Department of Neurology, Medical University of Graz, Austria.
Mult Scler. 2011 Feb;17(2):173-80. doi: 10.1177/1352458510384009. Epub 2010 Oct 18.
Cognitive deficits are frequent in multiple sclerosis (MS) and have been associated with morphologic brain changes. Less information exists on their extent and relation to MRI findings in clinically isolated syndrome (CIS). It is also unclear if structural changes as detected by magnetization transfer (MT) imaging may provide an additional explanation for cognitive dysfunction.
To analyse the extent of cognitive deficits and their relation to MRI metrics including MT imaging in CIS compared to relapsing-remitting MS (RRMS).
Forty-four CIS and 80 RRMS patients underwent the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) and a 3 T MRI scan.
BRB-N subtests revealed similar results in CIS and RRMS. Impaired mental processing speed was most prevalent in both groups (CIS 13.6%; RRMS 16.3%) and thus served for correlation with MRI metrics. Using stepwise linear regression analyses, the strongest predictor for decreased mental processing speed was normalized cortex volume (p < 0.001) followed by T₂-lesion load (p < 0.05) in RRMS, whereas cortical MT ratio was the only MRI parameter associated with decreased mental processing speed in CIS (p < 0.005).
Cognitive dysfunction occurs in CIS in a pattern similar to RRMS, with impaired mental processing speed being most prevalent. Cortical MT-ratio changes may be an early sign for tissue changes related to impaired mental processing speed in CIS while this association shifts to increased signs of cortical atrophy and lesion load in RRMS.
认知缺陷在多发性硬化症（MS）中很常见，并且与大脑形态变化有关。关于其在临床孤立综合征（CIS）中的程度及其与 MRI 发现的关系，信息较少。磁化传递（MT）成像检测到的结构变化是否可以为认知功能障碍提供额外的解释也不清楚。
分析 CIS 中认知缺陷的程度及其与 MRI 指标的关系，包括 MT 成像，与复发缓解型多发性硬化症（RRMS）相比。
44 例 CIS 和 80 例 RRMS 患者接受了简短的重复神经心理测试（BRB-N）和 3T MRI 扫描。
BRB-N 子测试在 CIS 和 RRMS 中均显示出相似的结果。精神处理速度受损在两组中最为常见（CIS 13.6%；RRMS 16.3%），因此与 MRI 指标相关。使用逐步线性回归分析，精神处理速度降低的最强预测因子是正常皮质体积（p<0.001），其次是 RRMS 中的 T₂ 病变负荷（p<0.05），而 CIS 中与精神处理速度降低相关的唯一 MRI 参数是皮质 MT 比（p<0.005）。
CIS 中的认知功能障碍与 RRMS 相似，精神处理速度受损最为常见。皮质 MT 比的变化可能是与 CIS 中精神处理速度受损相关的组织变化的早期迹象，而这种关联在 RRMS 中则转移到皮质萎缩和病变负荷增加的迹象上。
