalities and map the axons in the white matter (WM) and dendrites in the
      grey matter (GM). The aim of this study is to evaluate microstructural abnormalities in the
      dentate gyrus of the hippocampus in CIS patients compared to controls.
    

Detailed description: 
      Cognitive deficiencies could occur after a first clinical event of the central nervous system
      suggestive of MS called clinically isolated syndrome (CIS). Cognitive impairment concerned
      several cognitive domains including episodic memory, attention, working memory and executive
      functions. It is recognized the negative impact of cognitive impairment on quality of life
      and vocational status in patients living with MS. Slowness of information processing speed is
      the main cognitive dysfunction observed in MS seen at the earliest stage of the disease.
      Recently an international group of MS experts has explain IPS and episodic memory as the
      minimal cognitive assessment in patients with MS. Visuospatial and verbal episodic memory
      deficits have been observed in 18 to 28% of patients assessed after a CIS.

      Memory disorders could be preceded by microstructural abnormalities without visible atrophy
      in hippocampus. A recent MRI imaging of diffusion called NODDI (Neurite Orientation
      Dispersion and Density Imaging) can measure specifically microstructural abnormalities and
      map the axons in white matter and dendrite in the gray matter. No study has used the NODDI in
      CIS patients and very few studies have been conducted in MS.

      The hypothesis is that the dentate gyrus is the anatomical substrate of early episodic memory
      dysfunction in patients included after a CIS.

      The identification of predictive MRI biomarker of memory impairment would be a useful and
      clinically relevant prognostic marker at the early stage of MS. This biomarker could
      contribute to determine the prognosis of the disease and could help for the monitoring of the
      patients in clinical practice and clinical trials.
    

Intervention name(s): Clinical assessment; Neuropsychological evaluation; Psychological evaluation; MRI Evaluation
Intervention type(s): Other; Other; Other; Device
Intervention description(s): Expanded Disability Status Scale (EDSS), ambulation test and Multiple Sclerosis functional composite (MSFC). Medications will be recorded.; cognitive tests exploring episodic memories, information processing speed, attention/concentration and working memory.; included questionnaires for depression, anxiety, fatigue, cognitive complaint and reserve; Diffusion including NODDI, 3DT1 with and without gadolinium, 3D-FLAIR before and after gadolinium infusion, 3D White Matter nulled-MPRAGE, 3D Double-Inversion recovery sequences-weighted imaging and Resting state functional MRI
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: Clinically Isolated Syndrome; NODDI; Hippocampus; episodic memory function; dentate gyrus; MRI