Abstract
Background
Cognitive dysfunctions are very frequent in people living with multiple sclerosis
(MS). Several studies have previously indicated grey matter (GM) atrophy as useful
predictor of patients’ cognitive impairment. However, considerable uncertainty exists
about the possible impact of deep grey matter volumes on cognition. This study aimed
to evaluate the relationship of the subcortical (sc) GM volumes with the presence
and severity of global and selective cognitive impairment in MS.
Methods
A group of MS patients with relapsing remitting course were enrolled. Patients underwent
a neuropsychological evaluation by using the Brief Repeatable Battery of Neuropsychological
Tests (BRBN) and the Delis–Kaplan Executive Function System Sorting Test (D-KEFST);
z scores were estimated and items with z score below 2 standard deviation were considered
failed. Thus, brain MRIs images were acquired and measurements of whole brain (WB),
white matter (WM), and cortical grey matter (GM) were obtained by SIENAX. After FIRST
tool segmentation, volumes of subcortical GM structures were also estimated.
Results
The sample included 50 MS patients, of which 16/50 (32%) subjects were cognitively
impaired. Multiple regression analyses found a significant association of severity
of cognitive impairment, defined as number of failed neuropsychological tests, with
lower volumes of cortex (p=0.003), thalamus (p=0.009), caudate (p=0.011), putamen (p=0.020), pallidus (p=0.012) and hippocampus (p=0.045), independently from other MS features. In addition, an association between
accumbens volume and D-KEFS ST FSC and D-KEFS ST FSD z scores was observed (p<0.03).
Conclusions
Our results indicated that volumes of several scGM structures, and in particular of
thalamus, contribute to determine cognitive dysfunctions in MS, mainly influencing
the executive functioning. Further investigations in larger MS cohorts with cognitive
impairment are necessary to better understand the structural brain damage underlying
this “invisible disability”.
Keywords
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Article info
Publication history
Published online: July 01, 2020
Accepted:
June 30,
2020
Received in revised form:
June 3,
2020
Received:
April 23,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
