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White matter tract abnormalities are associated with cognitive dysfunction in secondary progressive multiple sclerosis

Meijer, Kim A, Muhlert, Nils, Cercignani, Mara, Sethi, Varun, Ron, Maria A, Thompson, Alan J, Miller, David H, Chard, Declan, Geurts, Jeroen JG and Ciccarelli, Olga 2016. White matter tract abnormalities are associated with cognitive dysfunction in secondary progressive multiple sclerosis. Multiple Sclerosis Journal 22 (11) , pp. 1429-1437. 10.1177/1352458515622694

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Background: While our knowledge of white matter (WM) pathology underlying cognitive impairment in relapsing remitting multiple sclerosis (MS) is increasing, equivalent understanding in those with secondary progressive (SP) MS lags behind. Objective: The aim of this study is to examine whether the extent and severity of WM tract damage differ between cognitively impaired (CI) and cognitively preserved (CP) secondary progressive multiple sclerosis (SPMS) patients. Methods: Conventional magnetic resonance imaging (MRI) and diffusion MRI were acquired from 30 SPMS patients and 32 healthy controls (HC). Cognitive domains commonly affected in MS patients were assessed. Linear regression was used to predict cognition. Diffusion measures were compared between groups using tract-based spatial statistics (TBSS). Results: A total of 12 patients were classified as CI, and processing speed was the most commonly affected domain. The final regression model including demographic variables and radial diffusivity explained the greatest variance of cognitive performance (R2 = 0.48, p = 0.002). SPMS patients showed widespread loss of WM integrity throughout the WM skeleton when compared with HC. When compared with CP patients, CI patients showed more extensive and severe damage of several WM tracts, including the fornix, superior longitudinal fasciculus and forceps major. Conclusion: Loss of WM integrity assessed using TBSS helps to explain cognitive decline in SPMS patients.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Publisher: Sage
ISSN: 1352-4585
Date of Acceptance: 23 November 2015
Last Modified: 01 May 2019 13:33

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