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Diffusion-weighted imaging predicts cognitive impairment in multiple sclerosis.

Ralph H B Benedict1, Jared Bruce, Michael G Dwyer

  • 1Department of Neurology, State University of New York (SUNY) at Buffalo, School of Medicine, Buffalo, NY 14203, USA. benedict@buffalo.edu

Multiple Sclerosis (Houndmills, Basingstoke, England)
|July 7, 2007
PubMed
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Diffusion-weighted imaging (DWI) shows significant correlations with cognitive dysfunction in multiple sclerosis (MS) patients. DWI measures, particularly entropy, offer a simpler, faster alternative for assessing cognitive impairment in MS.

Area of Science:

  • Neuroimaging
  • Neurology
  • Cognitive Science

Background:

  • Multiple Sclerosis (MS) is a demyelinating disease affecting the central nervous system.
  • Cognitive dysfunction is a common and debilitating symptom in MS patients.
  • Traditional MRI measures of brain atrophy and lesion load have limitations in fully capturing cognitive impairment.

Purpose of the Study:

  • To investigate the correlation between diffusion-weighted imaging (DWI) and cognitive dysfunction in MS patients.
  • To compare the predictive value of DWI measures against traditional MRI metrics for cognitive performance.
  • To assess the clinical validity and logistic advantages of DWI in MS.

Main Methods:

  • Sixty MS patients underwent 1.5-T MRI, including DWI and T1-weighted imaging.

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  • Automated methods were used for brain parenchyma segmentation and volume calculations (whole brain, gray matter).
  • DWI indices (peak position, peak height, mean parenchymal diffusivity (MPD), entropy) and neuropsychological tests were analyzed.

    • Main Results:

    • Significant correlations were found between all DWI indices and cognitive performance across all domains.
    • MPD and entropy showed stronger correlations with cognitive function than other DWI measures.
    • DWI entropy demonstrated the strongest association with processing speed and working memory (Symbol Digit Modalities Test, r = -0.54).
    • DWI, gray matter fraction, and whole brain fraction atrophy, along with lesion volumes, accounted for similar variance in cognitive testing.
    • Gray matter fraction and DWI entropy uniquely predicted variance in processing speed.

    Conclusions:

    • DWI is a clinically valid tool for assessing cognitive dysfunction in MS.
    • DWI measures, especially entropy, offer logistic advantages due to short acquisition times and automated processing.
    • DWI may serve as a valuable, efficient tool for predicting neuropsychological impairment in MS patients.