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Accumulation of cortical lesions in MS: relation with cognitive impairment

S D Roosendaal1, B Moraal, P J W Pouwels

  • 1Department of Radiology, MS Center Amsterdam, VU University Medical Center, The Netherlands. s.roosendaal@vumc.nl

Multiple Sclerosis (Houndmills, Basingstoke, England)
|May 14, 2009
PubMed
Abstract

Insights

Gray matter lesions in multiple sclerosis (MS) significantly increase over three years, particularly cortical lesions. These lesions are linked to cognitive decline and are more prevalent in secondary progressive MS patients.

Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Research

Background:

  • Gray matter (GM) lesions are common in multiple sclerosis (MS).
  • Advanced MRI techniques like double inversion recovery (DIR) improve GM lesion detection.
  • Longitudinal changes in GM lesions remain poorly understood.

Purpose of the Study:

  • To investigate the progression of GM lesions over time in MS patients.
  • To examine the relationship between GM lesion changes and cognitive impairment in MS.

Main Methods:

  • DIR MRI scans were obtained from 13 MS patients and 7 healthy controls at baseline and after a 3-year interval.
  • Cognitive testing was performed at the follow-up visit.
  • Lesions were categorized as white matter (WM), cortical, or hippocampal.

Main Results:

  • Cortical lesion count increased significantly from 18 to 26 (P=0.01) and WM lesion count from 56 to 65 (P=0.02) over 3 years.
  • Hippocampal lesions showed no significant change over time.
  • Higher cortical lesion burden was observed in secondary progressive (SP) MS compared to relapsing-remitting MS.
  • Cortical and WM lesion volumes correlated with impaired visuospatial memory and processing speed.
  • Hippocampal lesion volume was associated with visuospatial memory deficits.

Conclusions:

  • Cortical lesions in MS demonstrate significant progression over a 3-year period.
  • Cortical lesion accumulation is more pronounced in SP MS patients.
  • The presence and progression of cortical lesions are associated with cognitive impairment in MS.

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