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Cognitive impairment in benign multiple sclerosis: a multiparametric structural and functional MRI study.

Gianna C Riccitelli1, Elisabetta Pagani1, Alessandro Meani1

  • 1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Journal of Neurology
|July 4, 2020
PubMed
Summary

Cognitive impairment in benign multiple sclerosis (MS) is linked to brain damage. Specifically, white matter damage in parietal regions significantly predicts worse cognitive function in these patients.

Keywords:
Benign MSCognitive impairmentGray matterLesionsWhite matter

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Area of Science:

  • Neuroimaging
  • Neurology
  • Cognitive Neuroscience

Background:

  • Benign multiple sclerosis (BMS) presents challenges in identifying the substrates of cognitive impairment.
  • Understanding these substrates is crucial for managing cognitive decline in BMS patients.

Purpose of the Study:

  • To investigate the association between cognitive impairment in BMS patients and specific patterns of brain structural and functional abnormalities.
  • To identify independent predictors of cognitive impairment in BMS.

Main Methods:

  • Studied 37 BMS patients (EDSS ≤ 3.0, disease duration ≥ 15 years) and 50 healthy controls (HC).
  • Assessed cognitive impairment using a cognitive impairment index (CII).
  • Analyzed gray matter (GM) volumes, white matter (WM) fractional anisotropy (FA), and resting-state (RS) functional connectivity (FC) using univariate and multivariate analyses.

Main Results:

  • BMS patients exhibited reduced WM FA, GM atrophy, and increased RS FC in fronto-temporo-parietal regions compared to HC.
  • Multivariate analysis identified T2-lesion load in the corpus callosum, reduced posterior corona radiata (PCR) FA, and caudate nucleus atrophy as independent predictors of CII.
  • Reduced PCR FA emerged as the sole significant predictor of CII (R² = 0.39, p = 0.001).

Conclusions:

  • Cognitive impairment in BMS is associated with structural brain damage in critical areas.
  • White matter damage, particularly in parietal regions (posterior corona radiata), is the primary predictor of cognitive decline in BMS patients.