T1 cortical hypointensities and their association with cognitive disability in multiple sclerosis

2010 ◽  
Vol 16 (10) ◽  
pp. 1203-1212 ◽  
Author(s):  
Francesca Bagnato ◽  
Zeena Salman ◽  
Robert Kane ◽  
Sungyoung Auh ◽  
Fredric K Cantor ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
White Matter ◽  
Statistical Significance ◽  
Verbal Learning ◽  
Lesion Volume ◽  
Cognitive Disability ◽  
3.0 Tesla ◽  
Multiple Sclerosis Patients ◽  
The Impact

Background: Neocortical lesions (NLs) largely contribute to the pathology of multiple sclerosis (MS), although their relevance in patients’ disability remains unknown. Objective: To assess the incidence of T1 hypointense NLs by 3.0-Tesla magnetic resonance imaging (MRI) in patients with MS and examine neocortical lesion association with cognitive impairment. Methods: In this case-control study, 21 MS patients and 21 age-, sex- and years of education-matched healthy volunteers underwent: (i) a neuropsychological examination rating cognitive impairment (Minimal Assessment of Cognitive Function in MS); (ii) a 3.0-Tesla MRI inclusive of an isotropic 1.0 mm3 three-dimensional inversion prepared spoiled gradient-recalled-echo (3D-IRSPGR) image and T1- and T2-weighted images. Hypointensities on 3D-IRSPGR lying in the cortex, either entirely or partially were counted and association between NLs and cognitive impairment investigated. Results: A total of 95 NLs were observed in 14 (66.7%) patients. NL+ patients performed poorer (p = 0.020) than NLpatients only on the delayed recall component of the California Verbal Learning Test. This difference lost statistical significance when a correction for white matter lesion volume was employed. Conclusions: Although T 1 hypointense NLs may be present in a relatively high proportion of multiple sclerosis patients, the impact that they have in cognitive impairment is not independent from white matter disease.

scholarly journals The Impact of Cognitive Dysfunction on Locomotor Rehabilitation Potential in Multiple Sclerosis

2019 ◽  
Vol 11 ◽  
pp. 117957351988404
Author(s):  
Stijn Denissen ◽  
Alexander De Cock ◽  
Tom Meurrens ◽  
Luc Vleugels ◽  
Ann Van Remoortel ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Word Association ◽  
Verbal Learning ◽  
Cognitive Status ◽  
Attentional Deficits ◽  
Ambulatory Patients ◽  
The Impact ◽  
Locomotor Rehabilitation

Background: Cognitive dysfunction is a frequent manifestation of multiple sclerosis (MS) but its effect on locomotor rehabilitation is unknown. Objective: To study the impact of cognitive impairment on locomotor rehabilitation outcome in people with MS. Methods: We performed a retrospective analysis involving ambulatory patients with MS who were admitted for intensive, inpatient, multidisciplinary rehabilitation at the National Multiple Sclerosis Center of Melsbroek between the years 2012 and 2017. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) was used to determine the cognitive status of subjects as either impaired (COG–) or preserved (COG+). Locomotor outcome was compared between groups with the difference in 6-minute walk test (6MWT) measured at admission and discharge (Δ6MWT). In addition, individual test scores of the BRB-N for attention (Paced Auditory Serial Addition Test 2” and 3”), visuospatial learning/memory (7/24 Spatial Recall Test), verbal learning/memory (Selective Reminding Test) and verbal fluency (Controlled Oral Word Association Test) were correlated to the Δ6MWT. Results: A total of 318 complete and unique records were identified. Both groups showed a significant within-group Δ6MWT during hospitalization (COG+: 47.51 m; COG–: 40.97 m; P < .01). In contrast, Δ6MWT values were comparable between groups. The odds of achieving a minimal clinical important difference on the 6MWT did not differ significantly between both groups. Only attention/concentration was significantly correlated with Δ6MWT (r = 0.16, P = .013). Conclusion: Cognitive impairment based on BRB-N results appears not to impede locomotor rehabilitation in ambulatory patients with MS. Attentional deficits are correlated to the extent of locomotor rehabilitation, suggesting the presence of a subtle effect of cognition.

scholarly journals The impact of isolated lesions on white-matter fiber tracts in multiple sclerosis patients

2015 ◽  
Vol 8 ◽  
pp. 110-116 ◽  
Author(s):  
Amgad Droby ◽  
Vinzenz Fleischer ◽  
Marco Carnini ◽  
Hilga Zimmermann ◽  
Volker Siffrin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Fiber Tracts ◽  
White Matter Fiber Tracts ◽  
Multiple Sclerosis Patients ◽  
The Impact

Infratentorial lesion volume correlates with sensory functional system in multiple sclerosis patients: a 3.0-Tesla MRI study

2009 ◽  
Vol 115 (1) ◽  
pp. 115-124 ◽  
Author(s):  
C. C. Quattrocchi ◽  
A. Cherubini ◽  
G. Luccichenti ◽  
M. G. Grasso ◽  
U. Nocentini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Functional System ◽  
Lesion Volume ◽  
3.0 Tesla ◽  
Multiple Sclerosis Patients ◽  
Mri Study

Cognitive impairment at the onset of multiple sclerosis: relationship to lesion location

2011 ◽  
Vol 17 (6) ◽  
pp. 755-758 ◽  
Author(s):  
Françoise Reuter ◽  
Wafaa Zaaraoui ◽  
Lydie Crespy ◽  
Anthony Faivre ◽  
Audrey Rico ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Verbal Learning ◽  
Clinically Isolated Syndrome ◽  
Deep White Matter ◽  
Lesion Location ◽  
And Performance ◽  
The Right ◽  
The Impact ◽  
Learning Performances

The impact of lesion location on cognitive functioning was assessed in a group of 97 patients with a clinically isolated syndrome. Using the Brief Repeatable Battery, we evidenced that 24% of patients showed at least one abnormal test, 20% at least two and 15% at least three. Verbal learning performances were inversely associated with presence of lesions in Broca’s area, in the right frontal lobe and in the splenium while spatial learning performances were inversely correlated to the presence of lesions in the deep white matter. No associations were evidenced between lesion location and performance of tasks exploring attention and executive functions.

scholarly journals Assessing the Correlation between Grey and White Matter Damage with Motor and Cognitive Impairment in Multiple Sclerosis Patients

PLoS ONE ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. e63250 ◽  
Author(s):  
Emilia Sbardella ◽  
Nikolaos Petsas ◽  
Francesca Tona ◽  
Luca Prosperini ◽  
Eytan Raz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
White Matter ◽  
White Matter Damage ◽  
Multiple Sclerosis Patients

scholarly journals Quantitative MRI phenotypes capture biological heterogeneity in multiple sclerosis patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ide Smets ◽  
An Goris ◽  
Marijne Vandebergh ◽  
Jelle Demeestere ◽  
Stefan Sunaert ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Risk Score ◽  
Grey Matter ◽  
Quantitative Mri ◽  
Grey Matter Volume ◽  
Magnetization Transfer Ratio ◽  
Lesion Volume ◽  
Total Brain ◽  
Multiple Sclerosis Patients

AbstractMagnetization transfer ratio (MTR) and brain volumetric imaging are (semi-)quantitative MRI markers capturing demyelination, axonal degeneration and/or inflammation. However, factors shaping variation in these traits are largely unknown. In this study, we collected a longitudinal cohort of 33 multiple sclerosis (MS) patients and extended it cross-sectionally to 213. We measured MTR in lesions, normal-appearing white matter (NAWM), normal-appearing grey matter (NAGM) and total brain, grey matter, white matter and lesion volume. We also calculated the polygenic MS risk score. Longitudinally, inter-patient differences at inclusion and intra-patient changes during follow-up together explained > 70% of variance in MRI, with inter-patient differences at inclusion being the predominant source of variance. Cross-sectionally, we observed a moderate correlation of MTR between NAGM and NAWM and, less pronounced, with lesions. Age and gender explained about 30% of variance in total brain and grey matter volume. However, they contributed less than 10% to variance in MTR measures. There were no significant associations between MRI traits and the genetic risk score. In conclusion, (semi-)quantitative MRI traits change with ongoing disease activity but this change is modest in comparison to pre-existing inter-patient differences. These traits reflect individual variation in biological processes, which appear different from those involved in genetic MS susceptibility.

The relationship between total and regional corpus callosum atrophy, cognitive impairment and fatigue in multiple sclerosis patients

2013 ◽  
Vol 20 (3) ◽  
pp. 356-364 ◽  
Author(s):  
Özgür Yaldizli ◽  
Iris-Katharina Penner ◽  
Karl Frontzek ◽  
Yvonne Naegelin ◽  
Michael Amann ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Corpus Callosum ◽  
Disease Duration ◽  
Brain Magnetic Resonance Imaging ◽  
Lesion Volume ◽  
Poor Outcome ◽  
Edss Score ◽  
Multiple Sclerosis Patients ◽  
The Relationship

Objective: The objective of this paper is to investigate the relationship between total and regional corpus callosum (CC) atrophy, neuropsychological test performance and fatigue in multiple sclerosis (MS) patients. Methods: We conducted a cross-sectional study in 113 MS patients: mean age 48±11 years, 75/113 women, 84/113 relapsing–remitting MS, mean disease duration 21±9 years, mean Expanded Disability Status Scale (EDSS) score 3.2±1.7. All patients underwent brain magnetic resonance imaging, standardised neurological assessment and comprehensive cognitive testing including assessments for fatigue and depression. Total and regional CC atrophy was assessed using the corpus callosum index (CCI). Results: CCI correlated more strongly with T2- and T1-lesion volume and whole brain volume than with disease duration or EDSS score. CCI correlated strongly with the verbal fluency test (VFT), Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT). Multivariate regression analysis revealed that atrophy of the posterior CC segment was significantly associated with poor outcome in the PASAT, VFT and SDMT. In contrast, atrophy of the anterior CC segment was significantly associated with fatigue severity and poor outcome in the long-term memory test. Conclusions: Atrophy of the CC is associated with cognitive impairment and fatigue. Regional CCI results indicate that these associations are partially spatially segregated.

scholarly journals Lower total cerebral arterial flow contributes to cognitive performance in multiple sclerosis patients

2019 ◽  
Vol 26 (2) ◽  
pp. 201-209 ◽  
Author(s):  
Dejan Jakimovski ◽  
Ralph HB Benedict ◽  
Karen Marr ◽  
Sirin Gandhi ◽  
Niels Bergsland ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Performance ◽  
Cognitive Aging ◽  
Verbal Learning ◽  
Analysis Of Covariance ◽  
Arterial Blood Flow ◽  
Cognitively Impaired ◽  
Lesion Volume ◽  
Arterial Blood ◽  
Multiple Sclerosis Patients

Background: The cognitive performance in multiple sclerosis (MS) patients declines with aging, longer disease duration, and possibly cardiovascular comorbidities. Objectives: We investigated whether lower total cerebral arterial blood flow (CABF) measured at the level of the carotid and vertebral arteries may contribute to worse cognitive performance in 132 MS patients and 47 healthy controls. Methods: Total CABF was evaluated with extracranial Doppler, whereas structural T2-lesion volume (LV) and gray matter volume (GMV) were measured on 3T MRI. The cognitive performance was assessed by Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test—Revised (BVMT-R), and California Verbal Learning Test—Second Edition (CVLT-II). Analysis of covariance, partial correlation, and regression models were used to test the differences between study groups and cognition/CABF correlations. False discovery rate (FDR)-corrected (Benjamini–Hochberg) p-values (i.e. q-values) less than 0.05 were considered significant. Results: Association between lower total CABF and the lower cognitive performance was observed only in MS patients ( r = 0.318, q < 0.001 and r = 0.244, q = 0.012 for SDMT and BVMT-R, respectively). Lower GMV, higher T2-LV, and CABF were significantly associated with poorer performance on the processing speed measure of SDMT (adjusted R2 = 0.295, t-statistics = 2.538, standardized β = 0.203, and q = 0.020), but not with memory tests. Cognitively impaired MS patients had lower total CABF compared to cognitively preserved (884.5 vs 1020.2 mL/min, q = 0.008). Conclusion: Cognitively impaired MS patients presented with lower total CABF. Altered CABF may be a result of reduced metabolic rate and might contribute to abnormal cognitive aging in MS.

Clinical significance of atrophy and white matter mean diffusivity within the thalamus of multiple sclerosis patients

2013 ◽  
Vol 19 (11) ◽  
pp. 1478-1484 ◽  
Author(s):  
Ralph HB Benedict ◽  
Hanneke E Hulst ◽  
Niels Bergsland ◽  
Menno M Schoonheim ◽  
Michael G Dwyer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
White Matter ◽  
Cognitive Processing ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Brain Magnetic Resonance Imaging ◽  
Cognitive Tests ◽  
Explained Variance ◽  
Multiple Sclerosis Patients

Background: Gray-matter (GM) atrophy is strongly predictive of cognitive impairment in multiple sclerosis (MS) patients. The thalamus is the region where the atrophy/cognition correlation is most robust. However, few studies have assessed diffusion tensor imaging (DTI) metrics within the thalamus. Objective: This study was designed to determine if thalamus white matter DTI predicts cognitive impairment after accounting for the effects of volume loss. Methods: We enrolled 75 MS patients and 18 healthy controls undergoing 3T brain magnetic resonance imaging (MRI). Thalamus volumes were calculated on 3D T1 images. Voxelwise analyses of DTI metrics were performed within the thalamic white matter tracts. Neuropsychological (NP) testing, acquired using consensus standard methods, contributed measures of memory, cognitive processing speed and executive function. Results: All cognitive tests were significantly predicted ( R2 =0.31, p<0.001) by thalamus volume after accounting for influence of demographics. Mean diffusivity was retained in regression models predicting all cognitive tests, adding from 7–13% of additional explained variance ( p<0.02) after accounting for thalamus volume. Conclusions: We confirm the significant role of thalamus atrophy in MS-associated cognitive disorder, and further report that subtle thalamus pathology as detected by DTI adds incremental explained variance in predicting cognitive impairment.

Corpus callosum atrophy is strongly associated with cognitive impairment in multiple sclerosis: Results of a 17-year longitudinal study

2014 ◽  
Vol 21 (9) ◽  
pp. 1151-1158 ◽  
Author(s):  
Tobias Granberg ◽  
Juha Martola ◽  
Gösta Bergendal ◽  
Sara Shams ◽  
Soheil Damangir ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Corpus Callosum ◽  
Disease Duration ◽  
Control Group ◽  
Lesion Volume ◽  
Cognitive Disability ◽  
Clinical Implementation ◽  
Atrophy Rate

Background: Cognitive impairment is common in multiple sclerosis (MS) and may be subtle. The corpus callosum is essential for connectivity-demanding cognitive tasks and is significantly affected in MS, therefore it may serve as a marker for cognitive function. Objective: The objective of this paper is to longitudinally study the normalized corpus callosum area (nCCA) as a marker of cognitive function and disability in MS. Methods: Thirty-seven MS patients were followed from 1996 with follow-ups in 2004 and 2013. A healthy matched control group was recruited. The Expanded Disability Status Scale (EDSS) and Symbol Digit Modalities Test (SDMT) were assessed. The nCCA was measured on T2-weighted images. Volumetry was performed with FreeSurfer. Results: Disease duration spanned five decades (1.6–46 years). Annual corpus callosal atrophy rate decreased with disease duration. nCCA was strongly correlated with SDMT ( r = 0.793, p < 0.001) and moderately correlated with EDSS ( r = −0.545, p < 0.001) after adjusting for disease duration, age and sex. The correlations of brain parenchymal fraction, white matter fraction, gray matter fraction and normalized lesion volume were less strong. Conclusions: The nCCA correlates well with physical and cognitive disability in time perspectives close to two decades, outperforming volumetric measurements. The nCCA is fast and could be feasible for clinical implementation where it may help identify patients in need of neuropsychological evaluation.

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