Structural MRI correlates of PASAT performance in multiple sclerosis

Abstract

BackgroundThe Paced Auditory Serial Addition Test (PASAT) is a useful cognitive test in patients with multiple sclerosis (MS), assessing sustained attention and information processing speed. However, the neural underpinnings of performance in the test are controversial. We aimed to study the neural basis of PASAT performance by using structural magnetic resonance imaging (MRI) in a series of 242 patients with MS.MethodsPASAT (3-s) was administered together with a comprehensive neuropsychological battery. Global brain volumes and total T2-weighted lesion volumes were estimated. Voxel-based morphometry and lesion symptom mapping analyses were performed.ResultsMean PASAT score was 42.98 ± 10.44; results indicated impairment in 75 cases (31.0%). PASAT score was correlated with several clusters involving the following regions: bilateral precuneus and posterior cingulate, bilateral caudate and putamen, and bilateral cerebellum. Voxel-based lesion symptom mapping showed no significant clusters. Region of interest–based analysis restricted to white matter regions revealed a correlation with the left cingulum, corpus callosum, bilateral corticospinal tracts, and right arcuate fasciculus. Correlations between PASAT scores and global volumes were weak.ConclusionPASAT score was associated with regional volumes of the posterior cingulate/precuneus and several subcortical structures, specifically the caudate, putamen, and cerebellum. This emphasises the role of both cortical and subcortical structures in cognitive functioning and information processing speed in patients with MS.Electronic supplementary materialThe online version of this article (10.1186/s12883-018-1223-0) contains supplementary material, which is available to authorized users.

Brain structural and functional alterations in MOG antibody disease

“…clinical disability and cognitive scores), distinct clinical associations were observed in MOGAD and AQP4+ NMOSD, which might reflect different pathological mechanisms and underlying structural and functional alterations. GM atrophy in hippocampus/parahippocampal gyrus was associated with more clinical disability, implying the potential driving force of underlying GM involvement for the clinical disability and highlighting the role of the hippocampus in prognosis gyrus was associated with cognitive decline in MOGAD, which was consistent with previous findings of cortical and subcortical GM atrophy driving cognitive impairment in neuroimmune and neuroinflammatory diseases, as potential markers for evaluating cognitive impairment in both diseases 34,35. These findings were different from those in AQP4+ NMOSD, where clinical associations were mostly identified with structural and functional characteristics of the visual areas, fornix/stria terminalis and medial lemniscus, some of which are small structures needing further validation.…”

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

“…Episodic memory has been correlated with total grey matter and regional cortical structures (e.g., left precuneus [89]); visuospatial memory has been associated with brain MRI total lesion area, T1 lesion, and FLAIR lesion volume, BPF, third ventricular width, and right superior frontal atrophy, among others [90,91]; verbal episodic memory has been associated with total and regional hippocampal atrophy, total lesion load and BPF [90,91,92,93]; information processing speed has been correlated with thalamus, whole grey matter atrophy, and third ventricle width [94], cerebellum atrophy [95,96], as well as with less white matter integrity, and increases in functional connectivity [79]; executive disfunction has been associated with frontal lobe structural and functional damage [97,98] and with dorsolateral prefrontal, orbitofrontal, anterior cingulate, and insular areas [99], as well as with thalamic structural and functional changes [100]; PASAT-3” scores have been correlated with cortical and subcortical structures such as bilateral precuneus, posterior cingulate, caudate putamen, and cerebellum [101], and acute changes in PASAT score with no physical changes (EDSS) have been associated with presence of acute gadolinium enhancing lesions [102], with similar results observe with transient SDMT changes [103], proposing that patients could also experience “cognitive relapses”.…”

What is the meaning of PASAT rejection in multiple sclerosis?

“…Preprocessing and analysis were performed using the toolboxes VBM8 and Lesion Segmentation Tool, implemented in Statistical Parametric Mapping, as have been previously described. 10 Total intracranial volume and white matter lesion load were calculated.…”