Multiple white matter tract abnormalities underlie cognitive impairment in RRMS

Cognitive and White Matter Tract Differences in MS and Diffuse Neuropsychiatric Systemic Lupus Erythematosus

“…14,42 The results of this study are consistent with those in prior studies showing significant WM damage in patients with MS compared with HCs across measures of FA, MD, RD, and AD, by using both TBSS and global WM analysis. 33,43 The results are also consistent with prior studies showing that subjects with MS perform significantly worse than HCs on cognitive tests assessing processing speed, working and visual-spatial processing/memory, sustained attention, and executive function. 21,[44][45][46] The diffuse SLE syndromes such as anxiety disorders, mood disorders, headache, and cognitive impairment may be the result of diffuse damage, whereas focal SLE syndromes such as seizures, strokes, and transient ischemic attacks, result in high-attenuation focal lesions.…”

White Matter Diffusion Changes during the First Year of Natalizumab Treatment in Relapsing-Remitting Multiple Sclerosis

“…If the observed increases in FA persist for longer follow-up times, it is possible that natalizumab-induced improvement and/or stabilizations in brain tissue could affect cognitive function in these patients, given the strong correlation between the severity of FA abnormalities and overall cognition found in our data, as well as in other previous studies 5,7,38 and the previously shown slow rate of cognitive decline in MS. 39 It is currently unclear, however, whether this could be in the form of actual increases in cognitive scores or merely the slowing down of cognitive decline. Therefore studies with longer follow-up times are needed.…”

Early White Matter Changes in Childhood Multiple Sclerosis: A Diffusion Tensor Imaging Study

“…In adults, conflicting data on the correlation of FA measures with annual relapse rate, number of total relapses, and lesion load exist. Disease duration of Ͼ3 years is reported to negatively correlate with FA, 25,26 whereas in clinically isolated syndrome, no correlation was reported. 6 …”

“…In adults, conflicting data on the correlation of FA measures with the annual relapse rate, number of total relapses, and lesion load exist. Disease durations of Ͼ3 years have been reported to negatively correlate with FA, 25,26 whereas in clinically isolated syndrome, no correlation was reported. 6 It has been proposed that global changes in white matter occur to a lesser degree in childhood at the beginning of the disease compared with adult-onset MS. 6 However, early changes in childhood MS are known to be characterized by pathologic MR imaging findings of gray and white matter structures that are generally more subtle compared with MR imaging findings in adult MS. 12,13,27 This difference may explain why patients with early-onset MS tend to have a longer duration of illness before reaching a state of irreversible disability.…”