Neurosciences Unit, Department of Medicine and Surgery (DMEC), University of Parma, Parma, Italy.
Neuroradiology Unit, Department of Diagnostic, Parma University Hospital, Parma, Italy.
Brain Behav. 2018 Jun;8(6):e00955. doi: 10.1002/brb3.955. Epub 2018 Apr 21.
Gray matter (GM) damage is well known as a fundamental aspect of multiple sclerosis (MS). Above all, cortical lesions (CLs) burden, detectable at MRI with double inversion recovery (DIR) sequences, has been demonstrated to correlate with cognitive impairment (CI). The aim of this study was to investigate the role of CLs number in predicting CI in a cohort of patients with MS in a clinical practice setting.
Thirty consecutive patients with MS presenting CLs (CL+) at high-field (3.0 T) MRI 3D-DIR sequences and an even group of MS patients without CLs (CL-) as a control, were investigated with the Rao Brief Repeatable Battery of Neuropsychological Tests (BRB), Version A. Total and lobar CLs number were computed in CL+ patients.
Among the sixty patients with MS enrolled, forty-seven (78.3%) had a relapsing-remitting course, while thirteen (21.7%) a progressive one, eleven secondary progressive, and two primary progressive. Compared to CL-, CL+ patients had a greater proportion of progressive forms (p = .03). The most affected region was the frontal lobe (73.3% of patients), followed by temporal and parietal ones (both 60.0%). Multivariate (logistic regression) analysis revealed a significant correlation between total CLs number and the presence of mild cognitive impairment defined as pathologic score in at least one BRB test (p = .04); it was also correlated with deficit at PASAT 3 (p = .05) and Stroop Test (p = .02).
We confirmed CLs number, evaluated with a technique quite commonly available in clinical practice, as a predictive factor of CI in patients with MS, in order to improve the diagnosis and management of CI and monitor potential neuroprotective effects of therapies.
众所周知，灰质（GM）损伤是多发性硬化症（MS）的一个基本特征。尤其是，皮质病变（CLs）负担，可通过磁共振成像（MRI）的双反转恢复（DIR）序列检测到，已被证明与认知障碍（CI）相关。本研究旨在探讨在临床实践环境中，MS 患者 CL 数量在预测 CI 中的作用。
对 30 例在高场（3.0T）MRI 3D-DIR 序列上显示 CL（CL+）的连续 MS 患者和一组作为对照的无 CL（CL-）MS 患者进行了研究，采用 Rao 简明重复神经心理测试组（BRB），A 版。在 CL+患者中计算了总 CL 和叶 CL 的数量。
在纳入的 60 例 MS 患者中，47 例（78.3%）为复发缓解型，13 例（21.7%）为进展型，其中 11 例为继发进展型，2 例为原发进展型。与 CL-患者相比，CL+患者进展型的比例更高（p=0.03）。受影响最严重的区域是额叶（73.3%的患者），其次是颞叶和顶叶（均为 60.0%）。多变量（逻辑回归）分析显示，总 CL 数量与存在轻度认知障碍（BRB 测试中至少有一项病理评分）显著相关（p=0.04）；它还与 PASAT3 缺陷（p=0.05）和 Stroop 测试（p=0.02）相关。
我们证实了 CL 数量（通过一种在临床实践中相当常用的技术评估）是 MS 患者 CI 的预测因素，以提高 CI 的诊断和管理，并监测潜在的神经保护治疗效果。
