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Using Retinal Imaging to Study Dementia
Published on: November 6, 2017
Early imaging predicts later cognitive impairment in primary progressive multiple sclerosis
S Penny1, Z Khaleeli, L Cipolotti
1Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
Neurology
|February 17, 2010
Summary
Magnetic resonance imaging (MRI) abnormalities in early primary progressive multiple sclerosis (PPMS) can predict future cognitive impairment. Lesion volume and gray matter changes are key MRI indicators of cognitive decline in PPMS patients.
Area of Science:
- Neuroimaging
- Neurology
- Cognitive Science
Background:
- Cognitive impairment is frequent in primary progressive multiple sclerosis (PPMS).
- Current lesion burden and brain volume only modestly correlate with cognitive function.
- Predicting future cognitive decline in PPMS is crucial for patient management.
Purpose of the Study:
- To investigate the predictive ability of MRI abnormalities for future cognitive dysfunction in PPMS.
- To explore if MRI findings in normal-appearing brain tissue can predict cognitive impairment.
Main Methods:
- A longitudinal cohort/case-control study involving 31 PPMS patients and 31 controls.
- Neuropsychological assessments were performed 5.5 years after baseline.
- Baseline MRI data included lesion metrics, brain volumes, magnetization transfer ratio (MTR), and magnetic resonance spectroscopy (MRS) metabolites.
Main Results:
- Twenty-nine percent of PPMS patients developed cognitive impairment.
- T2 lesion volume best predicted overall cognitive function, verbal memory, and processing speed.
- Low gray matter MTR predicted attention and executive function deficits.
- Reduced gray and white matter volumes independently predicted executive function deficits.
Conclusions:
- Early MRI abnormalities in PPMS can predict cognitive impairment up to 5 years later.
- Focal white matter damage is a primary predictor of cognitive dysfunction.
- Gray matter pathology also contributes significantly to cognitive decline in PPMS.
