title: Attention and processing speed performance in multiple sclerosis is mostly related to thalamic volume.
abstract: Cognitive impairment (CI), mainly involving attention and processing speed (A-PS), is a common and disabling symptom in multiple sclerosis (MS). Symbol Digit Modalities Test (SDMT) is one of the more sensitive and reliable tests to assess A-PS deficits in MS. Structural MRI correlates of A-PS in MS still need to be clarified. This study aimed to investigate, in a large group of MS patients, the relationship between regional gray matter (GM) atrophy and SDMT performance. 125 relapsing remitting MS patients and 52 healthy controls (HC) underwent a 3 T-MRI protocol including high-resolution 3D-T1 imaging. All subjects underwent a neurological evaluation and SDMT. A Voxel Based Morphometry analysis was performed to assess: 1) correlations between regional GM volume and SDMT performance in MS patients; 2) regional differences in GM volume between MS patients and HC. Thalamic, putamen and cerebellar volumes were also calculated using FIRST tool from the FMRIB Software Library. A linear regression analysis was performed to assess the contribution of each one of these structures to A-PS performance. A significant negative correlation was found between regional GM volume and SDMT score at the level of the thalamus, cerebellum, putamen, and occipital cortex in MS patients. Thalamus, cerebellum and putamen also showed significant GM atrophy in MS patients compared to HC. Thalamic atrophy is also an independent and additional contributor to A-PS deficits in MS patients. These findings support the role of thalamus as the most relevant GM structure subtending A-PS performance in MS, as measured by SDMT.
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.|MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy.
authors.forename: Alvino
authors.initials: A
authors.lastname: Bisecco
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.|Multiprofile Hospital For Active Treatment in Neurology and Psychiatry "St. Naum", Medical Faculty, Medical University, Sofia, Bulgaria.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Stamenova
authors.affiliation: MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Caiazzo
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: d'Ambrosio
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.|MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Sacco
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Docimo
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Esposito
authors.affiliation: MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy.|Neuroradiology Service, Department of Radiology, University of Campania "Luigi Vanvitelli", Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Cirillo
authors.affiliation: MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy.|Department of Medicine and Surgery, University of Salerno, Salerno, Baronissi, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Esposito
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.|MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Bonavita
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy.|MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Tedeschi
authors.affiliation: I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", piazza Miraglia, 2, 80138, Naples, Italy. antonio.gallo@unina2.it.|MRI Center "SUN-FISM", University of Campania "Luigi Vanvitelli" and Institute of Diagnosis and Care "Hermitage-Capodimonte", Naples, Italy. antonio.gallo@unina2.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallo
mesh_terms: D000328:Adult; D001284:Atrophy; D001288:Attention; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008606:Mental Processes; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000000981:diagnostic imaging* / Q000473:pathology / Q000523:psychology*; D009483:Neuropsychological Tests; D009929:Organ Size; D011699:Putamen / Q000000981:diagnostic imaging / Q000473:pathology; D013788:Thalamus / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Attention; Gray matter; Magnetic resonance imaging; Multiple sclerosis; Processing speed; Thalamus