Identification of MS patients at highest risk of cognitive impairment using MRI volumetry.

What is it about?

While impaired cognitive performance is common in multiple sclerosis (MS), it has been largely underdiagnosed. Although, it is recommended to performe regular cognitive screening in all MS patients, this is not feasible in most of centers (time consuming, lack of trained personnel, organisation, money etc). In this study we identified brain MRI algorithm to identify patients at highest risk of cognitive impairment. We investigated 1052 MS patients, all patients had brain MRI and cognitive screening (BICAMS and PASAT).

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Why is it important?

Using this approach, we are able identify patients who should be monitored regularly due to their high risk of cognitive dysfunction. More specifically: 270 patients with high brain atrophy (low brain parenchymal fraction) and high lesion load (high T2 lesion volume) has 6.5x greater risk of presence of cognitive dysfunction compared with 518 patients with low brain atrophy and low lesion load. Moreover, cognitively normal patients with high brain atrophy and high lesion load had 3.5x greater risk of development of cognitive dysfunction over short-term follow-up compared with patients with low brain atrophy and low lesion load.

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