Introduction

The substrates of cognitive impairment in benign MS (BMS) still need to be identified. We investigated whether cognitive impairment in BMS patients is associated with specific patterns of brain structural and functional abnormalities.

Methods

Thirty-seven BMS patients (EDSS score ≤ 3.0 and disease duration ≥ 15 years) and 50 healthy controls (HC) were studied. In BMS patients, a cognitive impairment index (CII) was derived. Gray matter (GM) volumes, white matter (WM) fractional anisotropy (FA) and resting-state (RS) functional connectivity (FC) were investigated for whole-brain relevant regions (cortex, lobes, subcortical nuclei, fiber tracts) and functional networks. Univariate and multivariate analyses identified independent predictors of cognitive impairment.

Results

In BMS, median CII was 9 (IQR: 4–16). Compared to HC, BMS patients showed reduced WM FA, GM atrophy and increased RS FC in fronto-temporo-parietal regions. At multivariate analysis, percentage of T2-lesions of the corpus callosum, reduced posterior corona radiata (PCR) FA and caudate nucleus atrophy were independent predictors of worse CII. A multivariate model identified reduced PCR FA (R² = 0.39; p = 0.001) as the only predictor of CII.

Conclusions

Cognitive impairment in BMS is associated with structural damage of relevant brain areas. WM damage of parietal regions was the predominant predictor of worse cognitive performance in these patients.

中文翻译：

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良性多发性硬化症的认知障碍：一项多参数的结构和功能性MRI研究。

介绍

良性MS（BMS）认知障碍的底物仍需要确定。我们调查了BMS患者的认知障碍是否与脑结构和功能异常的特定模式有关。

方法

研究了37例BMS患者（EDSS评分≤3.0，病程≥15年）和50名健康对照者（HC）。在BMS患者中，获得了认知障碍指数（CII）。研究了全脑相关区域（皮质，叶，皮层下核，纤维束）和功能的灰质（GM）体积，白质（WM）分数各向异性（FA）和静止状态（RS）功能连通性（FC）网络。单因素和多因素分析确定了认知障碍的独立预测因子。

结果

在BMS中，平均CII为9（IQR：4-16）。与HC相比，BMS患者在额颞顶区的WM FA降低，GM萎缩和RS FC升高。在多变量分析中，call体T2病变百分比，后冠状放射线（PCR）FA减少和尾状核萎缩是CII恶化的独立预测因子。多元模型确定PCR FA降低（R ²  = 0.39；p  = 0.001）是CII的唯一预测因子​​。

结论

BMS的认知障碍与相关脑区域的结构损伤有关。壁区的WM损伤是这些患者认知能力较差的主要原因。