Predicting neuropsychological abnormalities in multiple sclerosis

Buffalo Neuroimaging Analysis Center, Buffalo, New York, United States
Journal of the Neurological Sciences (Impact Factor: 2.47). 07/2006; 245(1-2):67-72. DOI: 10.1016/j.jns.2005.05.020
Source: PubMed


Multiple Sclerosis (MS) is associated with MRI signal alteration and neuropsychological (NP) dysfunction. Screening tools have been developed to identify patients at high risk for these neurological complications of MS. One such measure, the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ), has well-established reliability and predictive validity. In this article, we report on the accumulated findings derived from 162 consecutive research participants and MS clinic attendees. Our data show significant correlation between both patient- and informant-report MSNQ and NP impairment. As shown previously, larger, and more significant correlations are found between informant-report MSNQs than with patient-report MSNQs. In addition, we find that the MSNQ predicts follow-up NP testing 51 weeks after baseline with a similar degree of association. Finally, the MSNQ is correlated with MRI measures of whole-brain lesion burden and atrophy, secondary progressive course, and vocational disability. We conclude that the MSNQ is reliable and valid for detecting neuropsychological and neuropsychiatric complications of MS.

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    • "The prevalence of depression in MS is reported to range from 16% to 46% and depression is considered to be more frequent in MS than in other chronic neurological diseases, with a higher risk of suicide [6–8]. Cognitive impairment is present in 40% to 65% of MS patients at any stage of the disease [9, 10] and mainly affects long-term episodic and working memory, executive functions, information processing speed, and attention. Verbal episodic memory impairment and memory complaint are common in the early stage of the disease. "
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    ABSTRACT: The primary goal of this study was to investigate associations between regional gray matter (GM) atrophy and neuropsychological function in multiple sclerosis (MS), while accounting for the influence of central brain atrophy (i.e. third ventricle enlargement). Using a cross-sectional design, we studied 59 MS patients with brain MRI and neuropsychological testing. Regional gray matter fractions (rGMFs) were calculated from MRI images for 11 homologous brain areas using the semiautomatic brain region extraction (SABRE) technique. Neuropsychological testing followed consensus panel guidelines and included tests emphasizing episodic memory, working memory and processing speed. The analytic approach was stepwise linear regression, with forward selection and p<0.05 threshold for significance. Consistent with previous research, there were significant correlations between third ventricle width and neuropsychological tests. Stepwise linear regression analyses controlling for third ventricle width retained rGMFs obtained from specific regions within the prefrontal cortex. Left frontal atrophy was associated with tests emphasizing auditory/verbal memory. Right frontal atrophy was associated with impairment in visual episodic and working memory. For the first time, we show an independent relationship between cortical atrophy and cognitive impairment after accounting for the effects of central atrophy.
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