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Changes in the normal appearing brain tissue and cognitive impairment in multiple sclerosis
M Filippi1, C Tortorella, M Rovaris
1Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute Ospedale San Raffaele, Milan, Italy. m.filippi@hsr.it
Journal of Neurology, Neurosurgery, and Psychiatry
|January 25, 2000
Summary
Magnetisation transfer (MT) histogram analysis reveals that changes in normal appearing brain tissue (NABT) significantly correlate with cognitive impairment in multiple sclerosis (MS) patients, independent of visible lesions.
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Cognitive dysfunction is a common and debilitating symptom in MS patients.
- Conventional MRI may not fully capture the extent of brain abnormalities contributing to cognitive decline.
Purpose of the Study:
- To investigate the correlation between changes in normal appearing brain tissue (NABT), assessed via magnetisation transfer (MT) histogram analysis, and cognitive dysfunction in MS.
- To determine the relative contribution of NABT changes compared to MS lesions in causing cognitive impairment.
Main Methods:
- Acquisition of dual echo, T1-weighted, and MT brain scans in MS patients with and without cognitive impairment.
- Assessment of lesion loads using T2 and T1 weighted scans.
- Generation of MT histograms of NABT by excluding lesion areas from MTR maps.
Main Results:
- Cognitively impaired MS patients exhibited higher T2/T1 lesion loads and lower average lesion MTR and brain size.
- Patients with cognitive deficits showed significantly lower average MTR and altered peak location in NABT histograms.
- Average NABT-MTR alone explained 68% of the variance in cognitive impairment, and was the sole significant predictor in multivariable analysis.
Conclusions:
- Abnormalities in normal appearing brain tissue, not always detected by conventional MRI, are crucial in determining cognitive impairment in MS.
- Magnetisation transfer (MT) histogram analysis of NABT offers valuable insights into the pathophysiology of cognitive dysfunction in multiple sclerosis.