Detecting cognitive dysfunction in multiple sclerosis with a magnetic resonance imaging rating scale: a pilot study.

Area of Science:

• Neurology
• Radiology
• Neuropsychology

Background:

• Cognitive impairment is a common challenge in multiple sclerosis (MS).
• Current MRI-based predictors of MS cognitive impairment often rely on complex computational analyses, limiting clinical applicability.
• There is a need for simpler, clinically viable methods to assess cognitive dysfunction in MS.

Purpose of the Study:

• To evaluate the clinical utility of the novel Cholinergic Pathways Hyperintensities Scale (CHIPS) for detecting cognitive impairment in MS patients.
• To determine if CHIPS scores correlate with cognitive test performance and lesion load.

Main Methods:

• Forty MS patients underwent brain MRI and cognitive testing using The Neuropsychological Screening Battery for MS.
• CHIPS visual rating scale assessed hyperintensities in 10 regions across four axial slices.
• Lesion volumes were quantified computationally; patients were grouped by low/high CHIPS scores.

Main Results:

• Patients with high CHIPS scores demonstrated significantly worse performance in verbal memory, visuospatial memory, and global cognitive function compared to those with low scores.
• A CHIPS score threshold of 18 achieved optimal sensitivity (82%) and specificity (83%) for detecting cognitive impairment.
• Total CHIPS score strongly correlated with total hyperintense lesion load (sigma = 0.82, P < .0001).

Conclusions:

• The CHIPS visual rating scale is a valuable tool for clinically predicting cognitive impairment in multiple sclerosis.
• CHIPS offers a practical approach to identifying MS patients at risk for cognitive dysfunction.