The unique impact of changes in normal appearing brain tissue on cognitive dysfunction in secondary progressive multiple sclerosis patients

Abstract

Objective: The purpose of this study was to examine the relationships between cognitive functioning, whole brain magnetic transfer ratio (MTR) imaging, supratentorial ¹H-magnetic resonance spectroscopy imaging (¹HMRSI), and conventional T₁ and T₂ imaging in a homogenous sample of SPMS patients. Methods: Nineteen patients underwent a single 90-min imaging session that obtained T₁-and T₂-weighted images and MTR. ¹HMRSI was obtained on 14 of these patients. Patients underwent a neuropsychological battery, which was used to create an integrated measure of cognitive impairment. Cognitive impairment was the dependent variable in two hierarchical multiple regression analyses in which T₂ lesion load, T₁ lesion load, and MTR or NAA/Cr were entered sequentially. Results: MTR was significantly related to cognitive functioning (ΔR²= 0.22, P= 0.02) after accounting for T₂ lesion load (ΔR²=0.33, P= 0.01) and T₁ lesion load (ΔR²= 0.00, P=0.98). NAA/Cr was not significantly related to cognitive functioning. Conclusions: Cognitive dysfunction may act as a clinical marker of normal appearing brain tissue pathology in multiple sclerosis.

Keywords

multiple sclerosis MRI cognitive impairment neuropsychological assessment spectroscopy magnetic transfer ratio imaging

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