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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool

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Predicting cognitive decline in multiple sclerosis: a 5-year follow-up study.

Anand J C Eijlers¹, Quinten van Geest¹, Iris Dekker^2,3

¹Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.

Brain : a Journal of Neurology

|September 1, 2018

Summary

Cognitive decline in multiple sclerosis is predicted by baseline MRI measures of structural brain damage. Cortical atrophy is a key predictor, especially in later disease stages, highlighting its potential as an outcome marker.

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Published on: December 26, 2015

Area of Science:

Neurology
Radiology
Neuropsychology

Background:

Cognitive decline significantly impacts the quality of life for individuals with multiple sclerosis (MS).
Predictors of future cognitive decline in MS remain poorly understood despite known MRI correlates of current impairment.

Purpose of the Study:

To identify baseline MRI, demographic, and clinical measures that predict cognitive decline over a 5-year follow-up period in MS patients.
To investigate disease-stage specific predictors of cognitive decline in relapsing-remitting and progressive MS phenotypes.

Main Methods:

Longitudinal study of 234 MS patients and 60 controls with 5-year follow-up.
Neuropsychological evaluation at baseline and follow-up to assess cognitive decline using the reliable change index.
Baseline MRI assessment including whole-brain and regional measures (lesion volume, white matter integrity, grey matter volume).

Main Results:

28% of MS patients showed cognitive decline over 5 years, with higher rates in progressive MS.
Whole-brain MRI models identified cortical grey matter volume as a predictor.
Regional MRI models revealed anterior thalamic radiation integrity, superior longitudinal fasciculus lesions, and temporal atrophy as significant predictors.
Early relapsing-remitting MS decline was linked to white matter integrity loss; late relapsing-remitting and progressive MS decline were linked to cortical atrophy.

Conclusions:

Greater baseline structural brain damage, particularly cortical atrophy, predicts future cognitive decline in MS.
Cortical atrophy is a key predictor in later disease stages and may serve as a valuable outcome marker in clinical trials and patient management.