Contributions
Abstract: P1104
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Although, majority of the previous studies showed relationship between MRI pathology and cognitive performance (CP) in multiple sclerosis (MS) patients, it is not clear whether this association is different according to patients characteristics.
Objective: To investigate, if sub-populations of MS patients show different strength of association between MRI and cognitive measures.
Methods: Of the 1253 patients enrolled in the study, 1052 patients with complete cognitive, MRI and clinical data were included. Brain MRI (T2 lesion volume [T2-LV], brain parenchymal fraction [BPF], gray and white matter, thalamic and corpus callosum fractions) and neuropsychological assessment (brief international cognitive assessment for MS [BICAMS] and paced auditory serial addition test) were performed. Spearman´s correlation and regression analysis adjusted for age, gender, education, depression, treatment status, expanded disability status scale (EDSS) were used to investigate the associations between MRI measures and CP in various MS subpopulations.
Results: Median of EDSS was 2.5, average disease duration was 10.0 years and 82% of patients were on disease-modifying treatments. Cognitive impairment was present in 27% of patients. A weak correlation among cognitive domains and MRI measures was observed in younger patients (age≤30 years; Spearman´s coefficient range [rho]=.08-.20), short disease duration (< 2 years; rho=.08-.17), low EDSS (≤1.5; rho=.09-.14), low T2-LV (lowest quartile; < .59 ml; rho=.06-.10) and high BPF (highest quartile; >86.66; rho=.05-.08). A stronger correlation among cognitive domains and MRI measures were observed in older patients (age>50 years; rho=.29-.33), longer disease duration (>15years; rho=.24-.38), higher EDSS (≥5.0; rho=.21-.27), greater T2-LV (highest quartile; >5.33 ml; rho=.16-.23) and lower BPF (lowest quartile; < 83.71; rho=.18-.27). Significant interactions (p≤.01) among majority of MRI measures and T2-LV or BPF in adjusted regression models with the dependent variable being CP confirmed our results.
Conclusions: Weak correlations between brain MRI and cognitive measures occur predominantly in patients with a low disease burden. This indicates that impact of MRI brain pathology on CP is greater in more advanced disease. This may have an important implication for clinical practice, interpretation of research findings, investigation of the role of brain reserve and designing of clinical trials.
Disclosure: Dr. Uher received financial support for conference travel and honoraria from Biogen Idec, Novartis, Genzyme and Merck Serono as well as support for research activities from Biogen Idec. Dr. Vaneckova received received compensation for speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono and Teva, as well as support for research activities from Biogen Idec.Dr. Sormani received consulting fees from Novartis, Biogen, Merck Serono, Teva, Genzyme, Roche and Vertex.Sobisek received funding for biostatistical support from Novartis. Dr. Blahova Dusankova, Dr. Barbora Benova and Karolina Kucerova reports no disclosures. Drs. Seidl and Krasensky received financial support for research activities from Biogen Idec.Dr. Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme, Actelion, Receptos and Teva, as well as support for research activities from Biogen Idec and Merck Serono.Dr. Kalincik served on an advisory scientific board for Novartis, Merck and Biogen, received conference travel support and/or speaker honoraria from WebMD Global, Novartis, Biogen, Sanofi, Genzyme, Teva, BioCSL and Merck and received research support from Biogen.Dr. Benedict: Research Support: Accorda, Biogen Idec, Genzyme, Novartis, Questor;Consultancy: Biogen Idec, Genzyme, Genentech, Novartis; CME: EMD Serono; Royalties: Psychological Assessment Resources, Inc.
Dr. Dana Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec.
Abstract: P1104
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Although, majority of the previous studies showed relationship between MRI pathology and cognitive performance (CP) in multiple sclerosis (MS) patients, it is not clear whether this association is different according to patients characteristics.
Objective: To investigate, if sub-populations of MS patients show different strength of association between MRI and cognitive measures.
Methods: Of the 1253 patients enrolled in the study, 1052 patients with complete cognitive, MRI and clinical data were included. Brain MRI (T2 lesion volume [T2-LV], brain parenchymal fraction [BPF], gray and white matter, thalamic and corpus callosum fractions) and neuropsychological assessment (brief international cognitive assessment for MS [BICAMS] and paced auditory serial addition test) were performed. Spearman´s correlation and regression analysis adjusted for age, gender, education, depression, treatment status, expanded disability status scale (EDSS) were used to investigate the associations between MRI measures and CP in various MS subpopulations.
Results: Median of EDSS was 2.5, average disease duration was 10.0 years and 82% of patients were on disease-modifying treatments. Cognitive impairment was present in 27% of patients. A weak correlation among cognitive domains and MRI measures was observed in younger patients (age≤30 years; Spearman´s coefficient range [rho]=.08-.20), short disease duration (< 2 years; rho=.08-.17), low EDSS (≤1.5; rho=.09-.14), low T2-LV (lowest quartile; < .59 ml; rho=.06-.10) and high BPF (highest quartile; >86.66; rho=.05-.08). A stronger correlation among cognitive domains and MRI measures were observed in older patients (age>50 years; rho=.29-.33), longer disease duration (>15years; rho=.24-.38), higher EDSS (≥5.0; rho=.21-.27), greater T2-LV (highest quartile; >5.33 ml; rho=.16-.23) and lower BPF (lowest quartile; < 83.71; rho=.18-.27). Significant interactions (p≤.01) among majority of MRI measures and T2-LV or BPF in adjusted regression models with the dependent variable being CP confirmed our results.
Conclusions: Weak correlations between brain MRI and cognitive measures occur predominantly in patients with a low disease burden. This indicates that impact of MRI brain pathology on CP is greater in more advanced disease. This may have an important implication for clinical practice, interpretation of research findings, investigation of the role of brain reserve and designing of clinical trials.
Disclosure: Dr. Uher received financial support for conference travel and honoraria from Biogen Idec, Novartis, Genzyme and Merck Serono as well as support for research activities from Biogen Idec. Dr. Vaneckova received received compensation for speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono and Teva, as well as support for research activities from Biogen Idec.Dr. Sormani received consulting fees from Novartis, Biogen, Merck Serono, Teva, Genzyme, Roche and Vertex.Sobisek received funding for biostatistical support from Novartis. Dr. Blahova Dusankova, Dr. Barbora Benova and Karolina Kucerova reports no disclosures. Drs. Seidl and Krasensky received financial support for research activities from Biogen Idec.Dr. Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme, Actelion, Receptos and Teva, as well as support for research activities from Biogen Idec and Merck Serono.Dr. Kalincik served on an advisory scientific board for Novartis, Merck and Biogen, received conference travel support and/or speaker honoraria from WebMD Global, Novartis, Biogen, Sanofi, Genzyme, Teva, BioCSL and Merck and received research support from Biogen.Dr. Benedict: Research Support: Accorda, Biogen Idec, Genzyme, Novartis, Questor;Consultancy: Biogen Idec, Genzyme, Genentech, Novartis; CME: EMD Serono; Royalties: Psychological Assessment Resources, Inc.
Dr. Dana Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec.