scholarly journals Structural and Functional MRI Techniques in Multiple Sclerosis Related Cognitive Dysfunction

Folia Medica ◽  
2018 ◽  
Vol 60 (4) ◽  
pp. 505-511 ◽  
Author(s):  
Dessislava Iancheva ◽  
Anastasiya Trenova ◽  
Stefka Mantarova ◽  
Kiril Terziyski
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Functional Mri ◽  
Cognitive Dysfunction ◽  
Gray Matter ◽  
Social Impact ◽  
Clinical Manifestations ◽  
Cortical Reorganization ◽  
Cortical Activation ◽  
Brain Morphology

Abstract Multiple sclerosis (MS) is an inflammatory demyelinating and neurodegenerative disease of the central nervous system that is prevalent in young adults and therefore with significant social impact. Cognitive impairment occurs in 40% to 70% of patients with MS and has a weak correlation with disease duration. Neuropsycho-logical assessment is a standard method in the detection of cognitive dysfunction. However, in order to understand the etiology and evolution of cognitive dysfunction, several elaborate magnetic resonance techniques have been developed. Their aim is to measure structural changes in the CNS that are considered main substrates in cognitive function such as whole brain and gray matter atrophy, cortical lesions and changes in subcortical gray matter. Evidence shows that the clinical manifestations of multiple sclerosis are complex interactions between tissue damage, tissue repair and cortical reorganization. In order to study this heterogeneity, structural magnetic resonance analysis of brain morphology and functional magnetic resonance imaging are essential. This review summarizes current techniques in structural MRI and the value of functional MRI in understanding the link between cognitive deficit and cortical activation and reorganization.

Normal-appearing white matter changes in multiple sclerosis: the contribution of magnetic resonance techniques

1999 ◽  
Vol 5 (4) ◽  
pp. 273-282 ◽  
Author(s):  
Massimo Filippi ◽  
Carla Tortorella ◽  
Marco Bozzali
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Magnetic Resonance ◽  
Clinical Manifestations ◽  
Present Knowledge ◽  
Pathological Changes ◽  
White Matter Changes ◽  
Disease Evolution ◽  
Normal Appearing White Matter ◽  
Neurological Conditions

Several magnetic resonance (MR) techniques have proved to be sensitive enough to detect the subtle pathological changes that post-mortem studies showed to occur in the normal-appearing white matter (NAWM) from patients with multiple sclerosis (MS). Although these abnormalities can be detected in other neurological conditions, they seem to be more frequent and diffuse in MS. However, the contribution of NAWM changes to the diagnosis is still unclear. Their nature is also unknown and perhaps differs in different phases and clinical manifestations of the disease. Nevertheless, the extent and severity of NAWM damage seems to be relevant in causing disability and influencing the clinical evolution in MS patients. This review will summarize the present knowledge about MR-detected NAWM changes in MS and their relevance to the diagnosis and the understanding of disease evolution.

scholarly journals Subjective cognitive concern in multiple sclerosis is associated with reduced thalamic and cortical gray matter volumes

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731982761 ◽  
Author(s):  
Isaiah Kletenik ◽  
Enrique Alvarez ◽  
Justin M Honce ◽  
Brooke Valdez ◽  
Timothy L Vollmer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Dysfunction ◽  
Gray Matter ◽  
Brain Volume ◽  
Brain Magnetic Resonance Imaging ◽  
Regions Of Interest ◽  
Patient Reported ◽  
Cortical Gray Matter ◽  
Gray Matter Volumes ◽  
The Relationship

Objective Brain atrophy has been correlated with objective cognitive dysfunction in multiple sclerosis but few studies have explored self-reported subjective cognitive concerns and their relationship to brain volume changes. This study explores the relationship between subjective cognitive concerns in multiple sclerosis and reduced brain volume in regions of interest implicated in cognitive dysfunction. Methods A total of 158 patients with multiple sclerosis completed the Quality of Life in Neurologic Disorders Measures (Neuro-QoL) short forms to assess subjective cognitive concerns and underwent brain magnetic resonance imaging. Regional brain volumes from regions of interest implicated in cognitive dysfunction were measured using NeuroQuant automated volumetric quantitation. Linear regression was used to analyze the relationship between subjective cognitive concerns and brain volume. Results Controlling for age, disease duration, gender, depression and fatigue, increased subjective cognitive concerns were associated with reduced thalamic volume (standardized β = 0.223, t150 =2.406, P = 0.017) and reduced cortical gray matter volume (standardized β = 0.240, t150 = 2.777, P = 0.006). Increased subjective cognitive concerns were not associated with any other regions of interest that were analyzed. Conclusions Subjective cognitive concern in MS is associated with reduced thalamic and cortical gray matter volumes, areas of the brain that have been implicated in objective cognitive impairment. These findings may lend neuroanatomical significance to subjective cognitive concerns and patient-reported outcomes as measured by Neuro-QoL.

scholarly journals Thalamic Injury and Cognition in Multiple Sclerosis

2021 ◽  
Vol 11 ◽  
Author(s):  
Moein Amin ◽  
Daniel Ontaneda
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Gray Matter ◽  
Diffusion Tensor ◽  
Clinical Manifestations ◽  
White Matter Injury ◽  
Volume Loss ◽  
Thalamic Nuclei ◽  
Dorsomedial Nucleus ◽  
Deep Gray Matter

Multiple sclerosis (MS) produces demyelination and degeneration in both gray and white matter. Both cortical and deep gray matter injury is observed during the course of MS. Among deep gray matter structures, the thalamus has received special attention, as it undergoes volume loss in different MS subtypes and is involved in the earliest form of the disease, radiologically isolated syndrome. The thalamus plays an important role as an information relay center, and involvement of the thalamus in MS has been associated with a variety of clinical manifestations in MS, including fatigue, movement disorders, pain, and cognitive impairment (CI). Similar to thalamic volume loss, CI is seen from the earliest stages of MS and is potentially one of the most debilitating manifestations of the disease. The thalamus, particularly the dorsomedial nucleus as part of the basolateral limbic circuit and anterior thalamic nuclei through connections with the prefrontal cortex, has been shown to be involved in CI. Specifically, several cognitive performance measures such as processing speed and memory correlate with thalamic volume. Thalamic atrophy is one of the most important predictors of CI in MS, and both thalamic volume, diffusion tensor imaging measures, and functional activation correlate with the degree of CI in MS. Although the exact mechanism of thalamic atrophy is not well-understood, it is hypothesized to be secondary to degeneration following white matter injury resulting in secondary neurodegeneration and neuronal loss. The thalamus may represent an ideal biomarker for studies aiming to test neuroprotective or restorative therapies aimed at cognition.

Functional network connectivity abnormalities in multiple sclerosis: Correlations with disability and cognitive impairment

2017 ◽  
Vol 24 (4) ◽  
pp. 459-471 ◽  
Author(s):  
Maria A Rocca ◽  
Paola Valsasina ◽  
Victoria M Leavitt ◽  
Mariaemma Rodegher ◽  
Marta Radaelli ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Magnetic Resonance ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Network Connectivity ◽  
Resonance Imaging ◽  
T2 Lesions ◽  
Magnetic Resonance Imaging Mri

Objective: To investigate resting state (RS) functional connectivity (FC) abnormalities within the principal brain networks in a large cohort of multiple sclerosis (MS) patients, to define the trajectory of FC changes over disease stages and their relation with clinical and structural magnetic resonance imaging (MRI) measures. Methods: RS functional magnetic resonance imaging (fMRI), clinical, and neuropsychological evaluation were obtained from 215 MS patients and 98 healthy controls. Connectivity abnormalities and correlations with clinical/neuropsychological/imaging measures were evaluated. We analyzed seed-voxel FC with seven major hubs, producing one visual/sensory, one motor, two cognitive, one cerebellar, and two subcortical networks. Results: MS patients showed reduced network average RS FC versus controls in the default-mode network. At regional level, a complex pattern of decreased and increased RS FC was found. Reduced RS FC mainly involved sensorimotor, cognitive, thalamic, and cerebellar networks, whereas increased RS FC involved visual/sensory and subcortical networks. Reduced RS FC correlated with T2 lesions. Reduced thalamic RS FC correlated with better neuropsychological performance, whereas for all remaining networks reduced FC correlated with more severe clinical/cognitive impairment. Conclusion: Increased and decreased RS FC occurs in MS and contributes to a wide spectrum of clinical manifestations. RS FC reduction is related to T2 lesions. Such a paradigm is inverted for the thalamic network.

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