Abstract
Cognitive dysfunction can be identified in patients with clinically isolated syndromes suggestive of multiple sclerosis using ocular motor testing. This study aimed to identify the functional neural correlates of cognitive dysfunction in patients with clinically isolated syndrome using MRI. Eighteen patients with clinically isolated syndrome and 17 healthy controls were recruited. Subjects underwent standard neurological and neuropsychological testing. Subjects also underwent functional MRI (fMRI) during a cognitive ocular motor task, involving pro-saccade (direct gaze towards target) and anti-saccade (direct gaze away from target) trials. Ocular motor performance variables (averaged response time and error rate) were calculated for each subject. Patients showed a trend towards a greater rate of anti-saccade errors (p = 0.09) compared to controls. Compared to controls, patients exhibited increased activation in the right postcentral, right supramarginal gyrus, and the right parietal operculum during the anti-saccade>pro-saccade contrast. This study demonstrated that changes in functional organisation of cognitive brain networks is associated with subtle cognitive changes in patients with clinically isolated syndrome.
Highlights
Multiple sclerosis is associated with a range of cognitive dysfunctions, affecting domains such as attention, working memory and information processing speed
This study aimed to identify the functional neural correlates of cognitive dysfunction in patients with clinically isolated syndrome using Magnetic resonance imaging (MRI)
This study demonstrated that changes in functional organisation of cognitive brain networks is associated with subtle cognitive changes in patients with clinically isolated syndrome
Summary
Multiple sclerosis is associated with a range of cognitive dysfunctions, affecting domains such as attention, working memory and information processing speed. While not all patients are overtly cognitively impaired, subtle cognitive changes may be evident at first presentation with a clinically isolated syndrome (CIS), becoming more pronounced as the disease progresses [1,2,3]. It is critical to identify assessment tools that can detect and predict the likely trajectory of cognitive decline in patients with CIS in order to optimise treatment at disease onset. Cognitive dysfunctions in people with multiple sclerosis are commonly identified through self-reporting, which is subjective and unreliable. Neuropsychological tests such as the paced auditory serial addition test (PASAT) and the symbol digit modalities test (SDMT) have been used as a tool for identifying cognitive dysfunction in patients with.
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