1. Home>
2. Specialties>
3. Neurology>
4. Summary and Comment

Neurocognitive Deficits Correlate with Brain Atrophy in MS

Patients with multiple sclerosis (MS) vary in the degree and pattern of their neuropsychological impairment. In this study, 41 patients with MS and 12 age- and sex-matched controls without MS underwent a battery of neuropsychological tests. The same 41 patients and 10 additional healthy controls underwent quantitative cranial MRI scans. Cognitive index scores (CIS) calculated from the neuropsychological tests were compared with normalized volumes of white matter, gray matter, ventricles, and corpus callosum.

Highly significant correlations of moderate strength were observed between CIS and volumes of white matter and of corpus callosum; MS patients had lower average CIS and smaller volumes than did controls. Ventricular and gray matter volumes did not correlate significantly with CIS. The authors conclude that subcortical pathology probably accounts for neuropsychological deficits in MS and that quantitative brain-volume estimates might prove useful in monitoring the effects of drug therapy during clinical trials.

Comment: This study adds to the growing literature on the relation between brain atrophy and neuropsychological impairment in MS. As the authors note, the findings are important because: (1) Neuropsychological impairment has been documented in 40 percent to 60 percent of patients with MS; (2) deficits are often subtle, and patients generally appear cognitively intact during routine neurologic visits; (3) deficits identified by comprehensive neuropsychological testing can affect social and vocational functioning; and (4) neuropsychological deficits are relatively independent of motor deficits such as gait impairment. These are compelling reasons to monitor neuropsychological functioning in patients with MS during both routine patient care and investigational drug treatment. The robust correlations between brain atrophy and neuropsychological performance in this study confirm prior work and suggest that reproducible image-analysis methods such as those used in this study will prove to be practical for monitoring this important aspect of MS.

— Richard A. Rudick, MD

Richard A. Rudick, MD, is Director, Mellen Center for Multiple Sclerosis, Department of Neurology, Cleveland Clinic Foundation, Cleveland, OH.

Published in Journal Watch Neurology November 21, 2001

Citation(s):

Edwards SGM et al. Cognitive correlates of supratentorial atrophy on MRI in multiple sclerosis. Acta Neurol Scand 2001 Oct 104 214-223.

• Medline abstract (Free)

2011 Top Stories