Abstract
BackgroundCognitive impairment is common in multiple sclerosis (MS). However, the relationship between cognitive deficits and microstructural abnormalities in Chinese MS patients remains unclear. We aimed to investigate the importance of microstructural abnormalities and the associations with cognitive impairment in Chinese MS patients.MethodsThree‐dimensional T1‐weighted magnetic resonance imaging (MRI) scans were obtained from 36 relapsing remitting MS patients. Diffusion tensor imaging (DTI) scans were acquired for 29 (81%) patients. Cognitive impairment was assessed using a comprehensive neuropsychological battery. Patients were classified into cognitively impaired (CI) group and cognitively preserved (CP) group. Using volBrain and FSL software, we assessed white matter lesion burden, white matter (WM) and gray matter (GM) volumetric as well as microstructural diffusivity. MRI variables explaining cognitive impairment were analyzed.ResultsFifteen (42%) patients were classified as CI. Verbal learning and memory was the most commonly impaired domain (n = 16, 44%). CI patients had lower mean skeleton fractional anisotropy (FA) value than CP patients (275.45 vs. 283.61 × 10−3, P = 0.023). The final predicting model including demographic variables and global skeleton mean diffusivity (MD) explained 43.6% of variance of the presence of cognitive impairment (β = 0.131, P = 0.041). CI patients showed a widespread change of microstructural integrity comparing to CP patients, which was rarely overlapping with lesion probability map. Microstructural abnormalities in corpus callosum were associated with performance in verbal learning and memory, processing speed and selective attention (P < 0.05).ConclusionLoss of microstructural integrity demonstrated by DTI helps explain cognitive dysfunction in Chinese MS patients.
Highlights
Cognitive impairment in multiple sclerosis has been recognized for a long time and occurs in 40-70% of multiple sclerosis (MS) patients,[1,2] most commonly affecting memory, information processing speed, attention, and executive functions.[3,4] Cognitive deficits can happen in early stage of disease, and severely impact patients’ quality of life.[5]
We aimed to identify the influence of microstructural integrity, white matter (WM) atrophy, gray matter (GM) atrophy, thalamic atrophy, white matter lesion (WML) load and demographic factors on cognitive performance in Chinese relapsing remitting multiple sclerosis (RRMS) patients
There was no significant difference between cognitively impaired (CI) and cognitively preserved (CP) patients for age, gender, educational years, disease duration, number of relapses, and Expanded Disability Status Scale (EDSS) score
Summary
Cognitive impairment in multiple sclerosis has been recognized for a long time and occurs in 40-70% of multiple sclerosis (MS) patients,[1,2] most commonly affecting memory, information processing speed, attention, and executive functions.[3,4] Cognitive deficits can happen in early stage of disease, and severely impact patients’ quality of life.[5]. Traditional treatment goals, including reduction of relapses, magnetic resonance imaging (MRI) lesions and prevention of disability worsening, put emphasis mainly on inflammatory activity. The relationship between cognitive deficits and microstructural abnormalities in Chinese MS patients remains unclear. We aimed to investigate the importance of microstructural abnormalities and the associations with cognitive impairment in Chinese MS patients. Methods: Three-dimensional T1-weighted magnetic resonance imaging (MRI) scans were obtained from 36 relapsing remitting MS patients. The final predicting model including demographic variables and global skeleton mean diffusivity (MD) explained 43.6% of variance of the presence of cognitive impairment (b = 0.131, P = 0.041). Microstructural abnormalities in corpus callosum were associated with performance in verbal learning and memory, processing speed and selective attention (P < 0.05). Conclusion: Loss of microstructural integrity demonstrated by DTI helps explain cognitive dysfunction in Chinese MS patients
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