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MR lesion load and cognitive function in patients with relapsing-remitting multiple sclerosis
J C Fulton1, R I Grossman, J Udupa
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA.
Background And Purpose:
Multiple sclerosis (MS) is a demyelinating disease most often associated with progressive physical impairment; however, its effects are noted to extend beyond physical disability. Our purpose was to determine the relationship between T2 lesion volume and neurocognitive and physical disability in relapsing-remitting multiple sclerosis.
Methods:
We studied a cohort of 19 patients with relapsing-remitting MS. Of this group, there were 15 women and four men from varying socioeconomic backgrounds. This volunteer sample was selected from a larger group of 53 patients with MS in our longitudinal MS study because they had been untreated with any beta-interferon medications, had been followed for at least 12 months, and had a clinical status of relapsing-remitting MS.
Results:
Of 12 neurocognitive parameters tested, two correlated significantly with lesion loads. The correlation of the Symbol-Digit Modalities test, which analyzes information-processing speed, was significant (P = .0204). The correlation of the fifth trial of the Rey Auditory Verbal Learning test, which tests verbal long-term memory, was also significant (P = .0348). None of the other 10 neurocognitive examinations, however, showed a significant correlation with total lesion volume (Paced Auditory Serial Addition test-1.6, P = .7381; Paced Auditory Serial Addition test-2.0, P = .4180; Controlled Oral Word Association test, P = .8906; Category Fluency test, P = .4423; Bells test, P = .9097; Rey Auditory Verbal Learning test-delay, P = .9843, Rey Auditory Verbal Learning test-recognition, P = .7467; Word Span test, P = .4939; Road Map test, P = 0.4939). The lesion load also did not correlate with the physical disability scales as rated according to the Expanded Disability Status Scale (P = .68) or Ambulation Index (P = .95).
Conclusion:
Our results indicate that T2 lesion volume does not seem to be a robust surrogate marker of neuropsychological impairment in patients with MS. We think that global measurements of parameters that are more specific to the disease process may offer more precise correlation with cognitive dysfunction and other disability parameters.
Insights
T2 lesion volume in multiple sclerosis (MS) did not correlate with cognitive or physical disability. More specific disease markers may better predict MS-related impairments.
Area of Science:
- Neurology
- Neuroscience
- Medical Imaging
Background:
- Multiple sclerosis (MS) is a demyelinating disease impacting physical function.
- MS effects extend beyond physical disability, affecting cognitive and other functions.
- Understanding the relationship between disease markers and disability is crucial for patient management.
Purpose of the Study:
- To investigate the correlation between T2 lesion volume and neurocognitive and physical disability.
- To determine if T2 lesion volume can serve as a surrogate marker for disability in relapsing-remitting MS.
Main Methods:
- A cohort of 19 patients with relapsing-remitting MS, untreated with beta-interferon, was studied.
- Neurocognitive function was assessed using 12 different parameters.
- Physical disability was measured using the Expanded Disability Status Scale and Ambulation Index.
Main Results:
- T2 lesion volume showed a significant correlation with information-processing speed (Symbol-Digit Modalities test) and verbal long-term memory (Rey Auditory Verbal Learning test).
- However, T2 lesion volume did not significantly correlate with other tested neurocognitive parameters.
- No significant correlation was found between T2 lesion volume and physical disability scores (EDSS, Ambulation Index).
Conclusions:
- T2 lesion volume is not a reliable surrogate marker for neuropsychological impairment in MS patients.
- Global measurements of disease-specific parameters may provide more accurate correlations with cognitive dysfunction and other disabilities in MS.