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

• Published in: PloS one 2015-03, Vol.10 (3), p.e0120754-e0120754
• Main Authors: Patti, Francesco, De Stefano, Manuela, Lavorgna, Luigi, Messina, Silvia, Chisari, Clara Grazia, Ippolito, Domenico, Lanzillo, Roberta, Vacchiano, Veria, Realmuto, Sabrina, Valentino, Paola, Coniglio, Gabriella, Buccafusca, Maria, Paolicelli, Damiano, D'Ambrosio, Alessandro, Montella, Patrizia, Brescia Morra, Vincenzo, Savettieri, Giovanni, Alfano, Bruno, Gallo, Antonio, Simone, Isabella, Viterbo, Rosa, Zappia, Mario, Bonavita, Simona, Tedeschi, Gioacchino
• Format: Article
• Language: English
• Subjects: Adult; Aging; Brain - pathology; Cerebrospinal fluid; Cognition Disorders - etiology; Cognition Disorders - pathology; Cognitive ability; Cognitive disorders; Cohort Studies; Disability; Disease Progression; Female; Follow-Up Studies; Gray Matter - pathology; Hospitals; Humans; Magnetic resonance; Magnetic Resonance Imaging; Male; Medical research; Memory; Memory, Short-Term; Metabolism; Middle Aged; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - pathology; Nerve Fibers, Myelinated - pathology; Neurology; Neuropsychological Tests; Neurosciences; NMR; Nuclear magnetic resonance; Patients; Performance prediction; Prognosis; Recall; Substantia alba; Substantia grisea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0120754

Magnetic Resonance Imaging (MRI) techniques provided evidences into the understanding of cognitive impairment (CIm) in Multiple Sclerosis (MS). To investigate the role of white matter (WM) and gray matter (GM) in predicting long-term CIm in a cohort of MS patients. 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. 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