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Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis.
Arch Neurol 2009; 66(9):1144-50AN

Abstract

BACKGROUND

Neuropsychological deficits in patients with multiple sclerosis (MS) have been shown to be associated with the major pathological substrates of the disease, ie, inflammatory demyelination and neurodegeneration. Double inversion recovery sequences allow cortical lesions (CLs) to be detected in the brain of patients with MS. Modern postprocessing techniques allow cortical atrophy to be assessed reliably.

OBJECTIVE

To investigate the contribution of cortical gray matter lesions and tissue loss to cognitive impairment in patients with relapsing-remitting MS.

DESIGN

Cross-sectional survey.

SETTING

Referral, hospital-based MS clinic. Patients Seventy patients with relapsing-remitting MS.

MAIN OUTCOME MEASURES

Neuropsychological performance was tested using the Rao Brief Repeatable Battery of Neuropsychological Tests, version A. Patients who scored 2 SDs below the mean normative values on at least 1 test of the Rao Brief Repeatable Battery of Neuropsychological Tests, version A, were considered to be cognitively impaired. A composite cognitive score (the cognitive impairment index) was computed. T2 hyperintense white matter lesion volume, contrast-enhancing lesion number, CL number and volume, normalized brain volume, and normalized neocortical gray matter volume were also assessed.

RESULTS

Twenty-four patients with relapsing-remitting MS (34.3%) were classified as cognitively impaired. T2 hyperintense white matter lesion volume and contrast-enhancing lesion number were not different between cognitively impaired and cognitively unimpaired patients. Cognitively impaired patients had a higher CL number (P = .01) and volume (P < .001) and decreased normalized brain volume (P = .02) and normalized neocortical gray matter volume (P = .002) when compared with cognitively unimpaired patients. Multivariate analysis revealed that age (beta = 0.228; P = .02), CL volume (beta = 0.452; P < .001), and normalized neocortical gray matter volume (beta = 0.349; P < .001) were independent predictors of the cognitive impairment index (r(2) = 0.55; F = 23.903; P < .001).

CONCLUSION

The burden of CLs and tissue loss are among the major structural changes associated with cognitive impairment in relapsing-remitting MS.

Authors+Show Affiliations

Multiple Sclerosis Centre of Veneto Region, First Neurology Clinic, Department of Neurosciences, University Hospital of Padua.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19752305

Citation

Calabrese, Massimiliano, et al. "Cortical Lesions and Atrophy Associated With Cognitive Impairment in Relapsing-remitting Multiple Sclerosis." Archives of Neurology, vol. 66, no. 9, 2009, pp. 1144-50.
Calabrese M, Agosta F, Rinaldi F, et al. Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis. Arch Neurol. 2009;66(9):1144-50.
Calabrese, M., Agosta, F., Rinaldi, F., Mattisi, I., Grossi, P., Favaretto, A., ... Filippi, M. (2009). Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis. Archives of Neurology, 66(9), pp. 1144-50. doi:10.1001/archneurol.2009.174.
Calabrese M, et al. Cortical Lesions and Atrophy Associated With Cognitive Impairment in Relapsing-remitting Multiple Sclerosis. Arch Neurol. 2009;66(9):1144-50. PubMed PMID: 19752305.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis. AU - Calabrese,Massimiliano, AU - Agosta,Federica, AU - Rinaldi,Francesca, AU - Mattisi,Irene, AU - Grossi,Paola, AU - Favaretto,Alice, AU - Atzori,Matteo, AU - Bernardi,Valentina, AU - Barachino,Luigi, AU - Rinaldi,Luciano, AU - Perini,Paola, AU - Gallo,Paolo, AU - Filippi,Massimo, PY - 2009/9/16/entrez PY - 2009/9/16/pubmed PY - 2009/10/24/medline SP - 1144 EP - 50 JF - Archives of neurology JO - Arch. Neurol. VL - 66 IS - 9 N2 - BACKGROUND: Neuropsychological deficits in patients with multiple sclerosis (MS) have been shown to be associated with the major pathological substrates of the disease, ie, inflammatory demyelination and neurodegeneration. Double inversion recovery sequences allow cortical lesions (CLs) to be detected in the brain of patients with MS. Modern postprocessing techniques allow cortical atrophy to be assessed reliably. OBJECTIVE: To investigate the contribution of cortical gray matter lesions and tissue loss to cognitive impairment in patients with relapsing-remitting MS. DESIGN: Cross-sectional survey. SETTING: Referral, hospital-based MS clinic. Patients Seventy patients with relapsing-remitting MS. MAIN OUTCOME MEASURES: Neuropsychological performance was tested using the Rao Brief Repeatable Battery of Neuropsychological Tests, version A. Patients who scored 2 SDs below the mean normative values on at least 1 test of the Rao Brief Repeatable Battery of Neuropsychological Tests, version A, were considered to be cognitively impaired. A composite cognitive score (the cognitive impairment index) was computed. T2 hyperintense white matter lesion volume, contrast-enhancing lesion number, CL number and volume, normalized brain volume, and normalized neocortical gray matter volume were also assessed. RESULTS: Twenty-four patients with relapsing-remitting MS (34.3%) were classified as cognitively impaired. T2 hyperintense white matter lesion volume and contrast-enhancing lesion number were not different between cognitively impaired and cognitively unimpaired patients. Cognitively impaired patients had a higher CL number (P = .01) and volume (P < .001) and decreased normalized brain volume (P = .02) and normalized neocortical gray matter volume (P = .002) when compared with cognitively unimpaired patients. Multivariate analysis revealed that age (beta = 0.228; P = .02), CL volume (beta = 0.452; P < .001), and normalized neocortical gray matter volume (beta = 0.349; P < .001) were independent predictors of the cognitive impairment index (r(2) = 0.55; F = 23.903; P < .001). CONCLUSION: The burden of CLs and tissue loss are among the major structural changes associated with cognitive impairment in relapsing-remitting MS. SN - 1538-3687 UR - https://www.unboundmedicine.com/medline/citation/19752305/Cortical_lesions_and_atrophy_associated_with_cognitive_impairment_in_relapsing_remitting_multiple_sclerosis_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneurol.2009.174 DB - PRIME DP - Unbound Medicine ER -