Abstract
Objective
Cognitive impairment concerns a significant percentage of patients with multiple sclerosis
(MS). A transient impairment of cognition with a simultaneous presence of non-symptomatic
gadolinium (Gd)-enhancing lesions in patients with MS was previously described. Our
study aimed to evaluate modifications in cognitive function before and after the occurrence
of asymptomatic MRI gadolinium (Gd)-enhancing lesions in relapsing MS patients.
Patients and methods
All patients underwent a neuropsychological evaluation before (30–60 days) and after
(30–60 days) brain MRI with Gd administration. Patients were classified as Gd positive
(presence of enhancing-lesions) and Gd negative (absence of enhancing-lesions). We
also recruited a healthy controls group underwent to the same neuropsychological assessment
for two times with the same timing of MS patients.
Results
We included 84 relapsing-remitting patients and 40 healthy controls. Brain MRI results
showed that 14/84 (16.7%) patients had asymptomatic Gd-enhancing-lesion. No significant
variation in cognitive performance between baseline and follow-up was observed in
patients with or without MRI-enhancing lesions. However, an increase between baseline
and follow-up was observed in the mean scores of the Symbol Digit Modality Test (41.9
at baseline versus 46.7 at follow-up, p :< 0.001). This increase was significantly
lower in Gd positive patients compared to Gd negative patients (mean increase 1.1
in Gd positive versus 4.9 in Gd negative, p: < 0.001) and to healthy controls groups
(mean increase 7.2; p < 0.001)
Conclusions
In our study, the absence of a practice effect in Gd positive compared to Gd negative
patients and to healthy controls suggests a possible role of focal inflammation on
cognitive function of MS patients.
Keywords
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Article info
Publication history
Published online: May 17, 2018
Accepted:
May 13,
2018
Received in revised form:
May 11,
2018
Received:
March 2,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
