Naslov
A longitudinal study of brain atrophy and cognitive disturbances in early phase of relapsing – remitting multiple sclerosis

Autori
Živadinov, Robert ; Zorzon, M. ; Sepčić, Juraj ; Monti-Bragadin, L. ; Moretti, R. ; De Masi, R. ; Nasuelli, D. ; Zambito Marsala, S. ; Tommasi, M.A. ; Ukmar, M. ; Pozzi-Mucelli, R.S. ; Grop, A. ; Cazzato, G.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstract Book. Revue Neurologique (Paris) 2000 ; Suppl 3 / Clanet, M. - Pariz : Masson, 2000

Skup
ECTRIMS 2000. 16th Congress of the European Committee for Treatment and Research in Multiple Sclerosis

Mjesto i datum
Toulouse, Francuska, 06.09.2000. - 09.09.2000

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
brain; atrophy; cognitive disturbances; multiple sclerosis

Sažetak
Introduction. Longitudinal studies apt to determine which are the most sensitive MRI parameters in monitoring cognitive decline in MS are lacking. Objective. The aim of the study was to establish if changes of brain parenchymal (BP) volume, and T2 and T1 lesion volumes can predict the cognitive impairment. Methods. For 2 years we monitored 53 patients with clinically definite RR MS. The neuropsychological performances, the psychological functioning and the neurologic disability have been assessed at baseline and after 2 years. Patient also underwet brain MRI, T2 and T1 lesion load volumes were measured by a semiautomatic technique. Quantification of BP volumes was obtained using a fully automatic highly reproducible computerized interactive program. The relationship between cognitive impairment and MRI abnormalities was investigated by partial correlation coefficients analysis excluding the effects of age, education, depressiom and anxiety. Results. The mean change in the two years of the study for T2, T1 and BP volumes were +1.7 mL (29.8%), 95% C.I. 1.3-2.2, p=0.005, +0.2 mL (25%), 95% C.I. 0.15-0.26, p=0.004 and -32.3 mL (27%), 95% C.I. 24.2-42.3 ; p<=0.0001, respectively. Eighteen neuropsychological test have been employed. The mean number of failed tests was 5.8, (SD 6) at baseline, and 8.4, (SD 8) (p=<0.0001) at the end of the study. Five patients (9, 4%) improved their cognitive status, 33 (62.3%) remained stable and 15 (28.3%) worsened after the 2-year follow-up T2 and T1 volume changes in improved, stable and worsened patients did not show any significant difference, whereas BP volume decrease in cognitively worsened patients was significantly higher (-66 ml [5.4%], 95% C.I. 37-108.9 ; p=0.0031). Only the decrease of BP volume was related to cognitive decline (R=-0.31 ; p=0.028). The patients who worsened >= 1.0 point in the EDSS had a decrease in BP volume of 99 ml (8%), 95% C.I. 47.6-182.3 ; p=0.005. Conclusions. Our data suggest that in RR MS patients the cognitive deterioration over time may rely more on BP atrophy than on the extent of disease burden in the brain.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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