Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; APHM, Hopital de la Timone, CEMEREM, Marseille, France; Aix Marseille Univ, CNRS, CRMBM, Marseille, France.
Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; Department of Cognitive Psychology, Institute of Psychology, University of Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany.
Neuroimage Clin. 2021;30:102606. doi: 10.1016/j.nicl.2021.102606. Epub 2021 Feb 24.
Multiple Sclerosis (MS) patients often suffer from significant cognitive impairment. Earlier research has shown relationships between regional cortical atrophy and cognitive deterioration. However, due to a large number of neuropsychological assessments and a heterogenous pattern of cognitive deficits in MS patients, reported associations patterns are also heterogenous. Using an extensive neuropsychological battery of 23 different tasks, we explored domain (attention/information processing, memory, spatial processing, executive functioning) and task-specific associations with regional cortical thickness in a representative sample of MS patients (N = 97). Cortical regions associated with multiple cognitive tasks in the left hemisphere were predominantly located in the inferior insula (attention p < 0.001, memory p = 0.047, spatial processing p = 0.004, executive functioning p = 0.037), the gyrus frontalis superior (attention p = 0.015, memory p = 0.037, spatial processing p = 0.033, executive functioning p = 0.017) and temporal medial (attention p < 0.001, memory two clusters p = 0.016 and p < 0.001, executive functioning p = 0.016). In the right hemisphere, we detected the strongest association in the sulcus interparietalis with five cluster (attention SDMT p = 0.003 and TAP_DA p < 0.001; memory Rey recall p = 0.013 and VLMT verbal learning p = 0.016; spatial processing Rey copy p < 0.001). We replicated parts of our results in an independent sample of 30 mildly disabled MS patients. Moreover, comparisons to 29 healthy controls showed that the regional associations seemed to represent rather pathophysiological dependency than a physiological one. We believe that our results may prove useful in diagnosis and rehabilitation of cognitive impairments and may serve as guidance in future magnetic resonance imaging (MRI) studies.
多发性硬化症 (MS) 患者常伴有明显的认知障碍。早期研究表明，区域性皮质萎缩与认知恶化之间存在关联。然而，由于 MS 患者需要进行大量的神经心理学评估，且认知缺陷模式存在异质性，因此报道的相关性也存在异质性。我们使用广泛的神经心理学测试，对 97 名 MS 患者的样本进行了 23 项不同任务的测试，以探讨大脑左半球皮质厚度与认知领域（注意力/信息处理、记忆、空间处理、执行功能）和任务特异性的关联。与多个认知任务相关的大脑左半球皮质区域主要位于下岛叶（注意力 p < 0.001，记忆 p = 0.047，空间处理 p = 0.004，执行功能 p = 0.037）、额上回（注意力 p = 0.015，记忆 p = 0.037，空间处理 p = 0.033，执行功能 p = 0.017）和颞叶内侧（注意力 p < 0.001，记忆两个聚类 p = 0.016 和 p < 0.001，执行功能 p = 0.016）。在大脑右半球，我们在顶间沟中检测到与五个聚类最强的关联（注意力 SDMT p = 0.003 和 TAP_DA p < 0.001；记忆 Rey 回忆 p = 0.013 和 VLMT 语言学习 p = 0.016；空间处理 Rey 复制 p < 0.001）。我们在一个独立的 30 名轻度残疾 MS 患者样本中复制了部分结果。此外，与 29 名健康对照者的比较表明，这些区域的关联似乎代表了病理生理学的依赖性，而不是生理学的依赖性。我们认为，我们的研究结果可能有助于认知障碍的诊断和康复，并为未来的磁共振成像 (MRI) 研究提供指导。
