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Updated: Mar 8, 2026
Evaluating Tests of Cognition using a Computerized Touch-Sensitive Tablet, Eye Tracking, and Functional Magnetic Resonance Imaging
Published on: January 30, 2026
Attention and processing speed performance in multiple sclerosis is mostly related to thalamic volume.
Alvino Bisecco1,2, Svetlana Stamenova1,3, Giuseppina Caiazzo2
1I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.
Gray matter atrophy in the thalamus, cerebellum, and putamen is linked to attention and processing speed deficits in multiple sclerosis (MS) patients, as measured by the Symbol Digit Modalities Test (SDMT). Thalamic atrophy specifically contributes to these cognitive impairments.
Area of Science:
- Neuroimaging
- Neurology
- Cognitive Neuroscience
Background:
- Cognitive impairment (CI), particularly in attention and processing speed (A-PS), is a common and disabling symptom in multiple sclerosis (MS).
- The Symbol Digit Modalities Test (SDMT) is a sensitive measure for A-PS deficits in MS.
- Structural magnetic resonance imaging (MRI) correlates of A-PS in MS require further clarification.
Purpose of the Study:
- To investigate the relationship between regional gray matter (GM) atrophy and SDMT performance in a large cohort of MS patients.
- To identify specific brain regions associated with A-PS deficits in MS.
Main Methods:
- 125 relapsing-remitting MS patients and 52 healthy controls (HC) underwent 3T-MRI (high-resolution 3D-T1 imaging) and neurological evaluation including SDMT.
- Voxel-Based Morphometry (VBM) was used to analyze regional GM volume differences and correlations with SDMT performance.
- Thalamic, putamen, and cerebellar volumes were quantified using the FIRST tool; linear regression assessed their contribution to A-PS.
Main Results:
- A significant negative correlation was observed between GM volume and SDMT score in the thalamus, cerebellum, putamen, and occipital cortex of MS patients.
- MS patients exhibited significant GM atrophy in the thalamus, cerebellum, and putamen compared to HC.
- Thalamic atrophy was identified as an independent and additional contributor to A-PS deficits in MS.
Conclusions:
- The thalamus plays a crucial role in attention and processing speed performance in MS, as indicated by SDMT results.
- Regional GM atrophy, particularly in the thalamus, is a significant factor underlying A-PS deficits in multiple sclerosis.
- These findings highlight the importance of assessing thalamic integrity for understanding and potentially managing cognitive dysfunction in MS.
