Cognitive Impairment In Multiple Sclerosis:
Changes In Normal-Appearing Brain Tissue

Filippi M, Tortorella C, Rovaris M, Bozzali M, Possa F, Sormani MP, Iannucci G, Comi G
J Neurol NeuroSurg Psychiatry 2000 Feb;68(2):157-161
Scientific Institute, Ospedale San Raffaele, NeuroImaging Research Unit, Dept of NeuroScience, Milan, Italy
PMID# 10644780

To assess whether:

  • The changes in the Normal-Appearing Brain Tissue (NABT), as revealed by Magnetization Transfer (MT) Histogram analysis, correlates with Cognitive Dysfunction in patients with Multiple Sclerosis

  • The relative contribution of these changes by comparison with that of Multiple Sclerosis lesions visible on conventional MRI

Dual echo, T1weighted and MT scans of the Brain were obtained in 12 patients with Multiple Sclerosis with Cognitive Impairment and in seven Without Cognitive Impairment. Lesion Loads were assessed from T2 and T1 weighted scans.

To create MTR Histograms of the NABT, Multiple Sclerosis Lesion outlines from Dual Echo scans were superimposed automatically and nulled out from the coregistered and scalp stripped MTR maps.

Average lesion MT Ratio (MTR) and Brain size were also measured.

T2 and T1 lesion loads were significantly higher and the average lesion MTR and Brain size were significantly lower in the group of Cognitively Impaired patients.

Patients with Cognitive deficits also had significantly lower average MTR and peak location of the NABT Histogram.

Logistic regression analysis showed that 68% of the total variance was explained by average NABT-MTR alone.

A multivariable regression model showed that NABT-MTR was the only factor that significantly correlated with Cognitive Impairment in these patients (p=0.001).

The extent of abnormalities which go undetected when using conventional MRI is relevant in determining Cognitive Impairment in Multiple Sclerosis.

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