Abstract Details

Title Cortical and Subcortical Grey Matter Atrophy as Predictors of Cognitive Dysfunction in Patients with Multiple Sclerosis: A 10-Year Follow-Up Study

Topic MS and Related Diseases

Presentation(s) S51 - (-)

Poster/Presentation
Number 005

Objective

Background Cognitive dysfunction is an important, debilitating symptom of multiple sclerosis, and there are few longitudinal studies published investigating the occurrence and the relationship to atrophy on brain magnetic resonance imaging (MRI).

Design/Methods We included 81 newly diagnosed MS patients with baseline- and follow-up examinations after 5 and 10 years. Cognitive dysfunction was assessed using Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT) and Selective Reminding Test (SRT). Cognitive dysfunction was defined as a worsening test-score after five and ten years. MRI was obtained using 1.5 T scanners. Global and tissue specific volumes and atrophy changes were assessed by using FIRST and SIENA/SIENAX.

Results At 5-year follow-up, baseline GM and lateral ventricle (LV) (p<0.001) and SDGM (p=0.003) volumes showed significant associations to worsening of all cognitive tests. Cortical atrophy at baseline was significantly related to worsening of SDMT and SRT scores. Decreased baseline thalamic and globus pallidum volumes (p<0.0001) were strongly predictive of 5-year cognitive deterioration. Development of SDGM (p=0.009) and cortical (p=0.01) atrophy over the first five years was significantly related to worsening of cognitive tests. Cognitive deterioration at the 10-year follow-up was predicted by GM, SDGM and LV atrophy at baseline (p<0.01). The decreased thalamic baseline volume showed the strongest relationship to SDMT deterioration at 10 years(p<0.0001). Development of SDGM and cortical atrophy (p<0.01) showed a significant relationship with cognitive deterioration at 10 years.

Conclusions This longitudinal study shows that cognitive dysfunction appears early in the course of MS, and is associated with the development of both cortical and SDGM atrophy at 5 and 10 years follow-up. Thalamic atrophy may play a central role in predicting cognitive deterioration over long-term.

Authors/Disclosures
Cecilie O. Jacobsen, MD (Stavanger University Hospital) PRESENTER	No disclosure on file
Ralph H. Benedict, PhD (University At Buffalo)	Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Benedict has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Roche. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Benedict has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Benedict has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Brystal Mier Squibb. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for EMD Serono. The institution of Dr. Benedict has received research support from Genzyme. The institution of Dr. Benedict has received research support from Biogen. The institution of Dr. Benedict has received research support from Bristol Myer Squib. Dr. Benedict has received intellectual property interests from a discovery or technology relating to health care.
Stephan Schuele, MD, FAAN (Northwestern Memorial Hospital)	Dr. Schuele has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris. Dr. Schuele has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurelis. Dr. Schuele has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for SK Life Science. Dr. Schuele has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Jazz. Dr. Schuele has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Neurophysiology. Dr. Schuele has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Thomas Needham. Dr. Schuele has received research support from National Institute of Health.
Niels Bergsland (Buffalo Neuroimaging Analysis Center / State University of New York At Buffalo)	Prof. Bergsland has nothing to disclose.
Turi Dalaker	No disclosure on file
Elisabeth Farbu (Stavanger Univ.Sjukehus)	No disclosure on file
Jesper Hagemeier	No disclosure on file
Jan P. Larsen (Rogaland Central Hospital)	No disclosure on file
	No disclosure on file
Kjell Morten Myhr, MD (Haukeland University Hospital)	No disclosure on file
Harald Nyland (Haukeland Unversity Hospital)	No disclosure on file
	No disclosure on file
Robert Zivadinov, MD, PhD, FAAN (Buffalo Neuroimaging Analysis Center)	The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Omnicuris. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Myrobalan. Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Zivadinov has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.

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