Cortical pathology in multiple sclerosis patients with epilepsy: a 3 year longitudinal study
M Calabrese1, P Grossi, A Favaretto
1Multiple Sclerosis Centre, First Neurology Clinic, University of Padova, Via Giustiniani 5, Padova 35128, Italy. calabresem@hotmail.it
Journal of Neurology, Neurosurgery, and Psychiatry
|September 6, 2011
Summary
Epilepsy in multiple sclerosis (MS) is linked to more severe cortical pathology, including lesions and atrophy. Patients with MS and epilepsy experienced faster cognitive decline and disability progression over three years.
Area of Science:
- Neurology
- Neuroscience
- Radiology
Background:
- The etiology of epilepsy in multiple sclerosis (MS) remains unclear.
- Cortical pathology, specifically cortical lesions (CLs) and cortical thickness (CTh), is increasingly recognized as a significant factor in MS progression.
Purpose of the Study:
- To evaluate the longitudinal relevance of cortical pathology in MS patients with and without epilepsy.
- To compare the progression of cortical lesions, grey matter atrophy, and cognitive decline between relapsing-remitting MS patients with epilepsy (RRMS/E) and those without (RRMS).
Main Methods:
- A 3-year longitudinal study included 32 RRMS/E patients and 60 matched RRMS patients.
- Clinical parameters (EDSS, cognitive score) and MRI parameters (CL number/volume, GMf, CTh, T2WMLV, new CLs, new WM lesions) were analyzed.
Main Results:
- At baseline, RRMS/E patients exhibited a higher prevalence and volume of CLs, lower global CTh, and poorer cognitive scores compared to RRMS patients.
- Over 3 years, RRMS/E patients showed a greater accumulation of new CLs and a faster reduction in grey matter fraction (GMf).
- No significant differences were observed in T2 white matter lesion volume (T2WMLV) or new Gad+ lesions between groups.
Conclusions:
- Relapsing-remitting MS patients with epilepsy demonstrate more severe and rapidly evolving cortical pathology, including CLs and atrophy, compared to those without epilepsy.
- The RRMS/E group experienced more pronounced cognitive decline and disability progression (higher EDSS).
- A higher prevalence of men was noted in the RRMS/E group.
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