Abstract Details

Title Early Diagnosis of Cognitive Disorders in Multiple Sclerosis: The HV3 Score

Topic MS and Related Diseases

Presentation(s) P04 - (-)

Poster/Presentation
Number 114

Objective

Background BACKGROUND: Cognitive Impaiment (CogImp) in MS is common and affects the quality of life. Early detection is difficult.

Design/Methods DESIGN/METHODS: Seventy-five Relapsing Remitting MS (RRMS) patients and 20 controls were recruited. The Paced Auditory Serial Addition Test (PASAT) was the only task used to detect CogImp. Any z-score below 2 standard deviations was considered impaired. A brain MRI was performed. We quantified T2 and T1 lesion volumes, cerebral white and gray matter volumes. Global brain atrophy was measured by the third-ventricle (V3) width (in millimeters), the bicaudate ratio, the lateral ventricle width and the brain diameter. A brain average model was built from the control group. Each MS MRI was compared to the average model using Jacobian integration to quantify regional volumetric changes. We compared demographic, clinical and MRI data in the MS group with and without CogImp.

Results RESULTS: Sixteen MS patients (21.3%) had CogImp. They had a higher Expanded Disability Status Scale (EDSS) score (p=0.021). T2 and T1 lesion volume, gray and white matter volumes were not different in both groups. An enlargement of the V3-width was observed in the cognitively impaired group (p=0.044) and V3-width was correlated with the PASAT score (r=-0.271;p=0.021). A composite score named HV3 was obtained by the sum of EDSS and V3-width in mm. A cutoff HV3 score over 5.5 identifies patients with CogImp with a positive predictive value of 92.5%. HV3 was more correlated with the PASAT score than EDSS or V3 width separately (r=-0.325; p=0.006). Focal atrophy was measured in the supplementary motor area, in, the cingulate gyrus, the right thalamus and in inferior parietal lobules of patients with abnormal PASAT performance.

Conclusions CONCLUSIONS: Specific brain morphological changes are associated with CogImp in RRMS patients. The HV3 score is an easy tool, directly accessible by clinicians.

Authors/Disclosures
Christine Lebrun Frenay, MD, FAAN (CRCSEP Neurologie) PRESENTER	Dr. Lebrun Frenay has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Revue Neurologique. The institution of Dr. Lebrun Frenay has received research support from FRANCE SEP.
	No disclosure on file
	No disclosure on file
Mikael Cohen (Hopital Pasteur)	Mikael Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Roche, Merck, Ad scientiam, Novartis, Alexion, BMS.
	No disclosure on file
Sven Schippling (University of Neurology)	No disclosure on file

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