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Updated: Jun 3, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
MRI predictors of cognitive outcome in early multiple sclerosis
M S A Deloire1, A Ruet, D Hamel
1INSERM U 1049, University Victor Segalen, case 78, 146 rue Léo Saignat, 33076 Bordeaux cedex, France.
Objective:
To determine MRI predictors for cognitive outcome in patients with early relapsing-remitting multiple sclerosis (MS).
Methods:
Forty-four patients recently diagnosed with clinically definite MS were followed up with clinical and cognitive evaluations at 1, 2, 5, and 7 years and underwent brain MRI including magnetization transfer (MT) imaging at baseline and 2 years. Cognitive evaluation was also performed in 56 matched healthy subjects at baseline. Cognitive testing included the Brief Repeatable Battery. Imaging parameters included lesion load, brain parenchymal fraction (BPF), ventricular fraction (VF), and mean MT ratio (MTR) of lesion and normal-appearing brain tissue (NABT) masks.
Results:
At baseline, patients presented deficits of memory, attention, and information processing speed (IPS). Over 2 years, all magnetic resonance parameters deteriorated significantly. Over 7 years, Expanded Disability Status Scale score deteriorated significantly. Fifty percent of patients deteriorated on memory cognitive domain and 22.7%of patients on IPS domain. Seven-year change of memory scores was significantly associated with baseline diffuse brain damage (NABT MTR). IPS z score change over 7 years was correlated with baseline global atrophy (BPF), baseline diffuse brain damage, and central brain atrophy (VF) change over 2 years.
Conclusion:
The main predictors of cognitive changes over 7 years are baseline diffuse brain damage and progressive central brain atrophy over the 2 years after MS diagnosis.
Insights
Early multiple sclerosis (MS) patients show cognitive decline. Baseline diffuse brain damage and progressive central brain atrophy over two years predict long-term memory and information processing speed changes.
Area of Science:
- Neuroimaging
- Neurology
- Cognitive Science
Background:
- Relapsing-remitting multiple sclerosis (MS) is characterized by neurological deficits and cognitive impairment.
- Early detection of predictors for cognitive decline in MS is crucial for timely intervention.
- Magnetic Resonance Imaging (MRI) offers insights into brain changes associated with MS progression.
Purpose of the Study:
- To identify MRI-based predictors of cognitive outcomes in patients diagnosed with early relapsing-remitting MS.
- To assess the relationship between baseline and evolving MRI parameters and cognitive function over seven years.
Main Methods:
- A cohort of 44 early MS patients underwent clinical, cognitive, and brain MRI assessments (including magnetization transfer imaging) at baseline, 2, 5, and 7 years.
- MRI parameters analyzed included lesion load, brain parenchymal fraction (BPF), ventricular fraction (VF), and mean magnetization transfer ratio (MTR) in normal-appearing brain tissue (NABT).
- Cognitive testing utilized the Brief Repeatable Battery, with comparisons to 56 healthy controls at baseline.
Main Results:
- MS patients exhibited baseline deficits in memory, attention, and information processing speed (IPS).
- Significant deterioration in MRI parameters was observed over two years, alongside worsening Expanded Disability Status Scale scores over seven years.
- Memory decline over seven years correlated with baseline NABT MTR (diffuse brain damage); IPS decline correlated with baseline BPF (global atrophy), baseline diffuse brain damage, and 2-year VF change (central atrophy).
Conclusions:
- Baseline diffuse brain damage, quantified by NABT MTR, is a key predictor of memory decline in early MS.
- Progressive central brain atrophy, indicated by VF changes over two years, also predicts long-term cognitive impairment.
- These MRI markers provide valuable prognostic information for cognitive outcomes in early MS.
