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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Normal-appearing white matter permeability distinguishes poor cognitive performance in processing speed and working

A Eilaghi1, A Kassner, I Sitartchouk

  • 1Department of Medical Imaging.

AJNR. American Journal of Neuroradiology
|June 1, 2013
PubMed
Abstract

Insights

Cognitively impaired patients with secondary-progressive MS show reduced normal-appearing white matter relative recirculation. This finding suggests more advanced disease and impacts processing speed and working memory.

Area of Science:

  • Neuroimaging
  • Neurology
  • Multiple Sclerosis Research

Background:

  • Secondary-progressive MS (SPMS) involves decreased inflammation but increased axonal degeneration and cognitive decline.
  • Blood-brain barrier (BBB) integrity is crucial in MS progression.
  • Relative recirculation from dynamic susceptibility contrast (DSC) MRI is a measure of BBB integrity.

Purpose of the Study:

  • To investigate if normal-appearing white matter (NAWM) relative recirculation is reduced in cognitively impaired SPMS patients compared to non-impaired patients.
  • To explore the association between NAWM relative recirculation and cognitive function in SPMS.

Main Methods:

  • Cognitive performance was assessed using the Minimal Assessment of Cognitive Function In MS (MACFIMS) test.
  • Demographic data, brain parenchymal fraction, and WM lesion fraction were compared between cognitively impaired and non-impaired groups.
  • Univariate and multivariate logistic regressions analyzed the association between cognitive test results and NAWM relative recirculation.

Main Results:

  • 36 SPMS patients (mean age 55.9 years) were studied.
  • NAWM relative recirculation was significantly lower in cognitively impaired patients for the Symbol Digit Modalities Test, Controlled Word Association Test, and Paced Auditory Serial Addition Test.
  • Reduced NAWM relative recirculation persisted for processing speed and working memory tests after adjusting for confounders.

Conclusions:

  • Cognitively impaired SPMS patients exhibit significantly reduced NAWM relative recirculation.
  • This reduction is localized to deficits in processing speed and working memory.
  • NAWM relative recirculation may serve as a biomarker for cognitive impairment in SPMS.

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