T1 cortical hypointensities and their association with cognitive disability in multiple sclerosis

Bagnato, Francesca; Salman, Zeena; Kane, Robert; Sungyoung Auh; Cantor, Fredric K.; Ehrmantraut, Mary; Gallo, Antonio; Ikonomidou, Vasiliki N.; Ohayon, Joan; Pellicano, Clelia; Stern, Susan K.; McFarland, Henry F.
October 2010
Multiple Sclerosis (13524585);Oct2010, Vol. 16 Issue 10, p1203
Academic Journal
Background: Neocortical lesions (NLs) largely contribute to the pathology of multiple sclerosis (MS), although their relevance in patients' disability remains unknown. Objective: To assess the incidence of T1 hypointense NLs by 3.0-Tesla magnetic resonance imaging (MRI) in patients with MS and examine neocortical lesion association with cognitive impairment. Methods: In this case-control study, 21 MS patients and 21 age-, sex- and years of education-matched healthy volunteers underwent: (i) a neuropsychological examination rating cognitive impairment (Minimal Assessment of Cognitive Function in MS); (ii) a 3.0-Tesla MRI inclusive of an isotropic 1.0 mm³ three-dimensional inversion prepared spoiled gradientrecalled- echo (3D-IRSPGR) image and T1- and T2-weighted images. Hypointensities on 3D-IRSPGR lying in the cortex, either entirely or partially were counted and association between NLs and cognitive impairment investigated. Results: A total of 95 NLs were observed in 14 (66.7%) patients. NL+ patients performed poorer (p=0.020) than NLpatients only on the delayed recall component of the California Verbal Learning Test. This difference lost statistical significance when a correction for white matter lesion volume was employed. Conclusions: Although T1 hypointense NLs may be present in a relatively high proportion of multiple sclerosis patients, the impact that they have in cognitive impairment is not independent from white matter disease.


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