title: Contribution of cortical lesion subtypes at 7T MRI to physical and cognitive performance in MS.
abstract: OBJECTIVE
  Evaluate cross-sectionally the contribution of focal cortical lesion (CL) subtypes at ultra-high-field MRI and traditional MRI metrics of brain damage to neurologic disability and cognitive performance in a heterogeneous multiple sclerosis (MS) cohort.
  
  
  METHODS
  Thirty-four patients with early or established disease including clinically isolated syndrome, relapsing-remitting MS, and secondary progressive MS were scanned on a human 7-tesla (7T) (Siemens) scanner to acquire fast low-angle shot (FLASH) T2*-weighted images for characterization of white matter and deep gray matter lesion volume, and CL types. Patients also underwent anatomical 3T MRI for cortical thickness estimation, and neuropsychological testing within 1 week of the 7T scan. Twenty-seven patient scans were acceptable for further analysis. Neurologic disability was measured using the Expanded Disability Status Scale.
  
  
  RESULTS
  Type III-IV CLs had the strongest relationship to physical disability (ρ = 0.670, p < 0.0001). White matter lesion volume and type I CLs are each significantly associated with 6 of 11 neuropsychological test variables. Type III-IV CLs significantly correlate with 4 of 11 neuropsychological test variables whereas type II CLs, deep gray matter lesion volume, and cortical thickness metrics are less frequently associated with cognitive performance.
  
  
  CONCLUSIONS
  Leukocortical (type I) and subpial (III-IV) CLs identified on 7T FLASH-T2* sequences are potential cortical biomarkers of cognitive and neurologic status in MS.
authors.affiliation: Virginia Mason Medical Center, Seattle, WA, USA.
authors.forename: A Scott
authors.initials: AS
authors.lastname: Nielsen
authors.forename: Revere P
authors.initials: RP
authors.lastname: Kinkel
authors.forename: Nancy
authors.initials: N
authors.lastname: Madigan
authors.forename: Emanuele
authors.initials: E
authors.lastname: Tinelli
authors.forename: Thomas
authors.initials: T
authors.lastname: Benner
authors.forename: Caterina
authors.initials: C
authors.lastname: Mainero
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D009483:Neuropsychological Tests