Causes, effects and connectivity changes in MS-related cognitive decline

Area of Science:

• Neuroscience
• Radiology
• Neurology

Background:

• Cognitive decline is a common yet underestimated symptom of multiple sclerosis (MS).
• The primary drivers of cognitive dysfunction in MS are not fully understood, though grey matter damage is strongly implicated.
• MS pathology involves interdependent factors causing brain atrophy and damage, impacting functional connectivity.

Purpose of the Study:

• To review the associations between magnetic resonance imaging (MRI) metrics and cognitive performance in MS.
• To explore how multiple facets of MS pathology interact to determine brain damage and affect network efficiency.
• To enhance understanding of disconnection syndromes and cognitive decline in MS through a comprehensive MRI approach.

Main Methods:

• Review of multi-parametric MRI studies in multiple sclerosis.
• Analysis of associations between structural MRI metrics and cognitive performance.
• Discussion of functional MRI findings related to brain connectivity changes in MS.

Main Results:

• Grey matter damage is a key determinant of cognitive impairment in MS.
• MS pathology factors are interconnected, leading to grey matter atrophy and brain damage.
• Functional MRI reveals a balance between disconnection and adaptive connectivity changes in MS patients.

Conclusions:

• A comprehensive MRI approach is necessary to link structural brain changes with functional organization in MS.
• Understanding the complex interactions of MS pathology is vital for addressing cognitive decline.
• Further research is warranted to elucidate the mechanisms of disconnection syndromes and cognitive dysfunction in MS.