Abstract
Multiple sclerosis exhibits specific neuropathological phenomena driving to both global and regional brain atrophy. At the clinical level, the disease is related to functional decline in cognitive domains as the working memory, processing speed, and verbal fluency. However, the compromise of social-cognitive abilities has concentrated some interest in recent years despite the available evidence suggesting the risk of disorganization in social life. Recent studies have used the MiniSEA test to assess the compromise of social cognition and have found relevant relationships with memory and executive functions, as well as with the level of global and regional brain atrophy. The present article aimed to identify structural changes related to socio-cognitive performance in a sample of patients with relapsing-remitting multiple sclerosis. 68 relapsing-remitting multiple sclerosis Chilean patients and 50 healthy control subjects underwent MRI scans and neuropsychological evaluation including social-cognition tasks. Total brain, white matter, and gray matter volumes were estimated. Also, voxel-based morphometry was applied to evaluate regional structural changes. Patients exhibited lower scores in all neuropsychological tests. Social cognition exhibited a significant decrease in this group mostly related to the declining social perception. Normalized brain volume and white matter volume were significantly decreased when compared to healthy subjects. The regional brain atrophy analysis showed that changes in the insular cortex and medial frontal cortices are significantly related to the variability of social-cognitive performance among patients. In the present study, social cognition was only correlated with the deterioration of verbal fluency, despite the fact that previous studies have reported its link with memory and executive functions. The identification of specific structural correlates supports the comprehension of this phenomenon as an independent source of cognitive disability in these patients.
Highlights
Multiple sclerosis (MS) has become a significant source of disability and cognitive impairment in young patients[1] attributed to a disconnection syndrome derived from white matter damage[2].The patients develop subclinical or measurable cognitive decline since the earliest stages of the disease, with significant changes in cortical recruitment related to cognitive tasks[3]
Some of its most studied domains are theory of mind, the ability to represent the psychological perspective of other subjects[7], and social perception, the ability to perceive mental states of others based on behavioral signals
No significant difference in mental status (MMSE) was found in comparison with healthy subjects, while significantly higher scores in fatigue and depression questionnaires were found in the patient group (Table 1)
Summary
The patients develop subclinical or measurable cognitive decline since the earliest stages of the disease, with significant changes in cortical recruitment related to cognitive tasks[3]. Recent studies have used the MiniSEA test to assess the compromise of social cognition and have found relevant relationships with memory and executive functions, as well as with the level of global and regional brain atrophy. Objective: The present article aimed to identify structural changes related to socio-cognitive performance in a sample of patients with relapsing-remitting multiple sclerosis. The regional brain atrophy analysis showed that changes in the insular cortex and medial frontal cortices are significantly related to the variability of social-cognitive performance among patients. The identification of specific structural correlates supports the comprehension of this phenomenon as an independent source of cognitive disability in these patients
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