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Cognitive impairment and structural brain damage in benign multiple sclerosis

M Rovaris1, G Riccitelli, E Judica

  • 1Neuroimaging Research Unit, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.

Neurology
|September 26, 2008
PubMed
Abstract

Insights

Cognitive impairment in benign multiple sclerosis (BMS) is linked to significant brain damage, similar to more advanced disease stages. Preserving cognitive function is key to defining BMS accurately.

Area of Science:

  • Neuroimaging
  • Neurology
  • Neuroscience

Background:

  • Benign multiple sclerosis (BMS) typically presents with minimal locomotor disability but may involve subclinical cognitive impairment.
  • Conventional MRI often misses subtle tissue damage, necessitating advanced techniques like Diffusion Tensor (DT) MRI.

Purpose of the Study:

  • To investigate the extent of structural brain damage associated with cognitive dysfunction in BMS.
  • To contribute to a more reliable definition of the BMS disease phenotype.

Main Methods:

  • Conventional and DT MRI scans were performed on 62 BMS patients, 36 secondary progressive multiple sclerosis (SPMS) patients, and 19 healthy controls.
  • Neuropsychological tests assessed memory, attention, and frontal lobe functions in BMS patients.
  • Metrics included normalized brain volume (NBV), mean diffusivity (MD), and fractional anisotropy (FA) in normal-appearing white matter (NAWM) and gray matter (GM).

Main Results:

  • 19% of BMS patients met criteria for cognitive impairment.
  • BMS patients exhibited abnormal MD and FA values in both NAWM and GM.
  • BMS patients with cognitive impairment showed no significant difference in MRI metrics compared to SPMS patients, unlike those without cognitive impairment.

Conclusions:

  • Cognitive dysfunction in BMS correlates with severe structural brain damage, comparable to patients with more debilitating MS.
  • The preservation of cognitive function should be an essential criterion for defining BMS.

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