Gray Matter Correlates of Cognitive Performance Differ between Relapsing-Remitting and Primary-Progressive Multiple Sclerosis.
Multiple Sclerosis (MS) is a chronic inflammatory/demyelinating and neurodegenerative disease of the central nervous system (CNS). Most patients experience a relapsing-remitting (RR) course, while about 15-20% of patients experience a primary progressive (PP) course. Cognitive impairment affects approximately 40-70% of all MS patients and differences in cognitive impairment between RR-MS and PP-MS have been found. We aimed to compare RR-MS and PP-MS patients in terms of cognitive performance, and to investigate the MRI correlates of cognitive impairment in the two groups using measures of brain volumes and cortical thickness. Fifty-seven patients (42 RR-MS, 15 PP-MS) and thirty-eight matched controls underwent neuropsychological (NP) testing and MRI. PP-MS patients scored lower than RR-MS patients on most of the NP tests in absence of any specific pattern. PP-MS patients showed significantly lower caudate volume. There was no significant difference in MRI correlates of cognitive impairment between the two groups except for a prevalent association with MRI measures of cortical GM injury in RR-MS patients and with MRI measures of subcortical GM injury in PP-MS patients. This suggests that although cognitive impairment results from several factors, cortical and subcortical GM injury may play a different role depending on the disease course.
Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America; Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands.
Laura E
LE
Jonkman
Department of Radiology, New York University School of Medicine, New York, New York, United States of America; Department of Population Health, New York University School of Medicine, New York, New York, United States of America.
Diana M
DM
Rosenthal
Department of Health Sciences, University of Genoa, Genoa, Italy.
Maria Pia
MP
Sormani
Department of Radiology, New York University School of Medicine, New York, New York, United States of America.
Laura
L
Miles
Department of Neurology, New York University School of Medicine, New York, New York, United States of America.
Joseph
J
Herbert
Department of Radiology, New York University School of Medicine, New York, New York, United States of America.
Robert I
RI
Grossman
Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America; Department of Radiology, Mount Sinai School of Medicine, New York, New York, United States of America; Department of Neuroscience, Mount Sinai School of Medicine, New York, New York, United States of America; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
Matilde
M
Inglese
D000328:Adult; D001284:Atrophy / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D003071:Cognition / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology* / Q000523:psychology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology* / Q000523:psychology; D009483:Neuropsychological Tests; D009929:Organ Size; D012720:Severity of Illness Index