title: T1 cortical hypointensities and their association with cognitive disability in multiple sclerosis.
abstract: BACKGROUND
  Neocortical lesions (NLs) largely contribute to the pathology of multiple sclerosis (MS), although their relevance in patients' disability remains unknown.
  
  
  OBJECTIVE
  To assess the incidence of T(1) hypointense NLs by 3.0-Tesla magnetic resonance imaging (MRI) in patients with MS and examine neocortical lesion association with cognitive impairment.
  
  
  METHODS
  In this case-control study, 21 MS patients and 21 age-, sex- and years of education-matched healthy volunteers underwent: (i) a neuropsychological examination rating cognitive impairment (Minimal Assessment of Cognitive Function in MS); (ii) a 3.0-Tesla MRI inclusive of an isotropic 1.0 mm(3) three-dimensional inversion prepared spoiled gradient-recalled-echo (3D-IRSPGR) image and T(1)- and T(2)-weighted images. Hypointensities on 3D-IRSPGR lying in the cortex, either entirely or partially were counted and association between NLs and cognitive impairment investigated.
  
  
  RESULTS
  A total of 95 NLs were observed in 14 (66.7%) patients. NL+ patients performed poorer (p = 0.020) than NL-patients only on the delayed recall component of the California Verbal Learning Test. This difference lost statistical significance when a correction for white matter lesion volume was employed.
  
  
  CONCLUSIONS
  Although T( 1) hypointense NLs may be present in a relatively high proportion of multiple sclerosis patients, the impact that they have in cognitive impairment is not independent from white matter disease.
authors.affiliation: Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1400, USA. bagnatof@ninds.nih.gov
authors.forename: Francesca
authors.initials: F
authors.lastname: Bagnato
authors.forename: Zeena
authors.initials: Z
authors.lastname: Salman
authors.forename: Robert
authors.initials: R
authors.lastname: Kane
authors.forename: Sungyoung
authors.initials: S
authors.lastname: Auh
authors.forename: Fredric K
authors.initials: FK
authors.lastname: Cantor
authors.forename: Mary
authors.initials: M
authors.lastname: Ehrmantraut
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallo
authors.forename: Vasiliki N
authors.initials: VN
authors.lastname: Ikonomidou
authors.forename: Joan
authors.initials: J
authors.lastname: Ohayon
authors.forename: Clelia
authors.initials: C
authors.lastname: Pellicano
authors.forename: Susan K
authors.initials: SK
authors.lastname: Stern
authors.forename: Henry F
authors.initials: HF
authors.lastname: McFarland
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology* / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology* / Q000523:psychology*; D009483:Neuropsychological Tests; D014706:Verbal Learning / Q000502:physiology; D055815:Young Adult