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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Quality and quantity of diffuse and focal white matter disease and cognitive disability of patients with multiple
Giuseppe Bomboi1, Vasiliki N Ikonomidou, Stefano Pellegrini
1Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD 20892-1400, USA.
Background And Purpose:
Using high-field magnetic resonance imaging (MRI), we investigated the relationships between white matter (WM) lesion volume (LV), normal-appearing WM (NAWM) normalized volume, WM-lesion and NAWM magnetization transfer ratios (MTRs), brain parenchyma fraction (BPF), and cognitive impairment (CI) in multiple sclerosis (MS).
Methods:
Twenty-four patients and 24 healthy volunteers (age, sex, and years of education-matched) underwent a 3.0 Tesla (3T) scan and evaluation of depression, fatigue, and CI using the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery.
Results:
In this clinically relatively well-preserved cohort of patients (median score on the Expanded Disability Status Scale=1.5), CI was detected on Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II), and Controlled Oral Word Association Test. MT data were available in 19 pairs on whom correlation analyses were performed. Associations were seen between SDMT and normalized NAWM volume (P=.034, r=.502), CVLT-II long delay and normalized NAWM volume (P=.012, r=.563), WM-LV (P=.024, r=.514), and BPF (P=.002, r=.666).
Conclusions:
The use of 3T MRI in a sample of clinically stable MS patients shows the importance of WM disease in hampering processing speed and word retrieval.
Insights
High-field MRI reveals that white matter disease in multiple sclerosis (MS) patients significantly impacts cognitive function, specifically processing speed and word retrieval. These findings highlight the importance of assessing white matter integrity for understanding cognitive impairment in MS.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple Sclerosis (MS) is a chronic neurological disease characterized by white matter (WM) lesions.
- Cognitive impairment (CI) is a common and often debilitating symptom in MS patients.
- Understanding the relationship between WM pathology and CI is crucial for patient management.
Purpose of the Study:
- To investigate the associations between various MRI-derived metrics of WM integrity and cognitive function in MS patients.
- To explore the relationship between white matter lesion volume (LV), normal-appearing white matter (NAWM) normalized volume, magnetization transfer ratios (MTRs), and brain parenchyma fraction (BPF) with cognitive impairment.
Main Methods:
- High-field (3.0 Tesla) MRI scans were performed on 24 MS patients and 24 healthy controls.
- Cognitive function was assessed using the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery.
- Correlation analyses were conducted to examine relationships between MRI metrics and cognitive test scores.
Main Results:
- Cognitive impairment was detected in MS patients on tests of processing speed (Symbol Digit Modalities Test - SDMT) and verbal learning (California Verbal Learning Test-II - CVLT-II).
- Normalized NAWM volume was significantly associated with SDMT and CVLT-II performance.
- White matter lesion volume (WM-LV) and brain parenchyma fraction (BPF) also showed significant correlations with cognitive function.
Conclusions:
- High-field MRI is valuable for detecting subtle WM changes associated with cognitive impairment in clinically stable MS.
- WM disease burden, including lesion volume and NAWM integrity, plays a significant role in cognitive deficits like impaired processing speed and word retrieval in MS.
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