title: Longitudinal MRI and neuropsychological assessment of patients with clinically isolated syndrome.
abstract: Cognitive impairment (CI) may occur in clinically isolated syndrome (CIS) patients. While the relationship between CI and magnetic resonance imaging (MRI) has been investigated extensively in multiple sclerosis (MS), MRI correlates of CI in CIS patients are unknown. To investigate the evolution of CI and to determine brain MRI structural correlates associated with CI in CIS patients. This prospective 24-month observational study examined 81 CIS patients treated with 30 µg of intramuscular interferon beta 1a once a week. MRI acquisition and neuropsychological (NP) assessment were performed at baseline, 6, 12 and 24 months. Participants were tested with Czech-validated version of Minimal Assessment of Cognitive Function in MS battery and MRI measures of lesion activity and burden, and global, tissue-specific and regional brain atrophy were performed. Over 24 months, 36 CIS patients developed clinically definite MS (CDMS). CI was observed in 10 (12.3 %) CIS patients at baseline and at the 24 months follow-up. Eight CIS patients changed their CI status over the follow-up (four improved and four worsened). No significant difference in development of CI was detected between stable CIS patients and those who developed CDMS. In multivariate regression and mixed-effect model analyses, no significant relationship was found between NP and MRI parameters. The lack of significant relationship between MRI metrics and cognition in this group of CIS patients could be attributed to several factors including the cognitive reserve, effect of disease-modifying therapy and relatively short follow-up period.
authors: Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic.
authors: Tomas
authors: T
authors: Uher
authors: Jana
authors: J
authors: Blahova-Dusankova
authors: Dana
authors: D
authors: Horakova
authors: Niels
authors: N
authors: Bergsland
authors: Michaela
authors: M
authors: Tyblova
authors: Ralph H B
authors: RH
authors: Benedict
authors: Tomas
authors: T
authors: Kalincik
authors: Deepa P
authors: DP
authors: Ramasamy
authors: Zdenek
authors: Z
authors: Seidl
authors: Jesper
authors: J
authors: Hagermeier
authors: Manuela
authors: M
authors: Vaneckova
authors: Jan
authors: J
authors: Krasensky
authors: Eva
authors: E
authors: Havrdova
authors: Robert
authors: R
authors: Zivadinov
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D003071:Cognition / Q000187:drug effects*; D060825:Cognitive Dysfunction / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D003711:Demyelinating Diseases / Q000188:drug therapy / Q000276:immunology / Q000473:pathology* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000008:administration & dosage / Q000494:pharmacology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology* / Q000523:psychology; D009483:Neuropsychological Tests; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D016899:Interferon-beta; D000068556:Interferon beta-1a