Cortical Lesions and Atrophy Associated With Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis

Abstract

Background: Neuropsychological deficits in patients with multiple sclerosis (MS) have been shown to be associated with the major pathological substrates of the disease, ie, inflammatory demyelination and neurodegeneration. Double inversion recovery sequences allow cortical lesions (CLs) to be detected in the brain of patients with MS. Modern postprocessing techniques allow cortical atrophy to be assessed reliably.Objective: To investigate the contribution of cortical gray matter lesions and tissue loss to cognitive impairment in patients with relapsing-remitting MS.

Longitudinal patterns of cortical thinning in multiple sclerosis

“…Moreover, other structures such as the spinal cord have been also shown to be better explanatory variables for T25fwt compared to brain metrics (Tsagkas et al, ; Tsagkas et al, ). Furthermore, in contrast to previous literature (Calabrese et al, ; Steenwijk et al, ), cognitive performance—as measured by PASAT and SDMT—in our cohort was not associated with CTh. However, a paradoxic significant improvement of those scores was evident in our patients in both scores, which may be attributed to a learning effect through repetition.…”

Longitudinal patterns of cortical thinning in multiple sclerosis

“…Moreover, other structures such as the spinal cord have been also shown to be better explanatory variables for T25fwt compared to brain metrics (Tsagkas et al, ; Tsagkas et al, ). Furthermore, in contrast to previous literature (Calabrese et al, ; Steenwijk et al, ), cognitive performance—as measured by PASAT and SDMT—in our cohort was not associated with CTh. However, a paradoxic significant improvement of those scores was evident in our patients in both scores, which may be attributed to a learning effect through repetition.…”

Hippocampal and Deep Gray Matter Nuclei Atrophy Is Relevant for Explaining Cognitive Impairment in MS: A Multicenter Study

“…Contrary to our expectations, we found only a nonsignificant trend toward a higher number of CLs in patients with MS who were CI compared with CP. This is in contrast to results of previous studies, 7,8 which reported associations between the number and volume of CLs and cognitive impairment. At least 2 factors could help explain this discrepancy.…”

Making Visible the Invisible: Automatically Measured Global and Regional Brain Volume Is Associated with Cognitive Impairment and Fatigue in Multiple Sclerosis

“…In the present study, we found that higher fatigue levels were associated with higher atrophy in the temporal lobe and insula, while patients who showed cognitive alterations were also those characterized by higher atrophy in key regions for cognitive performances, such as the limbic lobe, the cerebellum, and the insula, as well as in the whole brain and the GM, compared to cognitively normal patients. These results are in accordance with the literature for both cognitive alterations [19,37,38] and fatigue [23,24,25,26,27].…”

Longitudinal patterns of cortical thinning in multiple sclerosis

“…Moreover, other structures such as the spinal cord have been also shown to be better explanatory variables for T25fwt compared to brain metrics (Tsagkas et al, ; Tsagkas et al, ). Furthermore, in contrast to previous literature (Calabrese et al, ; Steenwijk et al, ), cognitive performance—as measured by PASAT and SDMT—in our cohort was not associated with CTh. However, a paradoxic significant improvement of those scores was evident in our patients in both scores, which may be attributed to a learning effect through repetition.…”

Hippocampal and Deep Gray Matter Nuclei Atrophy Is Relevant for Explaining Cognitive Impairment in MS: A Multicenter Study

“…Contrary to our expectations, we found only a nonsignificant trend toward a higher number of CLs in patients with MS who were CI compared with CP. This is in contrast to results of previous studies, 7,8 which reported associations between the number and volume of CLs and cognitive impairment. At least 2 factors could help explain this discrepancy.…”

Making Visible the Invisible: Automatically Measured Global and Regional Brain Volume Is Associated with Cognitive Impairment and Fatigue in Multiple Sclerosis

“…In the present study, we found that higher fatigue levels were associated with higher atrophy in the temporal lobe and insula, while patients who showed cognitive alterations were also those characterized by higher atrophy in key regions for cognitive performances, such as the limbic lobe, the cerebellum, and the insula, as well as in the whole brain and the GM, compared to cognitively normal patients. These results are in accordance with the literature for both cognitive alterations [19,37,38] and fatigue [23,24,25,26,27].…”

Longitudinal patterns of cortical thinning in multiple sclerosis

“…Moreover, other structures such as the spinal cord have been also shown to be better explanatory variables for T25fwt compared to brain metrics (Tsagkas et al, ; Tsagkas et al, ). Furthermore, in contrast to previous literature (Calabrese et al, ; Steenwijk et al, ), cognitive performance—as measured by PASAT and SDMT—in our cohort was not associated with CTh. However, a paradoxic significant improvement of those scores was evident in our patients in both scores, which may be attributed to a learning effect through repetition.…”

Hippocampal and Deep Gray Matter Nuclei Atrophy Is Relevant for Explaining Cognitive Impairment in MS: A Multicenter Study

“…Contrary to our expectations, we found only a nonsignificant trend toward a higher number of CLs in patients with MS who were CI compared with CP. This is in contrast to results of previous studies, 7,8 which reported associations between the number and volume of CLs and cognitive impairment. At least 2 factors could help explain this discrepancy.…”

Making Visible the Invisible: Automatically Measured Global and Regional Brain Volume Is Associated with Cognitive Impairment and Fatigue in Multiple Sclerosis

“…In the present study, we found that higher fatigue levels were associated with higher atrophy in the temporal lobe and insula, while patients who showed cognitive alterations were also those characterized by higher atrophy in key regions for cognitive performances, such as the limbic lobe, the cerebellum, and the insula, as well as in the whole brain and the GM, compared to cognitively normal patients. These results are in accordance with the literature for both cognitive alterations [19,37,38] and fatigue [23,24,25,26,27].…”