1. Identification of multiple sclerosis patients at highest risk of cognitive impairment using an integrated brain magnetic resonance imaging assessment approach
- Author
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M. P. Sormani, Ralph H.B. Benedict, Jan Krasensky, Dana Horakova, Manuela Vaneckova, Tomas Kalincik, J. Blahova Dusankova, Eva Havrdova, Tomas Uher, Z. Seidl, and Lukas Sobisek
- Subjects
Adult ,Male ,cognition ,medicine.medical_specialty ,brain atrophy ,Brief International Cognitive Assessment for Multiple Sclerosis ,lesions ,MRI ,multiple sclerosis ,Neurology ,Neurology (clinical) ,Neuropsychological Tests ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Atrophy ,Internal medicine ,medicine ,Humans ,Cognitive Dysfunction ,Effects of sleep deprivation on cognitive performance ,Neuropsychological assessment ,Cognitive decline ,medicine.diagnostic_test ,business.industry ,Multiple sclerosis ,Brain ,Magnetic resonance imaging ,Cognition ,Odds ratio ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Physical therapy ,Female ,business ,030217 neurology & neurosurgery - Abstract
Background and purpose While impaired cognitive performance is common in multiple sclerosis (MS), it has been largely underdiagnosed. Here a magnetic resonance imaging (MRI) screening algorithm is proposed to identify patients at highest risk of cognitive impairment. The objective was to examine whether assessment of lesion burden together with whole brain atrophy on MRI improves our ability to identify cognitively impaired MS patients. Methods Of the 1253 patients enrolled in the study, 1052 patients with all cognitive, volumetric MRI and clinical data available were included in the analysis. Brain MRI and neuropsychological assessment with the Brief International Cognitive Assessment for Multiple Sclerosis were performed. Multivariable logistic regression and individual prediction analysis were used to investigate the associations between MRI markers and cognitive impairment. The results of the primary analysis were validated at two subsequent time points (months 12 and 24). Results The prevalence of cognitive impairment was greater in patients with low brain parenchymal fraction (BPF) ( 3.5 ml) than in patients with high BPF (>0.85) and low T2-LV (
- Published
- 2016
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