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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
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DT MRI microstructural cortical lesion damage does not explain cognitive impairment in MS
Paolo Preziosa1, Elisabetta Pagani2, Maria E Morelli2
1Neuroimaging Research Unit, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy/Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|January 19, 2017
Summary
Diffuse gray matter and normal-appearing white matter damage, not cortical lesions, predict cognitive impairment in multiple sclerosis (MS) patients. This finding aids understanding of MS-related cognitive dysfunction.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Cognitive dysfunction is a common and disabling symptom in MS patients.
- The microstructural basis of cognitive impairment in MS remains incompletely understood.
Purpose of the Study:
- To investigate the contribution of cortical lesion (CL) microstructural abnormalities to cognitive dysfunction in relapse-onset MS.
- To combine double inversion recovery (DIR) and diffusion tensor (DT) magnetic resonance imaging (MRI) for quantitative assessment.
- To identify predictors of cognitive impairment in a large cohort of MS patients.
Main Methods:
- Acquired DIR, DT, dual-echo, and 3D T1-weighted MRI scans from 149 MS patients and 40 controls.
- Assessed diffusivity values in CLs, cortex, white matter (WM) lesions, and normal-appearing (NA) WM.
- Utilized random forest analysis to identify predictors of cognitive impairment (defined as >=2 abnormal neuropsychological tests).
Main Results:
- MS patients exhibited lower normalized brain volume (NBV), gray matter volume (GMV), and WM volume compared to controls.
- Cognitively impaired (CI) MS patients showed higher T2 WM lesion volume (LV), lower NBV and GMV, and more severe diffusivity abnormalities.
- Cortical lesion measures did not differ between cognitively impaired and preserved patients; cortex FA, age, disease duration, T2 WM LV, and GMV predicted cognitive impairment.
Conclusions:
- Diffuse gray matter and normal-appearing white matter damage, alongside white matter lesions, are key contributors to cognitive impairment in MS.
- Intrinsic cortical lesion microstructural damage is not a primary driver of cognitive dysfunction in this MS cohort.
- These findings highlight the widespread nature of MS pathology impacting cognition.
