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Brief international cognitive assessment for MS (BICAMS) and global brain volumes in early stages of MS – A longitudinal correlation study

  • Ellen Skorve
    Correspondence
    Corresponding author at: Department of Neurology, Haukeland University Hospital, Jonas Lies vei 71, 5053, Bergen.
    Affiliations
    Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway

    Department of Clinical Medicine, University of Bergen, Bergen, Norway
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  • Astri J. Lundervold
    Affiliations
    Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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  • Øivind Torkildsen
    Affiliations
    Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway

    Department of Clinical Medicine, University of Bergen, Bergen, Norway
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  • Frank Riemer
    Affiliations
    Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway

    Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Bergen, Norway
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  • Renate Grüner
    Affiliations
    Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Bergen, Norway

    Department of Physics and Technology, University of Bergen, N-5007 Bergen, Norway
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  • Kjell-Morten Myhr
    Affiliations
    Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway

    Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Published:November 04, 2022DOI:https://doi.org/10.1016/j.msard.2022.104398

      Highlights

      • BICAMS subtests are strongly correlated with whole brain and grey matter volumes.
      • Verbal learning test is moderately correlated with MRI lesion volumes.
      • White and grey matter volumes were significantly reduced during the 2 year follow-up.
      • White matter loss was more profound amongst confirmed cognitively impaired patients.
      • Cognitive and MRI changes were found despite stable EDSS and low disease activity.

      Abstract

      Background

      Cognitive impairment is common in patients with multiple sclerosis, even in the early stages of the disease. The Brief International Cognitive Assessment for multiple sclerosis (BICAMS) is a short screening tool developed to assess cognitive function in everyday clinical practice.

      Objective

      To investigate associations between volumetric brain measures derived from a magnetic resonance imaging (MRI) examination and performance on BICAMS subtests in early stages of multiple sclerosis (MS).

      Methods

      BICAMS was used to assess cognitive function in 49 MS patients at baseline and after one and two years. The patients were separated into two groups (with or without cognitive impairment) based on their performances on BICAMSs subtests. MRI data were analysed by a software tool (MSMetrix), yielding normalized measures of global brain volumes and lesion volumes. Associations between cognitive tests and brain MRI measures were analysed by running correlation analyses, and differences between subgroups and changes over time with independent and paired samples tests, respectively.

      Results

      The strongest baseline correlations were found between the BICAMS subtests and normalized whole brain volume (NBV) and grey matter volume (NGV); processing speed r = 0.54/r = 0.48, verbal memory r = 0.49/ r = 0.42, visual memory r = 0.48 /r = 0.39. Only the verbal memory test had significant correlations with T2 and T1 lesion volumes (LV) at both time points; T2LV r = 0.39, T1LV r = 0.38. There were significant loss of grey matter and white matter volume overall (NGV p<0.001, NWV p = 0.003), as well as an increase in T1LV (p = 0.013). The longitudinally defined confirmed cognitively impaired (CCI) and preserved (CCP) patients showed significant group differences on all MRI volume measures at both time points, except for NWV. Only the CCI subgroup showed significant white matter atrophy (p = 0.006) and increase in T2LV (p = 0.029).

      Conclusions

      The present study found strong correlations between whole brain and grey matter volumes and performance on the BICAMS subtests as well as significant changes in global volumes from baseline to follow-up with clear differences between patients defined as cognitively impaired and preserved at both baseline and follow-up.

      Keywords

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