Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients

Christodoulou, Christopher; Krupp, Lauren; Zhang, Liang; Huang, Wei; Melville, Patricia; Roque, Cassiano Garcia; Scherl, W. F.; Morgan, Tina; MacAllister, William S.; Li, L.; Tudorica, Luminita A.; Li, X.; Roche, Patricia; Peyster, Robert G.

doi:10.1212/01.wnl.0000072264.75989.b8

Cited by 185 publications

(154 citation statements)

References 37 publications

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“…39 The PASAT also measures information-processing speed and working memory; however, compared with SDMT, lower accuracy and sensitivity have been found in predicting cognitive deficits in MS, 39 and weaker correlations with MR imaging metrics have been previously reported. [40][41][42] Our findings suggesting the importance of cortical lesions with regard to CVLT-II are in line with previous studies showing associations between gray matter atrophy and verbal learning. 43,44 The absence of a significant correlation between cortical lesions and other cognitive tests (BVMT-R, COWAT, JLO, and D-KEFS) may be related to their lower sensitivity in showing associations with distributed multiple lesions [39][40][41]45 ; however, regional cortical lesions were not assessed in our study.…”

Section: Discussionsupporting

confidence: 90%

“…[40][41][42] Our findings suggesting the importance of cortical lesions with regard to CVLT-II are in line with previous studies showing associations between gray matter atrophy and verbal learning. 43,44 The absence of a significant correlation between cortical lesions and other cognitive tests (BVMT-R, COWAT, JLO, and D-KEFS) may be related to their lower sensitivity in showing associations with distributed multiple lesions [39][40][41]45 ; however, regional cortical lesions were not assessed in our study. Other factors may have contributed to our failure to find significant correlations across the spectrum of cognitive domains commonly affected in MS: The small sample size and the high proportion of patients with RRMS compared with SPMS may have limited the severity of the deficits observed.…”

Section: Discussionsupporting

confidence: 90%

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Identification and Clinical Impact of Multiple Sclerosis Cortical Lesions as Assessed by Routine 3T MR Imaging

Mike¹,

Glanz²,

Hildenbrand³

et al. 2011

AJNR Am J Neuroradiol

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Identification and Clinical Impact of Multiple Sclerosis Cortical Lesions as Assessed by Routine 3T MR Imaging

Mike¹,

Glanz²,

Hildenbrand³

et al. 2011

AJNR Am J Neuroradiol

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“…Other cognitive impairments have been described, involving such domains as spatial processing (Vleugels et al 2000), verbal fluency (Beatty 2002), and higher executive function (Arnett et al 1997;Beatty et al 1995;Beatty and Monson 1996;Foong et al 1997). Neuropsychological defects are associated with progressive more than relapsing disease course (Beatty et al 1988) and MRI evidence of lesion burden and brain atrophy (Amato et al 2004;Benedict et al 2002aBenedict et al , 2004aChristodoulou et al 2003;Rao et al 1989a). Abnormal neuropsychological testing also predicts failures in activities of daily living such as automobile driving (Schultheis et al 2001(Schultheis et al , 2002, employment Rao et al 1991b), success in rehabilitation (Langdon and Thompson 1999), and social skills (Arnett et al 1994;Benedict et al 2001;Knight et al 1997).…”

Section: Comparison With Msmentioning

confidence: 99%

Neuropsychological Impairment in Systemic Lupus Erythematosus: A Comparison with Multiple Sclerosis

et al. 2008

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In this manuscript, we review literature describing the neuropsychological and brain imaging characteristics of systemic lupus erythematosus (SLE) patients. The findings are compared and contrasted with multiple sclerosis (MS) studies, revealing similarities and differences of interest to clinicians and researchers. While cognitive impairment is somewhat less common in SLE than MS, the diseases share a similar cognitive profile with deficits most prominent on tests emphasizing the speed of information processing, working memory, and visual/spatial learning, and memory. In early or more mildly affected patients, diffuse white matter damage, which may not be apparent on conventional brain imaging, plays a major role in clinical presentation and cognitive testing. The causes of white matter damage are very different, however, and in later stages of the disease MS and SLE appear to give rise to different forms of cerebral pathology. MS may be characterized by increasing brain atrophy affecting especially the cortical and deep gray matter, at least after conversion to secondary progressive course. There is less evidence for neurodegenerative changes in SLE, but patients are increasingly at risk for cerebrovascular disease. We conclude by offering some suggestions for future clinical and imaging research. KeywordsSystemic lupus erythematosus; Multiple sclerosis; Cognition; Memory; Processing speed; MRI; Effect size Systemic lupus erythematosus (SLE) is a relapsing-remitting autoimmune disease with wide ranging organ involvement and clinical symptoms varying from mild and transient symptoms to death. Cognitive impairment is reported in SLE, even among those patients without documented or overt signs of central nervous system (CNS) involvement. Presumably, cognitive disorder is the result of underlying brain disease although the precise mechanisms remain to be elucidated. The prevalence and degree of cognitive impairment is also uncertain.In this article we will endeavor to evaluate the evidence for neuropsychological impairment in SLE, and to compare the findings with that of MS, another immunological disorder whose symptoms wax and wane and which affects women more than men. Unlike SLE, MS is a disease that always impacts the CNS, and the causes of cognitive disorder in MS are better understood.

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“…Such measures show relatively stronger correlations with clinical measures of disability (i.e., cognitive dysfunction and physical disability) than do conventional MRI measures. [71][72][73][74][75][76][77][78] Longitudinal studies suggest that MRS measures hold promise in predicting the development of disability. [71][72] MRS is just beginning to be applied to the study of the spinal cord in patients with MS (e.g., see section on "Spinal cord imaging" as follows for details).…”

Section: Mrsmentioning

confidence: 99%

MRI in Multiple Sclerosis: What’s Inside the Toolbox?

et al. 2007

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Summary: Magnetic resonance imaging (MRI) has played a central role in the diagnosis and management of multiple sclerosis (MS). In addition, MRI metrics have become key supportive outcome measures to explore drug efficacy in clinical trials. Conventional MRI measures have contributed to the understanding of MS pathophysiology at the macroscopic level yet have failed to provide a complete picture of underlying MS pathology. They also show relatively weak relationships to clinical status such as predictive strength for clinical progression. Advanced quantitative MRI measures such as magnetization transfer, spectroscopy, diffusion imaging, and relaxometry techniques are somewhat more specific and sensitive for underlying pathology. These measures are particularly useful in revealing diffuse damage in cerebral white and gray matter and therefore may help resolve the dissociation between clinical and conventional MRI findings. In this article, we provide an overview of the array of tools available with brain and spinal cord MRI technology as it is applied to MS. We review the most recent data regarding the role of conventional and advanced MRI techniques in the assessment of MS. We focus on the most relevant pathologic and clinical correlation studies relevant to these measures.

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Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients

Abstract: If a strong and stable association can be firmly established between cognitive and MR variables in appropriate subsets of MS patients, it might aid in the investigation of interventions to enhance cognition and modify the course of the disease.

Cited by 185 publications

References 37 publications

Identification and Clinical Impact of Multiple Sclerosis Cortical Lesions as Assessed by Routine 3T MR Imaging

Identification and Clinical Impact of Multiple Sclerosis Cortical Lesions as Assessed by Routine 3T MR Imaging

Neuropsychological Impairment in Systemic Lupus Erythematosus: A Comparison with Multiple Sclerosis

MRI in Multiple Sclerosis: What’s Inside the Toolbox?

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