Neuroimaging findings in multiple sclerosis with cognitive deficits
Keywords:
multiple sclerosis, cognitive deficiency, magnetic resonance imaging, voxel-based morphometryAbstract
Neuropsychological studies have identified cognitive dysfunctions in more than 40% of patients with multiple sclerosis.
Seriously disabling cognitive impairment in MS patients is associated with involvement of both white and gray matter, but more important is the neurodegenerative processes in the cortical and subcortical gray structures.
Multiple T2-lesions in white matter are associated with impaired metabolism in the cerebral hemispheres due to discontinuous projections between deep gray structures and functionally significant cortical areas.
After further post-processing of the MRI images with the socalled. voxel-based morphometry revealed that total volume loss of the brain parenchyma, as well as atrophic changes in certain brain structures (thalamus, nucleus caudatus, nucleus lentiformis, corpus callosum), are strongly correlated with cognitive deficits in MS.
Cognitive deficits in MS patients correlate with a greater number of cortical lesions. Of particular interest are subpial cortical lesions, which may involve a large extension of the cerebral cortex and are associated with marked cognitive deficits in primary or secondary progressive forms of MS.
In conclusion, MRI with subsequent voxel-based morphometry are essential for characterizing and staging the multiple CNS pathological processes relevant to cognitive deficits in MS.
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Copyright (c) 2019 Nikolay Topalov
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