Executive Functions Impairment in Patients with Multiple Sclerosis in Relation to Lesion Burden in MRI: A Case-Control Study

Abstract

Background: Multiple Sclerosis (MS) is a chronic demyelinating autoimmune disease impacting the central nervous system. It manifests through various neurological dysfunctions, including cognitive impairments, especially in executive functions.Objective: This study aimed to explore the relationship between executive function impairment and lesion burden in MS as evidenced by MRI. Results:The MS patients demonstrated lower scores in the five words test (learning median score 4 vs. 5, p<0.001; recall median score 4.5 vs. 5, p<0.001) and Stroop Color-Word Test (SCWT) (median score in color naming 73.5 vs. 82.5, p=0.001). MRI assessments revealed a median of 6 lesions, predominantly in the parietal (84.8%) and frontal (78.3%) lobes. A significant positive correlation was found between the number of lesions and color test score (r=0.493, p=0.001) and a negative correlation with recall score (r=-0.334, p=0.023). Conclusions:The study demonstrated that there was a relationship between executive functions impairment in MS and lesion burden in MRI. This can be observed through significant difference between MS patients and healthy control group in tests of working memory and inhibition. Also, our findings suggest that site, number of lesions and brain atrophy in MRI correlated significantly with tests of working memory and inhibition.