title: Association of MRI metrics and cognitive impairment in radiologically isolated syndromes.
abstract: OBJECTIVE
  To evaluate cognitive changes in a cohort of radiologically isolated syndromes (RIS) suggestive of multiple sclerosis (MS) and to assess their relationship with quantitative magnetic resonance (MR) measures such as white matter (WM), lesion loads, and cerebral atrophy.
  
  
  METHODS
  We assessed the cognitive performance in a group of 29 subjects with RIS recruited from 5 Italian MS centers and in a group of 26 patients with relapsing-remitting MS (RRMS). A subgroup of 19 subjects with RIS, 26 patients with RRMS, and 21 healthy control (HC) subjects also underwent quantitative MR assessments, which included WM T1 and T2 lesion volumes and global and cortical brain volumes.
  
  
  RESULTS
  Cognitive impairment of the same profile as that of RRMS was found in 27.6% of our subjects with RIS. On MR scans, we found comparable levels of lesion loads and brain atrophy in subjects with RIS and well-established RRMS. In subjects with RIS, high T1 lesion volume (ρ = 0.526, p = 0.025) and low cortical volume (ρ = -0.481, p = 0.043) were associated with worse cognitive performance.
  
  
  CONCLUSIONS
  These findings emphasize the importance of including accurate neuropsychological testing and quantitative MR metrics in subjects with RIS suggestive of MS. They can provide a better characterization of these asymptomatic subjects, potentially useful for diagnostic and therapeutic decisions.
authors.affiliation: Department of Neurology, University of Florence, Florence, Italy. mariapia.amato@unifi.it
authors.forename: M P
authors.initials: MP
authors.lastname: Amato
authors.forename: B
authors.initials: B
authors.lastname: Hakiki
authors.forename: B
authors.initials: B
authors.lastname: Goretti
authors.forename: F
authors.initials: F
authors.lastname: Rossi
authors.forename: M L
authors.initials: ML
authors.lastname: Stromillo
authors.forename: A
authors.initials: A
authors.lastname: Giorgio
authors.forename: M
authors.initials: M
authors.lastname: Roscio
authors.forename: A
authors.initials: A
authors.lastname: Ghezzi
authors.forename: L
authors.initials: L
authors.lastname: Guidi
authors.forename: M L
authors.initials: ML
authors.lastname: Bartolozzi
authors.forename: E
authors.initials: E
authors.lastname: Portaccio
authors.forename: N
authors.initials: N
authors.lastname: De Stefano
mesh_terms: D000328:Adult; D001284:Atrophy; D001921:Brain / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology; D003072:Cognition Disorders / Q000473:pathology* / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000473:pathology / Q000523:psychology; D005221:Fatigue / Q000473:pathology / Q000523:psychology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007558:Italy; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000473:pathology / Q000523:psychology; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology / Q000523:psychology; D019636:Neurodegenerative Diseases / Q000473:pathology* / Q000523:psychology*; D009483:Neuropsychological Tests