White matter tract abnormalities are associated with cognitive dysfunction in secondary progressive multiple sclerosis

Meijer, Kim A, Muhlert, Nils, Cercignani, Mara, Sethi, Varun, Ron, Maria A, Thompson, Alan J, Miller, David H, Chard, Declan, Geurts, Jeroen J G and Ciccarelli, Olga (2016) White matter tract abnormalities are associated with cognitive dysfunction in secondary progressive multiple sclerosis. Multiple Sclerosis, 22 (11). pp. 1429-1437. ISSN 1352-4585

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While our knowledge of white matter (WM) pathology underlying cognitive impairment in relapsing remitting multiple sclerosis (MS) is increasing, equivalent understanding in those with secondary progressive (SP) MS lags behind.


The aim of this study is to examine whether the extent and severity of WM tract damage differ between cognitively impaired (CI) and cognitively preserved (CP) secondary progressive multiple sclerosis (SPMS) patients.


Conventional magnetic resonance imaging (MRI) and diffusion MRI were acquired from 30 SPMS patients and 32 healthy controls (HC). Cognitive domains commonly affected in MS patients were assessed. Linear regression was used to predict cognition. Diffusion measures were compared between groups using tract-based spatial statistics (TBSS).


A total of 12 patients were classified as CI, and processing speed was the most commonly affected domain. The final regression model including demographic variables and radial diffusivity explained the greatest variance of cognitive performance (R(2) = 0.48, p = 0.002). SPMS patients showed widespread loss of WM integrity throughout the WM skeleton when compared with HC. When compared with CP patients, CI patients showed more extensive and severe damage of several WM tracts, including the fornix, superior longitudinal fasciculus and forceps major.


Loss of WM integrity assessed using TBSS helps to explain cognitive decline in SPMS patients.

Item Type: Article
Keywords: Multiple sclerosis, Secondary progressive, MRI, Cognition, Myelination, DTI
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
Subjects: R Medicine
R Medicine > RC Internal medicine > RC0321 Neurosciences. Biological psychiatry. Neuropsychiatry > RC0346 Neurology. Diseases of the nervous system Including speech disorders
Depositing User: Patricia Butler
Date Deposited: 14 Jul 2016 15:13
Last Modified: 25 Jul 2017 10:53
URI: http://sro.sussex.ac.uk/id/eprint/60366
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