Highlights
- •Few studies have investigated the correlates of cognitive decline in RRMS.
- •35.5% of RRMS patients were classified as cognitively-declining.
- •RRMS patients with more disease severity, higher GM atrophy, and increase WM lesion volume are more susceptible to cognitive decline.
Abstract
Background
In this study, we conducted a prospective 2-year cohort of patients with RRMS and
healthy controls (HCs) to investigate the rate and clinical/imaging predictors of
cognitive decline in relapsing-remitting multiple sclerosis (RRMS).
Methods
A total of 107 patients with clinically definite RRMS and 74 HCs were recruited at
Hebei General Hospital, Shijiazhuang, Hebei. Patients were assessed with the Minimal
Assessment of Cognitive Function in MS (MACFIMS) at baseline and 2-year follow-up
visits and were classified into cognitively-declining and cognitively-stable RRMS.
Baseline demographic, clinical, and imaging parameters were inserted in separate multivariate
regression models to investigate the predictive power of these factors for future
cognitive decline.
Results
Based on the classification protocol and the data from HCs, 35.5% of RRMS patients
were categorized as cognitively-declining. The multivariate logistic regression analyses
demonstrated that disease duration, EDSS, and average disease attack/year were the
clinical parameters with significant predictive value for future cognitive decline
(R2=0.344). Within whole-brain MRI measures, total brain, cortical grey matter (GM),
and subcortical GM volumes could significantly predict cognitive decline (R2=0.566). WM lesion volume could also significantly predict cognitive decline (R2=0.645). Within lobar brain measures, frontal and temporal lobe volumes (R2=0.666), and finally within subcortical GM volumes, hippocampus, pallidum, putamen,
and thalamus were predictive of future cognitive decline (R2=0.732).
Conclusions
Our findings suggest that RRMS patients with more disease severity, higher GM atrophy,
and increased WM lesion volume are more susceptible to cognitive decline. Further
studies could assess the underpinnings of cortical and subcortical atrophy that lead
to cognitive decline in RRMS patients.
Keywords
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Article info
Publication history
Published online: April 30, 2022
Accepted:
April 29,
2022
Received in revised form:
April 16,
2022
Received:
February 8,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
