Contributions
Abstract: 69
Type: Educational Session
Abstract Category: N/A
To understand cognitive impairment in multiple sclerosis (MS) and work towards effective future treatment strategies, knowledge of underlying pathological brain abnormalities is indispendable. Structural magnetic resonance imaging (MRI) has helped greatly in visualizing brain abnormalities relevant to cognition, and post mortem imaging and histopathology correlations have specified what is reflected on MRI.
We have learned that cognitive deficits cannot be sufficiently understood by studying classical white matter (WM) lesions. Microscopically, the damage underlying T2-hyperintensities on MRI is too heterogeneous. More advanced imaging metrics like diffusion tensor imaging have helped to better understand what is necessary for cognitive decline to ensue, by imaging damage to the normal-appearing WM. Furthermore, GM pathology is widespread in MS and affects structures that are central to cognition, such as the hippocampus, the thalamus, the cerebellum, and the frontotemporal neocortex. While initial studies focused on imaging GM lesions, more recent studies have relied on the measurement of (regional) GM atrophy. Importantly, over the years, the field has come to realize that, to account for complex clinical traits such as cognition, the brain should be studied as a network and information from separate brain areas should be integrated. As a result, there has been an upsurge of network analytical studies, demonstrating that cognitive deficits in MS should be regarded as a functional deficit, guided by disconnection within the structural and functional networks. Future endeavors in this field should focus on increasing knowledge about hub-areas of the brain that seem to be specifically vulnerable to damage related to cognitive impairment such as the thalamus. But also, crucially, on further combining data from structural and functional network analyses to work towards a more integrated model of the pathological processes that eventually lead down the slope of cognitive decline. With this, an interesting opportunity presents itself through the innovative combination of multiparametric empirical data and iterative theoretical modeling. In this lecture, an overview of structural MRI findings related to MS cognition will be shown, as well as a few of the most exciting recent developments in the field of translational network science.
Disclosure: Jeroen Geurst is Editor for Europe at MS Journal, and has served as a consultant for or received research support from Biogen Idec, Novartis Pharma and Sanofi-Genzyme.
Abstract: 69
Type: Educational Session
Abstract Category: N/A
To understand cognitive impairment in multiple sclerosis (MS) and work towards effective future treatment strategies, knowledge of underlying pathological brain abnormalities is indispendable. Structural magnetic resonance imaging (MRI) has helped greatly in visualizing brain abnormalities relevant to cognition, and post mortem imaging and histopathology correlations have specified what is reflected on MRI.
We have learned that cognitive deficits cannot be sufficiently understood by studying classical white matter (WM) lesions. Microscopically, the damage underlying T2-hyperintensities on MRI is too heterogeneous. More advanced imaging metrics like diffusion tensor imaging have helped to better understand what is necessary for cognitive decline to ensue, by imaging damage to the normal-appearing WM. Furthermore, GM pathology is widespread in MS and affects structures that are central to cognition, such as the hippocampus, the thalamus, the cerebellum, and the frontotemporal neocortex. While initial studies focused on imaging GM lesions, more recent studies have relied on the measurement of (regional) GM atrophy. Importantly, over the years, the field has come to realize that, to account for complex clinical traits such as cognition, the brain should be studied as a network and information from separate brain areas should be integrated. As a result, there has been an upsurge of network analytical studies, demonstrating that cognitive deficits in MS should be regarded as a functional deficit, guided by disconnection within the structural and functional networks. Future endeavors in this field should focus on increasing knowledge about hub-areas of the brain that seem to be specifically vulnerable to damage related to cognitive impairment such as the thalamus. But also, crucially, on further combining data from structural and functional network analyses to work towards a more integrated model of the pathological processes that eventually lead down the slope of cognitive decline. With this, an interesting opportunity presents itself through the innovative combination of multiparametric empirical data and iterative theoretical modeling. In this lecture, an overview of structural MRI findings related to MS cognition will be shown, as well as a few of the most exciting recent developments in the field of translational network science.
Disclosure: Jeroen Geurst is Editor for Europe at MS Journal, and has served as a consultant for or received research support from Biogen Idec, Novartis Pharma and Sanofi-Genzyme.