title: Neocortical volume decrease in relapsing-remitting multiple sclerosis with mild cognitive impairment.
abstract: The aim of the study was to assess neocortical changes and their relevance to cognitive impairment in early relapsing-remitting multiple sclerosis (RRMS). Conventional magnetic resonance was acquired in 41 RRMS patients and 16 demographically matched normal controls (NC). An automated analysis tool was used to obtain measures of cortical brain volumes normalized for head size. Neuropsychological performance of MS patients was assessed through the Rao's Brief Repeatable Battery. We identified 18 cognitively preserved (MS-cp) and 23 cognitively impaired (MS-ci) MS patients. Values of normalized cortical volumes (NCV) in the whole MS sample were lower than those in the NC group (p=0.01). MS-ci patients showed NCV values lower (p=0.02) than did both MS-cp patients and NC. Moreover, we found a positive correlation between NCV values and measures of verbal memory (r=0.51, p=0.02), verbal fluency (r=0.51, p=0.01) and attention/concentration (r=0.65, p<0.001) in MS-ci patients. Furthermore, NCV values were significantly decreased in patients who scored lower on a greater number of tests (r=-0.58, p<0.01) in the MS-ci group. Only MS-ci patients had cortical atrophy significantly correlated with a poorer neuropsychological performance. Grey matter pathology may contribute to the development of cognitive impairment in MS from the earliest stages of the disease.
authors.affiliation: Department of Neurology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy. portilio@tin.it
authors.forename: Emilio
authors.initials: E
authors.lastname: Portaccio
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Amato
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Bartolozzi
authors.forename: Valentina
authors.initials: V
authors.lastname: Zipoli
authors.forename: Marzia
authors.initials: M
authors.lastname: Mortilla
authors.forename: Leonello
authors.initials: L
authors.lastname: Guidi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Siracusa
authors.forename: Sandro
authors.initials: S
authors.lastname: Sorbi
authors.forename: Antonio
authors.initials: A
authors.lastname: Federico
authors.forename: Nicola
authors.initials: N
authors.lastname: De Stefano
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000473:pathology*; D019579:Neocortex / Q000473:pathology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D014706:Verbal Learning / Q000502:physiology