Regional magnetic resonance imaging lesion burden and cognitive function in multiple sclerosis: a longitudinal study

Area of Science:

• Neuroimaging
• Neuropsychology
• Neurology

Background:

• Multiple sclerosis (MS) is a chronic neurological disease affecting cognitive function.
• Understanding the relationship between brain lesions and cognitive decline is crucial for MS management.

Purpose of the Study:

• To investigate the longitudinal relationship between magnetic resonance imaging (MRI) detected lesion burden in specific brain regions and cognitive performance in patients with MS.
• To determine if the location and volume of MS lesions correlate with impairments in attention, processing speed, and memory over a 4-year period.

Main Methods:

• Twenty-eight MS patients underwent serial MRI scans and neuropsychological testing (Brief, Repeatable Battery of Neuropsychological Tests in Multiple Sclerosis) at baseline, 1 year, and 4 years.
• Automated 3D lesion detection identified lesion volumes in specific brain regions.
• Regression analyses examined the correlation between regional lesion volumes and cognitive test scores.

Main Results:

• Frontal and parietal white matter regions showed the highest lesion burden in MS patients.
• MS patients exhibited significant impairments in sustained attention, processing speed, and verbal memory compared to controls.
• Higher lesion volumes in frontal and parietal regions were strongly and negatively correlated with performance on these cognitive tests across all time points (R = -0.55 to -0.73, P<.001).

Conclusions:

• MS lesions preferentially affect frontal and parietal white matter.
• Lesion burden in these frontoparietal regions is significantly associated with deficits in complex attention and working verbal memory.
• The consistent relationship over 4 years suggests frontoparietal network disruption underlies cognitive impairment patterns in MS.