Abstract
BackgroundMultiple sclerosis is a chronic inflammatory disease affecting both white and gray matters of the central nervous system. It has been approved that the degree of gray matter involvement is closely associated with the degree of physical disability and the extent of cognitive impairment. Thus, it is necessary to incorporate widely available simple methods for neurocognitive evaluation and gray matter detection in the periodic assessment of MS patients that will influence treatment decisions.ObjectivesTo assess the correlation of cortical lesions of multiple sclerosis (MS) at double inversion recovery (DIR) with cognition screening scoresMethodsThis study was conducted on 30 patients with MS with an average age of 31.3±13.6 years. All of them underwent MRI and clinical assessment with the calculation of Expanded Disability Status Scale (EDSS), Montreal Cognitive Assessment (MoCA), and Symbol Digit Modality Test (SDMT) scores. The image analysis was performed by 2 reviewers for cortical lesion number, shape, and subtypes, and total lesion load.ResultsBoth MoCA and SDMT scales had a significant inverse correlation with cortical lesions number (r=− 0.68, − 0.72) respectively and total lesion load (r=− 0.53, − 0.65) respectively. Besides, there was a significant inverse correlation between the MoCA test, varied cortical subtypes: leukocortical, juxtacortical, and intracortical subtypes (r = − 0.63, − 0.56, − 0.52) respectively, and different cortical lesion shapes: oval, wedge, and curvilinear shaped (r = − 0.62, − 0.69, − 0.49) respectively. As well, the SDMT scale showed a significant inverse correlation with varied cortical subtypes: intracortical, leukocortical, and juxtacortical subtypes (r = − 0.63, − 0.61, − 0.57) respectively, and different cortical lesion shapes: oval, curvilinear, and wedge shaped (r = − 0.61, − 0.59, − 0.46) respectively. Interestingly, there was an excellent inter-observer correlation of cortical lesion number (r = 0.96), total lesion load (r = 0.95), subtypes of cortical lesion (r = 0.94), and cortical lesion shapes (r = 0.77).ConclusionWe concluded that DIR can detect cortical lesions of MS, and MRI findings were well-correlated with cognitive dysfunction in these patients.
Highlights
Multiple sclerosis (MS) is a chronic demyelinating and neurodegenerative disease of the central nervous system which strikes young adults and imposes major burdens on their lives through physical disability and cognitive deficit [1, 2]
We concluded that double inversion recovery (DIR) can detect cortical lesions of MS, and MRI findings were well-correlated with cognitive dysfunction in these patients
7 MS patients were diagnosed cognitively impaired using Montreal Cognitive Assessment (MoCA) while they normally scored by Symbol Digit Modality Test (SDMT)
Summary
Multiple sclerosis (MS) is a chronic demyelinating and neurodegenerative disease of the central nervous system which strikes young adults and imposes major burdens on their lives through physical disability and cognitive deficit [1, 2]. Inclusion of neurocognitive evaluation and gray matter detection in the periodic assessment of MS patients is mandatory to detect patients at increased risk of secondary progression that will influence treatment decisions regarding diseasemodifying drugs and rehabilitation therapy [9]. Neurocognitive screening tests such as Montreal Cognitive Assessment (MoCA) and Symbol Digit Modality Test (SDMT) are easy to assess cognitive status in MS patients [10, 11]. It is necessary to incorporate widely available simple methods for neurocognitive evaluation and gray matter detection in the periodic assessment of MS patients that will influence treatment decisions
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