Microstructural White Matter Alterations in Cognitively Impaired Patients at Early Stages of Multiple Sclerosis

Purpose As conventional quantitative magnetic resonance imaging (MRI) parameters are weakly associated with cognitive impairment (CI) in early multiple sclerosis (MS), we explored microstructural white matter alterations in early MS or clinically isolated syndrome (CIS) comparing patients with or wi...

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Published in:Clinical neuroradiology (Munich) 2021-12, Vol.31 (4), p.993-1003
Main Authors: Schneider, Ruth, Matusche, Britta, Genç, Erhan, Gold, Ralf, Bellenberg, Barbara, Lukas, Carsten
Format: Article
Language:English
Subjects:
Anisotropy
Cognitive ability
Comparative analysis
Corpus Callosum - diagnostic imaging
Diffusion Tensor Imaging
Humans
Magnetic resonance imaging
Medicine
Medicine & Public Health
Multiple sclerosis
Multiple Sclerosis - diagnostic imaging
Neurology
Neuroradiology
Neurosurgery
Original
Original Article
White Matter - diagnostic imaging
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Summary:Purpose As conventional quantitative magnetic resonance imaging (MRI) parameters are weakly associated with cognitive impairment (CI) in early multiple sclerosis (MS), we explored microstructural white matter alterations in early MS or clinically isolated syndrome (CIS) comparing patients with or without CI. Methods Based on a preceding tract-based spatial statistics analysis (3 Tesla MRI) which contrasted 106 patients with early MS or CIS and 49 healthy controls, diffusion metrics (fractional anisotropy, FA, mean diffusivity, MD) were extracted from significant clusters using an atlas-based approach. The FA and MD were compared between patients with (Ci_P n  = 14) and without (Cp_P n  = 81) cognitive impairment in a subset of patients who underwent CI screening. Results The FA was reduced in Ci_P compared to Cp_P in the splenium of corpus callosum ( p  = 0.001), right parahippocampal cingulum ( p  = 0.002) and fornix cres./stria terminalis (0.042), left posterior corona radiata ( p  = 0.012), bilateral cerebral peduncles, medial lemniscus and in cerebellar tracts. Increased MD was detected in the splenium of corpus callosum ( p  = 0.01). The CI-related localizations overlapped only partially with MS lesions. Conclusion Microstructural white matter alterations at disease onset were detectable in Ci_P compared to Cp_P in known cognitively relevant fiber tracts, indicating the relevance of early treatment initiation in MS and CIS.
ISSN:1869-1439
1869-1447
DOI:10.1007/s00062-021-01010-8