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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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Longitudinal fibre-specific white matter damage predicts cognitive decline in multiple sclerosis
Ismail Koubiyr1, Eva A Krijnen1,2, Anand J C Eijlers1
1MS Center Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam 1081 HV, The Netherlands.
Brain Communications
|February 12, 2024
Summary
This study reveals that white matter damage, both microstructural and macrostructural, significantly impacts cognitive function in multiple sclerosis (MS). Fixel-based analysis effectively predicts cognitive decline, highlighting its importance in understanding MS progression.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Cognitive deficits in multiple sclerosis (MS) are complex and not solely explained by lesion load.
- Understanding white matter's macro- and microstructural integrity is crucial for explaining cognitive impairment in MS.
- Novel analytical approaches are needed to investigate detailed white matter degeneration patterns in MS.
Purpose of the Study:
- To investigate specific patterns of white matter degeneration in MS using a fixel-based approach.
- To analyze the temporal evolution and disease stage-specific manifestation of white matter damage.
- To determine the role of white matter degeneration in cognitive impairment across different MS phenotypes.
Main Methods:
- Collected MRI scans (30-direction diffusion-weighted images) and neuropsychological test scores from 327 MS patients and 95 healthy controls.
- Classified patients into cognitively preserved, mildly impaired, or impaired groups based on Brief Repeatable Battery of Neuropsychological Tests (BRB-N) scores.
- Utilized fixel-based analysis to quantify microstructural (fibre density) and macrostructural (fibre cross-section) damage in white matter tracts.
Main Results:
- All fixel-based measures were significantly worse in MS patients compared to controls at baseline.
- Progressive MS phenotypes showed more severe white matter damage than relapsing-remitting MS.
- Cognitively impaired MS patients exhibited the most severe white matter degeneration, with distinct patterns of microstructural and macrostructural damage.
Conclusions:
- Fixel-based analysis is sensitive to white matter degeneration patterns in MS and can predict cognitive impairment.
- Longitudinal white matter deterioration is most pronounced in progressive MS, emphasizing its importance in this phenotype.
- Understanding detailed white matter changes offers valuable insights into cognitive decline in multiple sclerosis.
