Cognitive Impairment and Diffusion Tensor Imaging of the Normal Appearing White Matter in Multiple Sclerosis Patients,
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- Category: Vol. 84, March 2016
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Cognitive Impairment and Diffusion Tensor Imaging of the Normal Appearing White Matter in Multiple Sclerosis Patients, RANDA S. DEIF, OMAR A. AL-SRAFY, MOHAMMED EL-TOKHY, GEHAN M. RAMZY, DALIA M. LABIB and SHAIMAA SHAHEEN
Abstract
Background: Cognitive impairment is a common complaint of Multiple Sclerosis (MS) patients either in earlier or later stages of the disease. Diffusion Tensor Imaging (DTI) provides a measure of white matter pathology, including demyelination and axonal loss.
Objective: To detect the damage of Normal Appearing White Matter (NAWM) in different brain region using DTI and find a relation between it and cognitive impairment in patients with Relapsing Remitting Multiple Sclerosis (RRMS) and Secondary Progressive Multiple Sclerosis (SPMS).
Methods: This study done on forty Egyptian patients meeting modified McDonald criteria for MS (20 patients RRMS and 20 SPMS) and 20 healthy control. Cognitive function tests have been done for MS patients and control, magnetic resonance imaging (MRI, 1.5T GE) that included DTI sequences of the brain have been done only for MS patients. Fractional Anisotropy (FA) and Mean Diffusivity (MD) of NAWM were obtained.
Results: A significant difference was found between patients and control in most of cognitive function tests. Cognitive impairment was present in 29 patients (72.5%). Significant difference was found between RRMS and SPMS in cognitive function test and DTMRI brain results (for corpus callosum and temporal lobe) being severe in SPMS patients. DTI indices of NAWM founded to be correlated with poorer performance in cognitive tests.
Conclusion: The microstructural change of normal-appearing white matter of the brain has an important role in the pathogenesis of cognitive impairment in addition to lesion burden and brain atrophy in MS patients.