Lesion load may predict long-term cognitive dysfunction in multiple sclerosis patients

6533b7dcfe1ef96bd1271e6d

RESEARCH PRODUCT

Lesion load may predict long-term cognitive dysfunction in multiple sclerosis patients

Gioacchino Tedeschi Sabrina Realmuto Damiano Paolicelli Giovanni Savettieri Vincenzo Brescia Morra Alessandro D’ambrosio Silvia Messina Veria Vacchiano Mario Zappia Maria Buccafusca Bruno Alfano Roberta Lanzillo 2 Domenico Ippolito Paola Valentino Antonio Gallo Luigi Lavorgna Manuela De Stefano Francesco Patti Rosa Gemma Viterbo Patrizia Montella Isabella Laura Simone Clara Grazia Chisari G. Coniglio Simona Bonavita

subject

EMTREE medical terms: Article recall lcsh:Medicine Audiology Neuropsychological Tests Nerve Fibers Myelinated 030218 nuclear medicine & medical imaging Cohort Studies 0302 clinical medicine cognitive defect nuclear magnetic resonance imaging lcsh:Science Modified Card Sorting Test Multidisciplinary neuroimaging Semantically Related Word List Test Multiple Sclerosis Cognitive Dysfunction MRI medicine.diagnostic_test predictive value Brain Cognition Neuropsychological test gray matter Middle Aged Prognosis Magnetic Resonance Imaging Memory Short-Term female brain size multiple sclerosi Cohort Disease Progression Settore MED/26 - Neurologia white matter Research Article Adult medicine.medical_specialty Multiple Sclerosis Paced Auditory Serial Addition Test verbal memory cerebrospinal fluid working memory 03 medical and health sciences male medicine Humans controlled study human Recall business.industry Multiple sclerosis lcsh:R Magnetic resonance imaging medicine.disease major clinical study attention executive function Symbol Digit Modalities Test Paced Auditory Serial Addition Test neuropsychological test lcsh:Q Verbal memory business Cognition Disorders 030217 neurology & neurosurgery Follow-Up Studies

description

Background: Magnetic Resonance Imaging (MRI) techniques provided evidences into the understanding of cognitive impairment (CIm) in Multiple Sclerosis (MS). Objectives: To investigate the role of white matter (WM) and gray matter (GM) in predicting long-term CIm in a cohort of MS patients. Methods: 303 out of 597 patients participating in a previous multicenter clinical-MRI study were enrolled (49.4% were lost at follow-up). The following MRI parameters, expressed as fraction (f) of intracranial volume, were evaluated: cerebrospinal fluid (CSF-f), WM-f, GM-f and abnormal WM (AWM-f), a measure of lesion load. Nine years later, cognitive status was assessed in 241 patients using the Symbol Digit Modalities Test (SDMT), the Semantically Related Word List Test (SRWL), the Modified Card Sorting Test (MCST), and the Paced Auditory Serial Addition Test (PASAT). In particular, being SRWL a memory test, both immediate recall and delayed recall were evaluated. MCST scoring was calculated based on the number of categories, number of perseverative and non-perseverative errors. Results: AWM-f was predictive of an impaired performance 9 years ahead in SDMT (OR 1.49, CI 1.12-1.97 p = 0.006), PASAT (OR 1.43, CI 1.14-1.80 p = 0.002), SRWL-immediate recall (OR 1.72 CI 1.35-2.20 p<0.001), SRWL-delayed recall (OR 1.61 CI 1.28-2.03 p<0.001), MCST-category (OR 1.52, CI 1.2-1.9 p<0.001), MCST-perseverative error(OR 1.51 CI 1.2-1.9 p = 0.001), MCST-non perseverative error (OR 1.26 CI 1.02-1.55 p = 0.032). Conclusion: In our large MS cohort, focal WM damage appeared to be the most relevant predictor of the long-term cognitive outcome. © 2015 Patti et al.

year	journal	country	edition	language
2015-03-27

10.1371/journal.pone.0120754 http://hdl.handle.net/20.500.11769/42792