title: Relationship between brain volume loss and cognitive outcomes among patients with multiple sclerosis: a systematic literature review.
abstract: Patients with multiple sclerosis (MS) experience varying rates of brain volume (BV) loss ranging from 0.5 to 1.5 % per year. In addition, 66 % of patients with MS experience cognitive impairment, resulting in impact on daily activities. A systematic literature review (2003-2013) was conducted to identify all studies reporting a relationship between whole BV measures and selected patient outcomes measuring cognition, including the Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT) and MS Functional Composite (MSFC) scores. We identified 18 studies reporting associations between whole BV and cognitive outcomes. Six studies (33 %) examined the association between BV and SDMT; all six studies reported that BV loss (BVL) was significantly associated with a decline in SDMT scores (all p < 0.05). Among 14 studies (78 %) that examined the association between BV and PASAT scores, 12 (86 %) found a significant relationship between BVL and lower PASAT scores (all p < 0.05). Of the seven studies (39 %) that looked at BV and MSFC, six studies (86 %) found BVL significantly associated with lower MSFC scores (all p < 0.05). Our study demonstrated that BVL is associated with declines in cognition in MS patients across several cognition measures. The results of this study suggest that BV is a critical component of disease activity and progression in MS and has implications for treatment decisions to minimize BVL and preserve cognitive functioning.
authors.affiliation: Department of Neurology, University of Colorado Denver, 12631 East 17th Avenue, Aurora, CO, 80045, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Vollmer
authors.affiliation: Analysis Group, Inc., 111 Huntington Avenue, 10th floor, Boston, MA, 02199, USA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Huynh
authors.affiliation: Analysis Group, Inc., 111 Huntington Avenue, 10th floor, Boston, MA, 02199, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kelley
authors.affiliation: Analysis Group, Inc., 111 Huntington Avenue, 10th floor, Boston, MA, 02199, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Galebach
authors.affiliation: Analysis Group, Inc., 111 Huntington Avenue, 10th floor, Boston, MA, 02199, USA. james.signorovitch@analysisgroup.com.
authors.forename: James
authors.initials: J
authors.lastname: Signorovitch
authors.affiliation: Novartis Pharmaceuticals Corporation, 1 Health Plaza, East Hannover, NJ, 07936, USA.
authors.forename: Allitia
authors.initials: A
authors.lastname: DiBernardo
authors.affiliation: Novartis Pharmaceuticals Corporation, 1 Health Plaza, East Hannover, NJ, 07936, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Sasane
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000473:pathology; D009483:Neuropsychological Tests
keywords: Brain volume loss; Cognition; Multiple sclerosis; Patient outcomes; Systematic literature review