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Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

OBJECTIVE: To investigate whether the strength of the association between magnetic resonance imaging (MRI) metrics and cognitive outcomes differs between various multiple sclerosis subpopulations. METHODS: A total of 1052 patients were included in this large cross‐sectional study. Brain MRI (T1 and...

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Autores principales: Uher, Tomas, Krasensky, Jan, Sobisek, Lukas, Blahova Dusankova, Jana, Seidl, Zdenek, Kubala Havrdova, Eva, Sormani, Maria Pia, Horakova, Dana, Kalincik, Tomas, Vaneckova, Manuela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771324/
https://www.ncbi.nlm.nih.gov/pubmed/29376094
http://dx.doi.org/10.1002/acn3.512
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author Uher, Tomas
Krasensky, Jan
Sobisek, Lukas
Blahova Dusankova, Jana
Seidl, Zdenek
Kubala Havrdova, Eva
Sormani, Maria Pia
Horakova, Dana
Kalincik, Tomas
Vaneckova, Manuela
author_facet Uher, Tomas
Krasensky, Jan
Sobisek, Lukas
Blahova Dusankova, Jana
Seidl, Zdenek
Kubala Havrdova, Eva
Sormani, Maria Pia
Horakova, Dana
Kalincik, Tomas
Vaneckova, Manuela
author_sort Uher, Tomas
collection PubMed
description OBJECTIVE: To investigate whether the strength of the association between magnetic resonance imaging (MRI) metrics and cognitive outcomes differs between various multiple sclerosis subpopulations. METHODS: A total of 1052 patients were included in this large cross‐sectional study. Brain MRI (T1 and T2 lesion volume and brain parenchymal fraction) and neuropsychological assessment (Brief International Cognitive Assessment for Multiple Sclerosis and Paced Auditory Serial Addition Test) were performed. RESULTS: Weak correlations between cognitive domains and MRI measures were observed in younger patients (age≤30 years; absolute Spearman's rho = 0.05–0.21), with short disease duration (<2 years; rho = 0.01–0.21), low Expanded Disability Status Scale [EDSS] (≤1.5; rho = 0.08–0.18), low T2 lesion volume (lowest quartile; <0.59 mL; rho = 0.01–0.20), and high brain parenchymal fraction (highest quartile; >86.66; rho = 0.01–0.16). Stronger correlations between cognitive domains and MRI measures were observed in older patients (age>50 years; rho = 0.24–0.50), with longer disease duration (>15 years; rho = 0.26–0.53), higher EDSS (≥5.0; rho = 0.23–0.39), greater T2 lesion volume (highest quartile; >5.33 mL; rho = 0.16–0.32), and lower brain parenchymal fraction (lowest quartile; <83.71; rho = 0.13–0.46). The majority of these observed results were confirmed by significant interactions (P ≤ 0.01) using continuous variables. INTERPRETATION: The association between structural brain damage and functional cognitive impairment is substantially weaker in multiple sclerosis patients with a low disease burden. Therefore, disease stage should be taken into consideration when interpreting associations between structural and cognitive measures in clinical trials, research studies, and clinical practice.
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spelling pubmed-57713242018-01-26 Cognitive clinico‐radiological paradox in early stages of multiple sclerosis Uher, Tomas Krasensky, Jan Sobisek, Lukas Blahova Dusankova, Jana Seidl, Zdenek Kubala Havrdova, Eva Sormani, Maria Pia Horakova, Dana Kalincik, Tomas Vaneckova, Manuela Ann Clin Transl Neurol Research Article OBJECTIVE: To investigate whether the strength of the association between magnetic resonance imaging (MRI) metrics and cognitive outcomes differs between various multiple sclerosis subpopulations. METHODS: A total of 1052 patients were included in this large cross‐sectional study. Brain MRI (T1 and T2 lesion volume and brain parenchymal fraction) and neuropsychological assessment (Brief International Cognitive Assessment for Multiple Sclerosis and Paced Auditory Serial Addition Test) were performed. RESULTS: Weak correlations between cognitive domains and MRI measures were observed in younger patients (age≤30 years; absolute Spearman's rho = 0.05–0.21), with short disease duration (<2 years; rho = 0.01–0.21), low Expanded Disability Status Scale [EDSS] (≤1.5; rho = 0.08–0.18), low T2 lesion volume (lowest quartile; <0.59 mL; rho = 0.01–0.20), and high brain parenchymal fraction (highest quartile; >86.66; rho = 0.01–0.16). Stronger correlations between cognitive domains and MRI measures were observed in older patients (age>50 years; rho = 0.24–0.50), with longer disease duration (>15 years; rho = 0.26–0.53), higher EDSS (≥5.0; rho = 0.23–0.39), greater T2 lesion volume (highest quartile; >5.33 mL; rho = 0.16–0.32), and lower brain parenchymal fraction (lowest quartile; <83.71; rho = 0.13–0.46). The majority of these observed results were confirmed by significant interactions (P ≤ 0.01) using continuous variables. INTERPRETATION: The association between structural brain damage and functional cognitive impairment is substantially weaker in multiple sclerosis patients with a low disease burden. Therefore, disease stage should be taken into consideration when interpreting associations between structural and cognitive measures in clinical trials, research studies, and clinical practice. John Wiley and Sons Inc. 2017-12-15 /pmc/articles/PMC5771324/ /pubmed/29376094 http://dx.doi.org/10.1002/acn3.512 Text en © 2017 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Article
Uher, Tomas
Krasensky, Jan
Sobisek, Lukas
Blahova Dusankova, Jana
Seidl, Zdenek
Kubala Havrdova, Eva
Sormani, Maria Pia
Horakova, Dana
Kalincik, Tomas
Vaneckova, Manuela
Cognitive clinico‐radiological paradox in early stages of multiple sclerosis
title Cognitive clinico‐radiological paradox in early stages of multiple sclerosis
title_full Cognitive clinico‐radiological paradox in early stages of multiple sclerosis
title_fullStr Cognitive clinico‐radiological paradox in early stages of multiple sclerosis
title_full_unstemmed Cognitive clinico‐radiological paradox in early stages of multiple sclerosis
title_short Cognitive clinico‐radiological paradox in early stages of multiple sclerosis
title_sort cognitive clinico‐radiological paradox in early stages of multiple sclerosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771324/
https://www.ncbi.nlm.nih.gov/pubmed/29376094
http://dx.doi.org/10.1002/acn3.512
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