Abstract
BackgroundRecent studies suggest that cortical lesions in multiple sclerosis (MS) substantially contribute to clinical disease severity. The present study aimed at investigating clinical, neuroanatomical, and cognitive correlates of these cortical lesions with a novel approach, i.e. by comparing two samples of relapsing-remitting multiple sclerosis (RRMS) patients, one group with and the other without cortical lesions.MethodsHigh-resolution structural MRI was acquired from 42 RRMS patients and 43 controls (HC). The patient group was dichotomized based on the presence versus absence of DIR-hyperintense cortex-involving lesions, resulting in a cortical lesion group (CL, n = 32) and a non-cortical lesion group (nCL, n =10). Cognitive functioning was assessed in all participants with a comprehensive neuropsychological battery, covering mnestic, executive, and attentional functions.ResultsHighest densities of cortical lesions in the CL group were observed in the bilateral parahippocampal gyrus. Relative to HC, patients with cortical lesions - but not those without - showed significant global cortical thinning and mnestic deficits. The two patient groups did not differ from each other regarding demographic and basic disease characteristics such as EDSS scores.ConclusionThe appearance of cortical lesions in MS patients is associated with cortical thinning as well as mnestic deficits, which might be key characteristics of a 'cortically dominant' MS subtype.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0718-9) contains supplementary material, which is available to authorized users.
Highlights
Recent studies suggest that cortical lesions in multiple sclerosis (MS) substantially contribute to clinical disease severity
Multiple sclerosis is associated with a variety of symptoms that are responsible for functional impairment in affected patients
Bonferroni-corrected post-hoc analyses revealed a reduction of Brain parenchymal fraction (BPF) in Cortical lesion group (CL) patients relative to healthy control persons (HC) (p < 0.001) as well as an enlarged Third ventricle width (TVW) (p < 0.001)
Summary
Recent studies suggest that cortical lesions in multiple sclerosis (MS) substantially contribute to clinical disease severity. Multiple sclerosis (MS) is considered as an autoimmune inflammatory disorder [1], predominantly affecting the white matter of the central nervous system [2]. This view is based on the high sensitivity of conventional MRI sequences in the detection of white matter abnormalities in MS patients. Cognitive deficits – which were firstly described in the second half of the 19th century [9] – are found in up to 70 % of patients with multiple sclerosis at both the earlier and later stages of the disease [10]. MS patients often exhibit significant deficits in executive functions too [12, 13]
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