Pain, cognition and quality of life associate with structural measures of brain volume loss in multiple sclerosis.
BACKGROUND
Multiple sclerosis (MS) is characterized by physical and mental impairments that often result in pain and reduced quality of life.


OBJECTIVE
To understand the relationship of pain, quality of life, and cognition to structural measures of brain volume.


METHODS
Behavioral measures were assessed in a single session using standardized questionnaires and rating scales. Brain volume measures were assessed with structural magnetic resonance imaging (MRI).


RESULTS
Twenty-nine individuals with relapsing-remitting MS and 29 age-matched controls participated in this study. Pain, quality of life, and cognition were significantly interrelated. Higher fluid attenuation inversion recovery weighted lesion volume was significantly associated with increased reports of pain (p = 0.01), lower physical quality of life (p < 0.0001), and lower cognitive performance (p = 0.001) in our cohort.


CONCLUSIONS
Assessment of pain and quality of life along with structural MRI highlights the importance of understanding structure-function relationships in MS and suggests that therapists should not only evaluate individuals for cognition and quality of life, but should consider rehabilitation goals that target these areas.
Department of Physical Therapy, Wayne State University, Detroit, MI, USA.|Motion Analysis Laboratory, Kennedy Krieger Institute, Baltimore, MD, USA.|Johns Hopkins School of Medicine, Department of Physical Medicine & Rehabilitation, Baltimore, MD, USA.
Nora E
NE
Fritz
Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation, Bethesda, MD, USA.
Snehashis
S
Roy
Motion Analysis Laboratory, Kennedy Krieger Institute, Baltimore, MD, USA.
Jennifer
J
Keller
Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA.
Jerry
J
Prince
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Peter A
PA
Calabresi
Motion Analysis Laboratory, Kennedy Krieger Institute, Baltimore, MD, USA.|Johns Hopkins School of Medicine, Department of Physical Medicine & Rehabilitation, Baltimore, MD, USA.|Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Kathleen M
KM
Zackowski
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000000981:diagnostic imaging* / Q000523:psychology; D009483:Neuropsychological Tests; D009929:Organ Size; D010146:Pain / Q000000981:diagnostic imaging* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires
MRI; Multiple Sclerosis; brain volume; cognition; lesion volume; pain; quality of life
PLoS One. 2013 May 16;8(5):e63250
23696802
Neurology. 2009 May 19;72(20):1760-5
19451531
Neuroimage. 2002 Oct;17(2):825-41
12377157
Mult Scler. 2005 Jun;11(3):322-7
15957515
Mult Scler. 2005 Oct;11(5):524-31
16193889
IEEE Trans Med Imaging. 2010 Jun;29(6):1310-20
20378467
J Vis Exp. 2016 Jan 29;(107):e53449
26863451
J Clin Exp Neuropsychol. 2014;36(8):887-96
25338929
Qual Life Res. 1995 Jun;4(3):187-206
7613530
Mult Scler Relat Disord. 2014 Nov;3(6):720-7
25891551
IEEE J Biomed Health Inform. 2015 Sep;19(5):1598-609
26340685
Int J MS Care. 2015 Nov-Dec;17(6):268-74
26664332
Ann Neurol. 2007 Oct;62(4):335-46
17696126
Neuroimage. 2011 Jan 1;54(1):313-27
20656036
Mult Scler. 2012 Jul;18(7):914-24
22740603
Ann Acad Med Singapore. 1994 Mar;23(2):129-38
8080219
Med Care. 1992 Jun;30(6):473-83
1593914
Clin Neuropsychol. 2002 Aug;16(3):381-97
12607150
Neurorehabil Neural Repair. 2015 Jan;29(1):62-9
24795162
Neurol Sci. 2016 Feb;37(2):165-79
26537494
Neural Plast. 2015;2015:481574
26064692
Pain. 2005 Apr;114(3):473-81
15777872
J Allied Health. 2012 Spring;41(1):35-41
22544406
Clin Rehabil. 2006 Jan;20(1):67-78
16502752
Neuroimage. 2010 Jan 15;49(2):1524-35
19766196
Med Care. 1994 Jan;32(1):40-66
8277801
Ann Neurol. 2005 Dec;58(6):840-6
16283615
Int Rev Neurobiol. 2007;79:303-21
17531847
PLoS One. 2015 Mar 27;10(3):e0120754
25816303
Arch Neurol. 2000 Oct;57(10):1485-91
11030802
Proc SPIE Int Soc Opt Eng. 2014 Feb 15;9034:
27795605
Neuroimage. 2011 Jun 15;56(4):1982-92
21458576
Mult Scler. 2005 Aug;11(4):450-8
16042229
J Neurol Sci. 2014 Jul 15;342(1-2):62-8
24819917
Neuroimage Clin. 2014 Jul 05;5:322-31
25161898
J Neurovirol. 2000 May;6 Suppl 2:S186-90
10871811
Pain. 2008 Jul;137(1):96-111
17928147
Neurology. 2003 Jan 14;60(1):31-6
12525714
PLoS One. 2012;7(5):e37049
22615886
Neurol Sci. 2010 Nov;31(Suppl 2):S211-4
20640466
Neurology. 2015 May 19;84(20):2048-56
25878185
J Int Neuropsychol Soc. 2006 Jul;12(4):549-58
16981607
Mult Scler. 2013 Sep;19(10):1290-6
23459568
J Pain Symptom Manage. 2006 Sep;32(3):217-29
16939846