Abstract

OBJECTIVE: To determine which pathologic process could be responsible for the acceleration of cognitive decline during the course of multiple sclerosis (MS), using longitudinal structural MRI, which was related to cognitive decline in relapsing-remitting MS (RRMS) and progressive MS (PMS). METHODS: A prospective cohort of 230 patients with MS (179 RRMS and 51 PMS) and 59 healthy controls was evaluated twice with 5-year (mean 4.9, SD 0.94) interval during which 22 patients with RRMS converted to PMS. Annual rates of cortical and deep gray matter atrophy as well as lesion volume increase were computed on longitudinal (3T) MRI data and correlated to the annual rate of cognitive decline as measured using an extensive cognitive evaluation at both time points. RESULTS: The deep gray matter atrophy rate did not differ between PMS and RRMS (-0.82%/year vs -0.71%/year, p = 0.11), while faster cortical atrophy was observed in PMS (-0.87%/year vs -0.48%/year, p < 0.01). Similarly, faster cognitive decline was observed in PMS compared to RRMS (p < 0.01). Annual cognitive decline was related to the rate of annual lesion volume increase in stable RRMS (r = -0.17, p = 0.03) to the rate of annual deep gray matter atrophy in converting RRMS (r = 0.50, p = 0.02) and annual cortical atrophy in PMS (r = 0.35, p = 0.01). CONCLUSIONS: These results indicate that cortical atrophy and cognitive decline accelerate together during the course of MS. Substrates of cognitive decline shifted from worsening lesional pathology in stable RRMS to deep gray matter atrophy in converting RRMS and to accelerated cortical atrophy in PMS only.
Original languageEnglish
Pages (from-to)e1348-e1359
JournalNeurology
Volume93
Issue number14
Early online date4 Sep 2019
DOIs
Publication statusPublished - 2019

Cite this

@article{67b3d31f61cf43bd9058b10497364811,
title = "Cortical atrophy accelerates as cognitive decline worsens in multiple sclerosis",
abstract = "OBJECTIVE: To determine which pathologic process could be responsible for the acceleration of cognitive decline during the course of multiple sclerosis (MS), using longitudinal structural MRI, which was related to cognitive decline in relapsing-remitting MS (RRMS) and progressive MS (PMS). METHODS: A prospective cohort of 230 patients with MS (179 RRMS and 51 PMS) and 59 healthy controls was evaluated twice with 5-year (mean 4.9, SD 0.94) interval during which 22 patients with RRMS converted to PMS. Annual rates of cortical and deep gray matter atrophy as well as lesion volume increase were computed on longitudinal (3T) MRI data and correlated to the annual rate of cognitive decline as measured using an extensive cognitive evaluation at both time points. RESULTS: The deep gray matter atrophy rate did not differ between PMS and RRMS (-0.82{\%}/year vs -0.71{\%}/year, p = 0.11), while faster cortical atrophy was observed in PMS (-0.87{\%}/year vs -0.48{\%}/year, p < 0.01). Similarly, faster cognitive decline was observed in PMS compared to RRMS (p < 0.01). Annual cognitive decline was related to the rate of annual lesion volume increase in stable RRMS (r = -0.17, p = 0.03) to the rate of annual deep gray matter atrophy in converting RRMS (r = 0.50, p = 0.02) and annual cortical atrophy in PMS (r = 0.35, p = 0.01). CONCLUSIONS: These results indicate that cortical atrophy and cognitive decline accelerate together during the course of MS. Substrates of cognitive decline shifted from worsening lesional pathology in stable RRMS to deep gray matter atrophy in converting RRMS and to accelerated cortical atrophy in PMS only.",
author = "Eijlers, {Anand J. C.} and Iris Dekker and Steenwijk, {Martijn D.} and Meijer, {Kim A.} and Hulst, {Hanneke E.} and Pouwels, {Petra J. W.} and Uitdehaag, {Bernard M. J.} and Frederik Barkhof and Hugo Vrenken and Schoonheim, {Menno M.} and Geurts, {Jeroen J. G.}",
note = "{\circledC} 2019 American Academy of Neurology.",
year = "2019",
doi = "10.1212/WNL.0000000000008198",
language = "English",
volume = "93",
pages = "e1348--e1359",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "14",

}

TY - JOUR

T1 - Cortical atrophy accelerates as cognitive decline worsens in multiple sclerosis

AU - Eijlers, Anand J. C.

AU - Dekker, Iris

AU - Steenwijk, Martijn D.

AU - Meijer, Kim A.

AU - Hulst, Hanneke E.

AU - Pouwels, Petra J. W.

AU - Uitdehaag, Bernard M. J.

AU - Barkhof, Frederik

AU - Vrenken, Hugo

AU - Schoonheim, Menno M.

AU - Geurts, Jeroen J. G.

N1 - © 2019 American Academy of Neurology.

PY - 2019

Y1 - 2019

N2 - OBJECTIVE: To determine which pathologic process could be responsible for the acceleration of cognitive decline during the course of multiple sclerosis (MS), using longitudinal structural MRI, which was related to cognitive decline in relapsing-remitting MS (RRMS) and progressive MS (PMS). METHODS: A prospective cohort of 230 patients with MS (179 RRMS and 51 PMS) and 59 healthy controls was evaluated twice with 5-year (mean 4.9, SD 0.94) interval during which 22 patients with RRMS converted to PMS. Annual rates of cortical and deep gray matter atrophy as well as lesion volume increase were computed on longitudinal (3T) MRI data and correlated to the annual rate of cognitive decline as measured using an extensive cognitive evaluation at both time points. RESULTS: The deep gray matter atrophy rate did not differ between PMS and RRMS (-0.82%/year vs -0.71%/year, p = 0.11), while faster cortical atrophy was observed in PMS (-0.87%/year vs -0.48%/year, p < 0.01). Similarly, faster cognitive decline was observed in PMS compared to RRMS (p < 0.01). Annual cognitive decline was related to the rate of annual lesion volume increase in stable RRMS (r = -0.17, p = 0.03) to the rate of annual deep gray matter atrophy in converting RRMS (r = 0.50, p = 0.02) and annual cortical atrophy in PMS (r = 0.35, p = 0.01). CONCLUSIONS: These results indicate that cortical atrophy and cognitive decline accelerate together during the course of MS. Substrates of cognitive decline shifted from worsening lesional pathology in stable RRMS to deep gray matter atrophy in converting RRMS and to accelerated cortical atrophy in PMS only.

AB - OBJECTIVE: To determine which pathologic process could be responsible for the acceleration of cognitive decline during the course of multiple sclerosis (MS), using longitudinal structural MRI, which was related to cognitive decline in relapsing-remitting MS (RRMS) and progressive MS (PMS). METHODS: A prospective cohort of 230 patients with MS (179 RRMS and 51 PMS) and 59 healthy controls was evaluated twice with 5-year (mean 4.9, SD 0.94) interval during which 22 patients with RRMS converted to PMS. Annual rates of cortical and deep gray matter atrophy as well as lesion volume increase were computed on longitudinal (3T) MRI data and correlated to the annual rate of cognitive decline as measured using an extensive cognitive evaluation at both time points. RESULTS: The deep gray matter atrophy rate did not differ between PMS and RRMS (-0.82%/year vs -0.71%/year, p = 0.11), while faster cortical atrophy was observed in PMS (-0.87%/year vs -0.48%/year, p < 0.01). Similarly, faster cognitive decline was observed in PMS compared to RRMS (p < 0.01). Annual cognitive decline was related to the rate of annual lesion volume increase in stable RRMS (r = -0.17, p = 0.03) to the rate of annual deep gray matter atrophy in converting RRMS (r = 0.50, p = 0.02) and annual cortical atrophy in PMS (r = 0.35, p = 0.01). CONCLUSIONS: These results indicate that cortical atrophy and cognitive decline accelerate together during the course of MS. Substrates of cognitive decline shifted from worsening lesional pathology in stable RRMS to deep gray matter atrophy in converting RRMS and to accelerated cortical atrophy in PMS only.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85072790819&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31484713

U2 - 10.1212/WNL.0000000000008198

DO - 10.1212/WNL.0000000000008198

M3 - Article

VL - 93

SP - e1348-e1359

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 14

ER -