Memory impairment in multiple sclerosis: correlation with deep grey matter and mesial temporal atrophy

Benedict, Ralph H. B.; Ramasamy, Deepa P.; Munschauer, Frederick E.; Weinstock‐Guttman, Bianca; Zivadinov, Robert

doi:10.1136/jnnp.2008.148403

Cited by 182 publications

(172 citation statements)

References 61 publications

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“…8,10,13 Hippocampal atrophy has been described in RRMS and progressive MS and has been related to both memory deficits and depressive symptoms. 8,16,30,35,36 However, this is the first study to report evidence of hippocampal atrophy in patients with CIS. This finding is contrary to what has been previously reported by our own group 8 and is probably related to the much larger sample size of patients with CIS in this study.…”

Section: Discussionmentioning

confidence: 75%

Subcortical and Cortical Gray Matter Atrophy in a Large Sample of Patients with Clinically Isolated Syndrome and Early Relapsing-Remitting Multiple Sclerosis

Bergsland

Horáková²,

Dwyer

et al. 2012

AJNR Am J Neuroradiol

141

134

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BACKGROUND AND PURPOSE:Recent studies have shown that selective regional, but not global, GM atrophy occurs from clinical onset to conversion to clinically definite MS. Our aim was to investigate the difference in the extent of SDGM and cortical atrophy in a large sample of patients with CIS and early RRMS and to explore the relationship between SDGM and cortical atrophy and other MR imaging and clinical outcomes. MATERIALS AND METHODS:Two hundred twelve patients with CIS recruited at the first clinical event (mean age, 29.3 years; median EDSS, 1.5; median disease duration, 3 months) and 177 patients with early RRMS (mean age, 30.7 years; median EDSS, 2.0; median disease duration, 47 months) were imaged on a 1.5T scanner by using a high-resolution 3D T1 spoiled gradient-recalled sequence. Volumetric data for SDGM structures were obtained by using FSL FIRST, while whole-brain, GM, white matter, cortical, and lateral ventricle volumes were estimated by using SIENAX software. Comparisons between the groups were adjusted for age and sex. RESULTS:Patients with early RRMS showed significantly lower SDGM but not cortical volumes compared with patients with CIS. The most apparent SDGM differences were evident in the caudate and thalamus (P Ͻ .0001), total SDGM (P ϭ .0001), and globus pallidus (P ϭ .01). Patients with CIS with a median T2 lesion volume Ͼ4.49 mL showed lower total SDGM, caudate, thalamus (P Ͻ .001), globus pallidus (P ϭ .007), hippocampus (P ϭ .004), and putamen (P ϭ .01) volumes and higher lateral ventricle volume (P ϭ .001) than those with a median T2 lesion volume Ͻ4.49 mL. Decreased thalamic volume showed the most consistent relationship with MR imaging outcomes (P Ͻ .0001) in patients with CIS.CONCLUSIONS: Significant SDGM, but not cortical, atrophy develops during the first 4 years of the RRMS. GM atrophy is relevant for disease progression from the earliest clinical stages.ABBREVIATIONS: ASA ϭ Avonex-Steroid-Azathioprine; CIS ϭ clinically isolated syndrome; EDSS ϭ Expanded Disease Status Scale; FSL ϭ FMRIB Software Library; GM ϭ gray matter; NBV ϭ normalized brain volume; NCV ϭ normalized cortical volume; NGMV ϭ normalized gray matter volume; NLVV ϭ normalized lateral ventricle volume; NWMV ϭ normalized white matter volume; RRMS ϭ relapsing remitting MS; SDGM ϭ subcortical deep gray matter; SET ϭ Study of Early Interferon ␤ 1a Treatment in High Risk Subjects after CIS M R imaging is a vital tool enabling clinicians to diagnose, monitor, and predict the progression of MS. Conventional MR imaging has proved to be very sensitive for detecting focal changes in the WM, yet it is relatively insensitive to involvement of the GM in MS. GM pathology in MS is quite different from that in WM, with only mild blood-brain barrier disruption and little-to-no inflammation due to minimal Tcell infiltration.1 Hence, the difference between lesion and normal GM relaxation times on MR imaging is less than that seen between lesion and normal white matter. 2In the past decade, continuous effort has been made to develop n...

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Section: Discussionmentioning

confidence: 75%

Subcortical and Cortical Gray Matter Atrophy in a Large Sample of Patients with Clinically Isolated Syndrome and Early Relapsing-Remitting Multiple Sclerosis

Bergsland

Horáková²,

Dwyer

et al. 2012

AJNR Am J Neuroradiol

141

134

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“…The medial temporal cortex atrophy is associated with a decrease in processing speed and impaired episodic and verbal memories. The most important within the subcortical gray mater are atrophy, structural changes, and an altered metabolism of the thalamus, which are associated with the impairment of many cognitive domains [28]. Generally, it can be concluded that the cognitive impairment observed in MS patients is caused by inflammatory lesions and a widespread loss of gray matter.…”

Section: Cognitive Abilities and Imaging Methodsmentioning

confidence: 99%

Cognitive Deficits and Neuropsychological Assessment in Multiple Sclerosis

Javůrková¹,

Zimová²,

Tomašovičová³

et al. 2016

Trending Topics in Multiple Sclerosis

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The aim of this chapter was to introduce the contents of neuropsychological assessment in multiple sclerosis, which should include the functional evaluation of cognitive domains, the psychopathology of personality, levels of depression, and the assessment of psychosocial aspects and quality of life with multiple sclerosis. Further, the most commonly used neuropsychological diagnostics are described. The chapter hopes to draw attention to the importance of neuropsychological assessment which should be a part of neurological diagnostics and therapy, including rehabilitation and psychotherapy.

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“…[16][17][18][19][20] Other studies indicate that damage to the SDGM is associated with memory impairment. 21,22 However, to date, there have been no longterm longitudinal studies investigating possible associations among SDGM, cortical atrophy, and disability progression in RRMS.…”

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confidence: 99%

Evolution of Cortical and Thalamus Atrophy and Disability Progression in Early Relapsing-Remitting MS during 5 Years

Zivadinov

Bergsland

Doležal³

et al. 2013

AJNR Am J Neuroradiol

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Memory impairment in multiple sclerosis: correlation with deep grey matter and mesial temporal atrophy

Abstract: For the first time, the predictive validity of MTL and DGM atrophy were simultaneously compared with MS using reliable and validated neuropsychological measures. This study found that both compartments play significant but different roles in the amnesia of MS.

Cited by 182 publications

References 61 publications

Subcortical and Cortical Gray Matter Atrophy in a Large Sample of Patients with Clinically Isolated Syndrome and Early Relapsing-Remitting Multiple Sclerosis

Subcortical and Cortical Gray Matter Atrophy in a Large Sample of Patients with Clinically Isolated Syndrome and Early Relapsing-Remitting Multiple Sclerosis

Cognitive Deficits and Neuropsychological Assessment in Multiple Sclerosis

Evolution of Cortical and Thalamus Atrophy and Disability Progression in Early Relapsing-Remitting MS during 5 Years

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