Contributions
Abstract: P362
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Objectives: To explore cognitive impairment and identify associated magnetic resonance imaging (MRI) biomarkers in patients with multiple sclerosis (MS).
Methods: MRI of the brain was performed in 81 of the patients. Cognitive tests were performed in 74 of the patients at time of inclusion, and repeated after 5 and 10 years. Cognitive testing was performed using the Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Selective Reminding Test (SRT) delayed recall and SRT long time storage. Cognitive impairment at baseline was defined as scoring less than 1.5 SD compared to a healthy control group on two out of four cognitive tests. MRI was acquired on 1.5 T scanners. Global and tissue-specific volumes were calculated at each time point, and atrophy changes were longitudinally assessed, using a direct measurement approach, by calculating percentage volume changes between different time points. Statistical analysis was performed using a mixed linear model.
Results: At baseline we defined 37 (46%) of the patients as cognitively impaired (CI). The patients defined as CI had significantly lower whole brain volume (WBV) (p=0.003), grey matter volume (GMV) (p=0.002) and cortical volume (CV) (p=0.007); and significantly greater ventricular volume (p=0.009) and T1 (p=0.01)/T2 (p=0.007) lesion volume than the cognitively preserved (CP) patient-group at baseline. No significant differences were found between the CI and CP patient-group over 10 year follow-up.
We examined the cognitive test and found that PASAT showed a significant decline over 10-year follow-up (p=0.003), a trend was seen for SDMT to be significantly declining over the follow-up (p=0.057). Worsening SDMT score was correlated to total subcortical deep grey matter (SDGM) atrophy (p=0.001), and specifically atrophy of the putamen (p=0.001), pallidus (p=< 0.001) and thalamus (p< 0.001) were significantly correlated to worsening SDMT score.
Conclusion: This study shows that cognitive impairment is a common symptom in MS, with almost 50% of the patients affected at baseline in our data. We found significantly greater atrophy of WBV, CV and GMV at baseline in the CI patient-group, but no accelerated atrophy of the CI patient group over the 10-year follow-up. PASAT and SDMT scores decreased over time. Atrophy of total SDGM volume, specifically putamen, pallidus and thalamus, showed a significant correlation to worsening SDMT score.
Disclosure:
Cecilie O. Jacobsen: Grant from Novartis.
Elisabeth Farbu: Unrestricted grant from Novartis.
Turi O. Dalaker: Nothing to disclose.
Kolbjørn Brønnich: Nothing to disclose.
Robert Zivadinov: received personal compensation from EMD Serono, Genzyme-Sanofi, Claret Medical, Celgene and Novartis for speaking and consultant fees. He received financial support for research activities from Teva Pharmaceuticals, Biogen, Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and IMS Health.
Abstract: P362
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Objectives: To explore cognitive impairment and identify associated magnetic resonance imaging (MRI) biomarkers in patients with multiple sclerosis (MS).
Methods: MRI of the brain was performed in 81 of the patients. Cognitive tests were performed in 74 of the patients at time of inclusion, and repeated after 5 and 10 years. Cognitive testing was performed using the Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Selective Reminding Test (SRT) delayed recall and SRT long time storage. Cognitive impairment at baseline was defined as scoring less than 1.5 SD compared to a healthy control group on two out of four cognitive tests. MRI was acquired on 1.5 T scanners. Global and tissue-specific volumes were calculated at each time point, and atrophy changes were longitudinally assessed, using a direct measurement approach, by calculating percentage volume changes between different time points. Statistical analysis was performed using a mixed linear model.
Results: At baseline we defined 37 (46%) of the patients as cognitively impaired (CI). The patients defined as CI had significantly lower whole brain volume (WBV) (p=0.003), grey matter volume (GMV) (p=0.002) and cortical volume (CV) (p=0.007); and significantly greater ventricular volume (p=0.009) and T1 (p=0.01)/T2 (p=0.007) lesion volume than the cognitively preserved (CP) patient-group at baseline. No significant differences were found between the CI and CP patient-group over 10 year follow-up.
We examined the cognitive test and found that PASAT showed a significant decline over 10-year follow-up (p=0.003), a trend was seen for SDMT to be significantly declining over the follow-up (p=0.057). Worsening SDMT score was correlated to total subcortical deep grey matter (SDGM) atrophy (p=0.001), and specifically atrophy of the putamen (p=0.001), pallidus (p=< 0.001) and thalamus (p< 0.001) were significantly correlated to worsening SDMT score.
Conclusion: This study shows that cognitive impairment is a common symptom in MS, with almost 50% of the patients affected at baseline in our data. We found significantly greater atrophy of WBV, CV and GMV at baseline in the CI patient-group, but no accelerated atrophy of the CI patient group over the 10-year follow-up. PASAT and SDMT scores decreased over time. Atrophy of total SDGM volume, specifically putamen, pallidus and thalamus, showed a significant correlation to worsening SDMT score.
Disclosure:
Cecilie O. Jacobsen: Grant from Novartis.
Elisabeth Farbu: Unrestricted grant from Novartis.
Turi O. Dalaker: Nothing to disclose.
Kolbjørn Brønnich: Nothing to disclose.
Robert Zivadinov: received personal compensation from EMD Serono, Genzyme-Sanofi, Claret Medical, Celgene and Novartis for speaking and consultant fees. He received financial support for research activities from Teva Pharmaceuticals, Biogen, Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and IMS Health.