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Isolated cognitive impairment in people with multiple sclerosis: frequency, MRI patterns and its development over
Piet M Bouman1,2, Maureen A van Dam3,4,5, Laura E Jonkman4,6
1Department of Anatomy and Neurosciences, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC VUmc, De Boelelaan 1117, Amsterdam, The Netherlands. p.bouman@amsterdamumc.nl.
Journal of Neurology
|January 29, 2024
Summary
Isolated cognitive impairment is common in people with multiple sclerosis (PwMS) and can predict future decline, especially in processing speed. Early detection and intervention are key to managing cognitive changes in MS.
Area of Science:
- Neuroscience
- Neurology
- Radiology
Background:
- Cognitive impairments are prevalent in people with multiple sclerosis (PwMS).
- Understanding the frequency, MRI correlates, and longitudinal development of isolated cognitive impairments is crucial for effective management.
Purpose of the Study:
- To determine the frequency of isolated cognitive impairments in PwMS.
- To identify specific MRI correlates associated with single-domain cognitive deficits.
- To examine the longitudinal progression of isolated cognitive impairments over five years.
Main Methods:
- 348 PwMS underwent neuropsychological testing at baseline and five-year follow-up.
- Isolated cognitive impairment was defined as a Z-score of at least 1.5 SD below normative data in a single cognitive domain.
- Structural MRI was used to explore correlations with cognitive function.
Main Results:
- At baseline, 31% of PwMS had isolated cognitive impairment, with executive functioning/working memory being the most affected domain.
- Isolated impairment in information processing speed (IPS) was associated with cortical volume and fractional anisotropy.
- Memory impairment correlated with cortical and hippocampal volume.
- Cognitive decline was observed in 69% of PwMS with isolated IPS impairment at baseline after five years.
Conclusions:
- Isolated cognitive impairment is frequent in PwMS and can indicate future cognitive decline, particularly when affecting processing speed.
- Cortical and deep grey matter atrophy are significant factors in isolated cognitive impairment.
- Early detection and tailored interventions, especially for processing speed deficits, may help mitigate further cognitive decline in PwMS.
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