title: Regional cortical thinning in multiple sclerosis and its relation with cognitive impairment: A multicenter study.
abstract: The objectives of this paper are to compare in a multicenter setting patterns of regional cortical thickness in patients with relapsing-remitting multiple sclerosis (RRMS) and cognitive impairment (CI) and those cognitively preserved (CP), and explore the relationship between cortical thinning and cognitive performance.
  
  
  
  T1-weighted isotropic brain scans were collected at 3T from seven European centers in 60 RRMS patients and 65 healthy controls (HCs). Patients underwent clinical and neuropsychological examinations. Cortical thickness (CTh) measures were calculated using FreeSurfer (failing in four) and both lobar and vertex-based general linear model (GLM) analyses were compared between study groups.
  
  
  
  Twenty (36%) MS patients were classified as CI. Mean global CTh was smaller in RRMS patients compared to HCs (left 2.43 vs. 2.53 mm, right 2.44 vs. 2.54 mm, p < 0.001). Multivariate GLM regional analysis showed significantly more temporal thinning in CI compared to CP patients. Verbal memory scores correlated to regional cortical thinning in the insula whereas visual memory scores correlated to parietal thinning.
  
  
  
  This multicenter study showed mild global cortical thinning in RRMS. The extent of thinning is less pronounced than previously reported. Only subtle regional differences between CI and CP patients were observed, some of which related to specific cognitive domains.
authors.affiliation: Department of Neurology, Mayo Clinic, USA/Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Tillema
authors.affiliation: Department of Anatomy and Neurosciences, VU University Medical Center, The Netherlands.
authors.forename: H E
authors.initials: HE
authors.lastname: Hulst
authors.affiliation: Neuroimaging Research Unit, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy/Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Rocca
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands/Department of Physics and Medical Technology, VU University Medical Center, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Vrenken
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands.
authors.forename: M D
authors.initials: MD
authors.lastname: Steenwijk
authors.affiliation: Neuroimaging Research Unit, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Damjanovic
authors.affiliation: Department of Neurology and Division of Neuroradiology, Department of Radiology, Medical University of Graz, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Enzinger
authors.affiliation: Department of Neurology and Division of Neuroradiology, Department of Radiology, Medical University of Graz, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Ropele
authors.affiliation: MRI Center "SUN-FISM," Second University of Naples and Institute of Diagnosis and Care "Hermitage-Capodimonte," Italy/Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Tedeschi
authors.affiliation: MRI Center "SUN-FISM," Second University of Naples and Institute of Diagnosis and Care "Hermitage-Capodimonte," Italy/Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gallo
authors.affiliation: NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, UK/National Institute for Health Research (NIHR) University College London Hospital (UCLH) Biomedical Research Centre (BRC).
authors.forename: O
authors.initials: O
authors.lastname: Ciccarelli
authors.affiliation: Magnetic Resonance Unit, Department of Radiology, Hospital Universitari Vall d'Hebron, Spain/Unitat de Neuroimmunologia Clinica, CEM-Cat, Hospital Universitari Vall d'Hebron, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rovira
authors.affiliation: Unitat de Neuroimmunologia Clinica, CEM-Cat, Hospital Universitari Vall d'Hebron, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Montalban
authors.affiliation: Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
authors.forename: N
authors.initials: N
authors.lastname: de Stefano
authors.affiliation: Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Stromillo
authors.affiliation: Neuroimaging Research Unit, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy/Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Filippi
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands f.barkhof@vumc.nl.
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012307:Risk Factors
keywords: MRI; Multiple sclerosis; cognitive impairment; cortical atrophy