Clinical and imaging assessment of cognitive dysfunction in multiple sclerosis

Summary In patients with multiple sclerosis (MS), grey matter damage is widespread and might underlie many of the clinical symptoms, especially cognitive impairment. This relation between grey matter damage and cognitive impairment has been lent support by findings from clinical and MRI studies. How...

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Bibliographic Details
Published in:Lancet neurology 2015-03, Vol.14 (3), p.302-317
Main Authors: Rocca, Maria A, MD, Amato, Maria P, MD, De Stefano, Nicola, MD, Enzinger, Christian, MD, Geurts, Jeroen J, PhD, Penner, Iris-K, MD, Rovira, Alex, MD, Sumowski, James F, PhD, Valsasina, Paola, MsC, Filippi, Massimo, Prof
Format: Article
Language:English
Subjects:
Cognition Disorders - diagnosis
Cognition Disorders - epidemiology
Cognition Disorders - psychology
Cognitive ability
Comorbidity
Cross-Sectional Studies
Diagnostic Imaging - methods
Humans
Information processing
Longitudinal Studies
Magnetic Resonance Imaging - methods
Memory
Multiple sclerosis
Multiple Sclerosis - diagnosis
Multiple Sclerosis - epidemiology
Multiple Sclerosis - psychology
Neurology
Neuropsychological Tests
Older people
Studies
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Summary:Summary In patients with multiple sclerosis (MS), grey matter damage is widespread and might underlie many of the clinical symptoms, especially cognitive impairment. This relation between grey matter damage and cognitive impairment has been lent support by findings from clinical and MRI studies. However, many aspects of cognitive impairment in patients with MS still need to be characterised. Standardised neuropsychological tests that are easy to administer and sensitive to disease-related abnormalities are needed to gain a better understanding of the factors affecting cognitive performance in patients with MS than exists at present. Imaging measures of the grey matter are necessary, but not sufficient to fully characterise cognitive decline in MS. Imaging measures of both lesioned and normal-appearing white matter lend support to the hypothesis of the existence of an underlying disconnection syndrome that causes clinical symptoms to trigger. Findings on cortical reorganisation support the contribution of brain plasticity and cognitive reserve in limiting cognitive deficits. The development of clinical and imaging biomarkers that can monitor disease development and treatment response is crucial to allow early identification of patients with MS who are at risk of cognitive impairment.
ISSN:1474-4422
1474-4465
DOI:10.1016/S1474-4422(14)70250-9