Cognitive dysfunction and atrophic changes of selected cerebral structures in patients with relapsing-remitting multiple sclerosis.

Abstract

Purpose: The aim of this study was to compare the results of the selected neuropsychological tests in patients with newly diagnosed multiple sclerosis (MS) in relation to the selected volumetric brain measurements assessed by magnetic resonance imaging (MRI).

Methods: The study group consisted of 76 patients with newly diagnosed MS. Each patient underwent functional assessment using the Multiple Sclerosis Functional Composite Battery (MSFC), the Kurtzke Expanded Disability Status Scale (EDSS) and evaluation of cognitive function using a battery of tests. The patients also underwent head MRI with the assessment of the volume of the cortex and subcortical structures. Psychological assessment and head MRI were performed before initiating immunomodulatory treatment and after 12 months of follow-up.

Results: Positive correlations were obtained between partial brain volume and Paced Auditory Serial Addition Test (PASAT3"), total volume of grey matter and Selective Reminding Test (SRT) and Brief Visuospatial Memory Test - Recognition Discrimination (BVMT-RD), the cortical volume and PASAT3", SRT, Brief Visuospatial Memory Test - Revised (BVMT-R) and BVMT-RD in assessing the relationship between atrophic changes in brain structures and the severity of cognitive impairment in MS patients at baseline. Significant relationships were found between the volumetric parameters and SRT-D. Positive correlations were obtained between the volumetric parameters and the scores of PASAT3". No significant correlations were found between the severity of cognitive dysfunction and the duration of MS.

Conclusions: There is a clear need to evaluate particular cognitive domains in patients with MS as early as from the onset of the disease, and to perform long-term follow-up of these changes. The assessment of the two most frequently impaired cognitive domains could be a screening indicator for detecting cognitive dysfunction in MS patients.