Assessing the Correlation between Grey and White Matter Damage with Motor and Cognitive Impairment in Multiple Sclerosis Patients

Cognitive impairment (CI) is frequently present in multiple sclerosis patients. Despite ongoing research, the neurological substrates have not been fully elucidated. In this study we investigated the contribution of gray and white matter in the CI observed in mildly disabled relapsing-remitting multiple sclerosis (RRMS) patients. For that purpose, 30 patients with RRMS (median EDSS = 2), and 30 age- and sex-matched healthy controls were studied. CI was assessed using the symbol digit modalities test (SDMT) and the memory alteration test. Brain magnetic resonance imaging, diffusion tensor imaging (DTI), voxel-based morphometry (VBM), brain segmentation, thalamic vertex analysis, and connectivity-based thalamic parcellation analyses were performed. RRMS patients scored significantly lower in both cognitive tests. In the patient group, significant atrophy in the thalami was observed. Multiple regression analyses revealed associations between SDMT scores and GM volume in both hemispheres in the temporal, parietal, frontal, and occipital lobes. The DTI results pointed to white matter damage in all thalamocortical connections, the corpus callosum, and several fasciculi. Multiple regression and correlation analyses suggested that in RRMS patients with mild disease, thalamic atrophy and thalamocortical connection damage may lead to slower cognitive processing. Furthermore, white matter damage at specific fasciculi may be related to episodic memory impairment.

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T1 cortical hypointensities and their association with cognitive disability in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458510377223 ◽

2010 ◽

Vol 16 (10) ◽

pp. 1203-1212 ◽

Cited By ~ 16

Author(s):

Francesca Bagnato ◽

Zeena Salman ◽

Robert Kane ◽

Sungyoung Auh ◽

Fredric K Cantor ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

White Matter ◽

Statistical Significance ◽

Verbal Learning ◽

Lesion Volume ◽

Cognitive Disability ◽

3.0 Tesla ◽

Multiple Sclerosis Patients ◽

The Impact

Background: Neocortical lesions (NLs) largely contribute to the pathology of multiple sclerosis (MS), although their relevance in patients’ disability remains unknown. Objective: To assess the incidence of T1 hypointense NLs by 3.0-Tesla magnetic resonance imaging (MRI) in patients with MS and examine neocortical lesion association with cognitive impairment. Methods: In this case-control study, 21 MS patients and 21 age-, sex- and years of education-matched healthy volunteers underwent: (i) a neuropsychological examination rating cognitive impairment (Minimal Assessment of Cognitive Function in MS); (ii) a 3.0-Tesla MRI inclusive of an isotropic 1.0 mm3 three-dimensional inversion prepared spoiled gradient-recalled-echo (3D-IRSPGR) image and T1- and T2-weighted images. Hypointensities on 3D-IRSPGR lying in the cortex, either entirely or partially were counted and association between NLs and cognitive impairment investigated. Results: A total of 95 NLs were observed in 14 (66.7%) patients. NL+ patients performed poorer (p = 0.020) than NLpatients only on the delayed recall component of the California Verbal Learning Test. This difference lost statistical significance when a correction for white matter lesion volume was employed. Conclusions: Although T 1 hypointense NLs may be present in a relatively high proportion of multiple sclerosis patients, the impact that they have in cognitive impairment is not independent from white matter disease.

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Cognitive impairment in paediatric multiple sclerosis patients is not related to cortical lesions

Multiple Sclerosis Journal ◽

10.1177/1352458514557303 ◽

2014 ◽

Vol 21 (7) ◽

pp. 956-959 ◽

Cited By ~ 12

Author(s):

Maria A Rocca ◽

Ermelinda De Meo ◽

Maria P Amato ◽

Massimiliano Copetti ◽

Lucia Moiola ◽

...

Keyword(s):

Cognitive Impairment ◽

White Matter ◽

Grey Matter ◽

Cognitively Impaired ◽

Grey Matter Volume ◽

Cortical Lesions ◽

White Matter Volume ◽

White Matter Damage ◽

Matter Volume ◽

Multiple Sclerosis Patients

We investigated the contribution of cortical lesions to cognitive impairment in 41 paediatric MS patients. Thirteen (32%) paediatric MS patients were considered as cognitively impaired. T2-hyperintense and T1-hypointense white matter lesion volumes did not differ between cognitively impaired and cognitively preserved MS patients. Cortical lesions number, cortical lesions volume and grey matter volume did not differ between cognitively impaired and cognitively preserved patients, whereas white matter volume was significantly lower in cognitively impaired versus cognitively preserved MS patients ( p=0.01). Contrary to adult MS, cortical lesions do not seem to contribute to cognitive impairment in paediatric MS patients, which is likely driven by white matter damage.

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Correlation between white matter damage and gray matter lesions in multiple sclerosis patients

Neural Regeneration Research ◽

10.4103/1673-5374.206650 ◽

2017 ◽

Vol 12 (5) ◽

pp. 787 ◽

Cited By ~ 7

Author(s):

Xia Cao ◽

Xue-mei Han ◽

Hong-ji Tian ◽

Zheng Han ◽

Ce Zhang ◽

...

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Gray Matter ◽

White Matter Damage ◽

Multiple Sclerosis Patients

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Neuropsychiatric Disorders-1Processing Speed Tasks Predict White Matter Damage in Multiple Sclerosis Patients 10 Years Later: A Tract-Based Spatial Statistics (TBSS) Study

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acw042.21 ◽

2016 ◽

Vol 31 (6) ◽

pp. 581.2-581

Author(s):

C Roman ◽

P Arnett

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Spatial Statistics ◽

Neuropsychiatric Disorders ◽

White Matter Damage ◽

Tract Based Spatial Statistics ◽

Multiple Sclerosis Patients

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Clinical significance of atrophy and white matter mean diffusivity within the thalamus of multiple sclerosis patients

Multiple Sclerosis Journal ◽

10.1177/1352458513478675 ◽

2013 ◽

Vol 19 (11) ◽

pp. 1478-1484 ◽

Cited By ~ 64

Author(s):

Ralph HB Benedict ◽

Hanneke E Hulst ◽

Niels Bergsland ◽

Menno M Schoonheim ◽

Michael G Dwyer ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

White Matter ◽

Cognitive Processing ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

Brain Magnetic Resonance Imaging ◽

Cognitive Tests ◽

Explained Variance ◽

Multiple Sclerosis Patients

Background: Gray-matter (GM) atrophy is strongly predictive of cognitive impairment in multiple sclerosis (MS) patients. The thalamus is the region where the atrophy/cognition correlation is most robust. However, few studies have assessed diffusion tensor imaging (DTI) metrics within the thalamus. Objective: This study was designed to determine if thalamus white matter DTI predicts cognitive impairment after accounting for the effects of volume loss. Methods: We enrolled 75 MS patients and 18 healthy controls undergoing 3T brain magnetic resonance imaging (MRI). Thalamus volumes were calculated on 3D T1 images. Voxelwise analyses of DTI metrics were performed within the thalamic white matter tracts. Neuropsychological (NP) testing, acquired using consensus standard methods, contributed measures of memory, cognitive processing speed and executive function. Results: All cognitive tests were significantly predicted ( R2 =0.31, p<0.001) by thalamus volume after accounting for influence of demographics. Mean diffusivity was retained in regression models predicting all cognitive tests, adding from 7–13% of additional explained variance ( p<0.02) after accounting for thalamus volume. Conclusions: We confirm the significant role of thalamus atrophy in MS-associated cognitive disorder, and further report that subtle thalamus pathology as detected by DTI adds incremental explained variance in predicting cognitive impairment.

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