Related Experiment Video

Updated: May 13, 2026

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
09:41

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis

Published on: July 19, 2019

Cognitive impairment in MS: impact of white matter integrity, gray matter volume, and lesions

Hanneke E Hulst1, Martijn D Steenwijk, Adriaan Versteeg

  • 1Department of Radiology, VU University Medical Center, Amsterdam, the Netherlands. he.hulst@vumc.nl

Neurology
|March 8, 2013
PubMed
Abstract

Insights

Diffusion tensor imaging (DTI) metrics reveal significant white matter (WM) damage in cognitively impaired (CI) multiple sclerosis (MS) patients compared to cognitively preserved (CP) individuals. These WM integrity changes correlate with cognitive deficits, suggesting DTI

Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Multiple sclerosis (MS) is a demyelinating disease affecting white matter (WM).
  • Cognitive impairment is a common but heterogeneous symptom in MS.
  • Distinguishing between cognitively preserved (CP) and cognitively impaired (CI) MS patients is crucial for management.

Purpose of the Study:

  • To determine if white matter (WM) damage, assessed by diffusion tensor imaging (DTI), can differentiate CP from CI MS patients.
  • To investigate the relationship between WM integrity and cognitive status in MS.

Main Methods:

  • Acquired conventional MRI and DTI data from 55 MS patients (35 CP, 20 CI) and 30 healthy controls (HC).
  • Performed voxelwise analyses on WM skeleton metrics: fractional anisotropy (FA), mean diffusivity, radial diffusivity, and axial diffusivity.
  • Quantified regional gray matter volume and generated lesion probability maps.

Main Results:

  • Decreased FA was observed in 49% of WM in CP patients and 76% in CI patients compared to HCs.
  • CI patients exhibited significantly greater FA reduction in key cognitive-related WM tracts (e.g., corpus callosum, corticospinal tracts).
  • WM integrity damage was more widespread in CI patients, affecting additional areas like the thalamus and brainstem, independent of lesion load or gray matter volume.

Conclusions:

  • Diffusion tensor imaging (DTI) metrics effectively distinguish between cognitively impaired and preserved MS patients.
  • WM integrity alterations in specific cognitive-relevant pathways are associated with cognitive deficits in CI MS patients.
  • DTI shows promise as a sensitive tool for monitoring cognitive impairment progression in multiple sclerosis.

More Related Videos

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping10:25

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping

Published on: September 25, 2019

Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
Dementia l: Introduction01:22

Dementia l: Introduction

Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...
Language and Cognition01:27

Language and Cognition

Language serves as a bridge between ideas and communication, influencing how individuals perceive and interact with the world. Psychologists have long debated whether language shapes thought or vice versa. This discussion gained grip with Edward Sapir and Benjamin Lee Whorf in the 1940s, who proposed that language determines thought, a concept known as linguistic determinism. They suggested that the vocabulary and structure of a language influence how its speakers think and perceive reality.
Dementia01:30

Dementia

Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual.
Alzheimer's Disease: Overview01:26

Alzheimer's Disease: Overview

Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ and tau...
Alzheimer Disease ll: Pathophysiology01:23

Alzheimer Disease ll: Pathophysiology

Alzheimer disease involves structural changes in the brain that begin long before symptoms appear. The most distinctive features are extracellular neuritic plaques and intracellular neurofibrillary tangles.Neuritic plaques form in the cerebral cortex and around blood vessels. These plaques contain a dense core of beta-amyloid (Aβ)—a toxic protein fragment that clumps outside neurons. The core is surrounded by damaged neuronal extensions, as well as reactive astrocytes and microglia. Abnormal...