Relationship between structural abnormalities and cognitive impairment in Multiple Sclerosis patients Cruz Gómez J1, González Torre A1, Ripollés-Vidal P1, Belenguer A2, Forn C1. 1.- Department of Basic, Clinical Psychology and Psychobiology. Universidad Jaume I. Castellón de la Plana 2.- Neurology Service. Hospital General de Castellón. Castellón de la Plana.
C68
e-mail:
[email protected]
8th FENS FORUM OF NEUROSCIENCE 2012
RESULTS INTRODUCTION
DEMOGRAPHICAL, CLINICAL, NEUROPSYCHOLOGICAL AND MRI VARIABLES
Cognitive impairment is a common symptom in MS, affecting up to 65% of patients, (Amato et al., 2006). Several magnetic resonance imaging (MRI) studies have demonstrated that the quantification of atrophy in cortical and subcortical brain regions represents a robust correlate of MS-associated cognitive impairment. Diffeomorphic Anatomical Registration Exponentiated Lie algebra (DARTEL) is a voxel based morphometry (VBM) tool recently developed to improve the identification and quantification of cerebral WM and GM atrophy in neurodegenerative diseases such as Multiple Sclerosis (MS). In this regard, it is generally accepted that DARTEL might provide specific information about the role of brain atrophy and the clinical deficits observed in MS patients.
DEMOGRAPHICAL VARIABLES CLINICAL VARIABLES
OBJECTIVES The aim of this study was to observe the distribution of gray (GM) and white matter (WM) atrophy in MS patients and their relationship with cognitive variables
We acquired anatomical MRI scans from 92 patients with MS and 23 healthy controls. Patients were assessed using the Rao’s Brief Repeatable Battery BRB-N (Rao, 1990) and divided according their neuropsychological performance. 1. Cognitive preserved patients (CP): normal performance in all tests of the battery.
Following Sepulcre y cols., 2006 criteria, we calculated a z score for each cognitive domain assessed by the BRB-N and also a global z score reflecting the overall performance in the neuropsychological battery.
Symbol Digit Modalities Test (SDMT) Paced Auditory Serial Addition Test (PASAT) 3 seconds Controlled Word Association Test (COWAT)
Phonemic Fluency Semantic Fluency
CP vs CI patients
Age mean (SD)
32.26 (6.10)
37.85 (9.17)
42.31 (8.65)
.038 *
.000 **
.050*
Years of education mean (SD)
14.43 (2.71)
9.96 (2.86)
11.98 (2.74)
.003**
.000**
.003**
Years of evolution disease mean (SD) (range)
-
6.33 (5.9)
10.89 (8.39)
-
-
.003**
Median EDSS (range)
-
2.14 (0-2.6)
3.40 (1-7)
-
-
.000**
FSS (SD)
3,39 (1,33)
3,74 (1,85)
4,52 (1,81)
.731
.047*
.115
Matrix (subtest WAIS III)
21.43 (3.53)
20 (10.88)
13.17 (4.08)
.758
.000**
.000**
SRT long term storage (SD)
52.43 (12.07)
48.98 (9.19)
31.11 (13.45)
.510
.000**
.000**
SRT consistence long term retrieval (SD)
43.61 (11.74)
39,11 (10,83)
21,48 (12,53)
.326
.000**
.000**
9.78 (1.65)
9.02 (1.89)
5.85 (2.84)
.429
.000**
.000**
23.09 (4.42)
22.07 (4.33)
17.30 (5.40)
.708
.000**
.000**
8.22 (2.04)
7.70 (1.84)
5.72 (2.07)
.587
.000**
.000**
SDMT (SD)
59.13 (11.02)
56 (8.36)
35.33 (9.32)
.424
.000**
.000**
WLGT (SD)
23.35 (4.05)
23.65 (3.80)
16.07 (5.19)
.568
.000**
.000**
PASAT 3 seconds (SD)
48.35 (9.56)
46.70 (8.20)
15.07 (19.53)
.899
.000**
.000**
-
3.3 (4.5)
6.6 (11.8)
-
-
.101
.003**
.000**
.024*
Z SCORES
Verbal learning and long- term memory
Z-verbal memory (Zv) (Z SRT-S + Z SRT-R + Z SRT-D) / 3
Spatial learning and long- term memory
Z-visual memory (Zvi) (Z SPART-S + Z SPART-D) / 2
Information processing speed and selective attention Information processing speed and working memory
Z-attentional / executive (Za) (Z SDMT + Z PASAT 3 sec.) / 2
Verbal Fluency
Z-fluency (Zf) (Z phonemic + Z semantic) / 2
Mean ICV (ml)
1241.77 (100.44) 1129.53 (117.87) 1057.25 (141.74)
Mean GM volume (ml)
732.21 (67.18)
661,91 (75,04)
616,27 (92,76)
.004**
.000**
.030*
Mean WM volume (ml)
509.56 (48.95)
467,62 (56,44)
441,00 (68,27)
.027*
.000**
.110
* p < .05 ** p < .01
Figure 2: Overlay of GM and WM atrophy distribution for correlation analysis between neuropsychological test and atrophy in MS patients. Images are in neurological convention and results showed at uncorrected level p
