TY - JOUR
T1 - Lesion Load May Predict Long-Term Cognitive Dysfunction in Multiple Sclerosis Patients
AU - Realmuto, Sabrina
AU - Savettieri, Giovanni
AU - D'Ambrosio, Alessandro
AU - De Stefano, Manuela
AU - Chisari, Clara Grazia
AU - Viterbo, Rosa
AU - Valentino, Paola
AU - Gallo, Antonio
AU - Ippolito, Domenico
AU - Vacchiano, Veria
AU - Lanzillo, Roberta
AU - Buccafusca, Maria
AU - Montella, Patrizia
AU - Paolicelli, Damiano
AU - Morra, Vincenzo Brescia
AU - Valentino, Paola
AU - Bonavita, Simona
AU - Zappia, Mario
AU - Simone, Isabella
AU - Alfano, Bruno
AU - Messina, Silvia
AU - Patti, Francesco
AU - Tedeschi, Gioacchino
AU - Lavorgna, Luigi
AU - Coniglio, Gabriella
PY - 2015
Y1 - 2015
N2 - BACKGROUND: Magnetic Resonance Imaging (MRI) techniques provided evidences into the understanding of cognitive impairment (CIm) in Multiple Sclerosis (MS).OBJECTIVES: To investigate the role of white matter (WM) and gray matter (GM) in predicting long-term CIm in a cohort of MS patients.METHODS:303 out of 597 patients participating in a previous multicenter clinical-MRI study were enrolled (49.4% were lost at follow-up). The following MRI parameters, expressed as fraction (f) of intracranial volume, were evaluated: cerebrospinal fluid (CSF-f), WM-f, GM-f and abnormal WM (AWM-f), a measure of lesion load. Nine years later, cognitive status was assessed in 241 patients using the Symbol Digit Modalities Test (SDMT), the Semantically Related Word List Test (SRWL), the Modified Card Sorting Test (MCST), and the Paced Auditory Serial Addition Test (PASAT). In particular, being SRWL a memory test, both immediate recall and delayed recall were evaluated. MCST scoring was calculated based on the number of categories, number of perseverative and non-perseverative errors.RESULTS: AWM-f was predictive of an impaired performance 9 years ahead in SDMT (OR 1.49, CI 1.12-1.97 p = 0.006), PASAT (OR 1.43, CI 1.14-1.80 p = 0.002), SRWL-immediate recall (OR 1.72 CI 1.35-2.20 p<0.001), SRWL-delayed recall (OR 1.61 CI 1.28-2.03 p<0.001), MCST-category (OR 1.52, CI 1.2-1.9 p<0.001), MCST-perseverative error(OR 1.51 CI 1.2-1.9 p = 0.001), MCST-non perseverative error (OR 1.26 CI 1.02-1.55 p = 0.032).CONCLUSION: In our large MS cohort, focal WM damage appeared to be the most relevant predictor of the long-term cognitive outcome
AB - BACKGROUND: Magnetic Resonance Imaging (MRI) techniques provided evidences into the understanding of cognitive impairment (CIm) in Multiple Sclerosis (MS).OBJECTIVES: To investigate the role of white matter (WM) and gray matter (GM) in predicting long-term CIm in a cohort of MS patients.METHODS:303 out of 597 patients participating in a previous multicenter clinical-MRI study were enrolled (49.4% were lost at follow-up). The following MRI parameters, expressed as fraction (f) of intracranial volume, were evaluated: cerebrospinal fluid (CSF-f), WM-f, GM-f and abnormal WM (AWM-f), a measure of lesion load. Nine years later, cognitive status was assessed in 241 patients using the Symbol Digit Modalities Test (SDMT), the Semantically Related Word List Test (SRWL), the Modified Card Sorting Test (MCST), and the Paced Auditory Serial Addition Test (PASAT). In particular, being SRWL a memory test, both immediate recall and delayed recall were evaluated. MCST scoring was calculated based on the number of categories, number of perseverative and non-perseverative errors.RESULTS: AWM-f was predictive of an impaired performance 9 years ahead in SDMT (OR 1.49, CI 1.12-1.97 p = 0.006), PASAT (OR 1.43, CI 1.14-1.80 p = 0.002), SRWL-immediate recall (OR 1.72 CI 1.35-2.20 p<0.001), SRWL-delayed recall (OR 1.61 CI 1.28-2.03 p<0.001), MCST-category (OR 1.52, CI 1.2-1.9 p<0.001), MCST-perseverative error(OR 1.51 CI 1.2-1.9 p = 0.001), MCST-non perseverative error (OR 1.26 CI 1.02-1.55 p = 0.032).CONCLUSION: In our large MS cohort, focal WM damage appeared to be the most relevant predictor of the long-term cognitive outcome
UR - http://hdl.handle.net/10447/132852
M3 - Article
SN - 1932-6203
VL - 10
JO - PLoS One
JF - PLoS One
ER -