title: The relationship between cognitive function and high-resolution diffusion tensor MRI of the cingulum bundle in multiple sclerosis.
abstract: BACKGROUND
  Imaging can provide noninvasive neural markers of disease progression in multiple sclerosis (MS) that are related to behavioral and cognitive symptoms. Past work suggests that diffusion tensor imaging (DTI) provides a measure of white matter pathology, including demyelination and axonal counts.
  
  
  OBJECTIVE
  In the current study, the authors investigate the relationship of DTI measures in the cingulum bundle to common deficits in MS, including episodic memory, working memory, and information processing speed.
  
  
  METHODS
  Fifty-seven patients with MS and 17 age- and education-matched controls underwent high-spatial resolution diffusion scans and cognitive testing. Probabilistic tracking was used to generate tracks from the posterior cingulate cortex to the entorhinal cortex.
  
  
  RESULTS
  Radial and axial diffusivity values were significantly different between patients and controls (p < 0.031), and in patients bilateral diffusion measures were significantly related to measures of episodic memory and speed of processing (p < 0.033).
  
  
  CONCLUSIONS
  The tractography-based measures of posterior cingulum integrity reported here support further development of DTI as a viable measure of axonal integrity and cognitive function in patients with MS.
authors.affiliation: Imaging Institute, Cleveland Clinic, Cleveland, OH, USA koenigk@ccf.org.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Koenig
authors.affiliation: Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Ken E
authors.initials: KE
authors.lastname: Sakaie
authors.affiliation: Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Lowe
authors.affiliation: Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Lin
authors.affiliation: Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Lael
authors.initials: L
authors.lastname: Stone
authors.affiliation: Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bermel
authors.affiliation: Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Erik B
authors.initials: EB
authors.lastname: Beall
authors.affiliation: Schey Center for Cognitive Neuroimaging, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Rao
authors.affiliation: Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Trapp
authors.affiliation: Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Micheal D
authors.initials: MD
authors.lastname: Phillips
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D018450:Disease Progression; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology; D006801:Humans; D008297:Male; D061212:Memory, Episodic; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology*; D009434:Neural Pathways / Q000473:pathology; D011597:Psychomotor Performance / Q000502:physiology; D066127:White Matter / Q000473:pathology*
keywords: Multiple sclerosis; cingulate gyrus; cognition; diffusion tensor imaging; disease progression; episodic memory