Serial neuropsychological assessment and magnetic resonance imaging analysis in multiple sclerosis.
OBJECTIVE
To assess the correlation between cognitive dysfunction and disease burden in multiple sclerosis (MS) during a 1-year period.


METHODS
The Brief, Repeatable Battery of Neuropsychological Tests in Multiple Sclerosis was performed at entrance and 1 year. Patients underwent at least 20 proton density (range, 20-24) and T2-weighted axial magnetic resonance imaging (MRI) brain scans except for stable patients who were scanned monthly. Magnetic resonance imaging was evaluated using computer-automated, 3-dimensional volumetric analysis.


METHODS
A research clinic of a university hospital.


METHODS
Forty-four patients with MS of the following disease categories: relapsing-remitting (14), relapsing-remitting progressive (12), chronic progressive (13), and stable (5).


METHODS
The relationships between scores on the Brief, Repeatable Battery of Neuropsychological Tests in Multiple Sclerosis and 2 MRI measures (total lesion volume and brain to intracranial cavity volume ratio) were assessed using linear regression. These MRI measures were also compared with cognitive status at 1 year using analysis of variance.


RESULTS
Overall, there was no decline in mean cognitive test performance during 1 year. Significant correlations were found between baseline neuropsychological test scores of nonverbal memory, information-processing speed, and attention and both MRI measures. Patients with chronic progressive MS demonstrated the strongest correlations. At 1 year, change in information-processing speed and attention correlated with change in total lesion volume. The mean increase in total lesion volume was 5.7 mL for 4 patients whose cognitive status worsened compared with 0.4 mL for 19 patients who improved and 0.5 mL for 21 patients who remained stable.


CONCLUSIONS
During a 1-year period mean cognitive performance did not worsen. Automated volumetric MRI measures of total lesion volume and brain to intracranial cavity volume ratio correlated with neuropsychological performance, especially in patients with chronic progressive MS. Worsening MRI lesion burden correlated with cognitive decline.
Hohol
M J
MJ
Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, MA 02115, USA.
Guttmann
C R
CR
Orav
J
J
Mackin
G A
GA
Kikinis
R
R
Khoury
S J
SJ
Jolesz
F A
FA
Weiner
H L
HL
D000328:Adult; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology* / Q000523:psychology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales